Cephalohematoma is a birth injury causing a lump on the baby’s head due to bleeding between the bone and periosteum. It usually resolves on its own, but may require intervention. It can be caused by interventional procedures or pressure from the birth canal. It rarely requires treatment and does not suggest permanent brain damage, but children should be observed closely for developmental delays.
A cephalohematoma is a birth injury that causes a reddish-colored lump on the baby’s head, usually evident at or shortly after birth. It is due to bleeding between the bone and the fibrous material covering it, called the periosteum. This condition typically resolves on its own within a few months, but in rare cases it causes further physical problems or requires some form of intervention.
Cephalohematoma most often occurs when pressure is placed on the head due to interventional procedures such as vacuum extraction or forceps delivery. It can also develop without these interventions, and situations where the baby’s head is subjected to pressure from the birth canal during labor for an extended period of time can also cause this condition. When babies have it, a soft or slightly hardened and reddish lump will be quite obvious, and such damage to the infant’s head can be shocking at first, especially if the lump is very large. Even large clots may simply go away over time as red blood cells are broken down and reabsorbed. The biggest risk of resorption may be that a baby will develop jaundice from processing so many red blood cells, which can be helped with treatments such as a bile blanket.
If a cephalhematoma is present, doctors may still want to do other tests. Sometimes its presence can indicate a minor fracture of the skull, or a very large collection of blood coming through the sutures or unjoined plates of the baby’s skull, and this could be indicative of problems. Alternatively, instead of receding, the cephalohematoma may begin to harden due to calcification or ossification (new bone growth).
In rare cases, calcified nodules may still recede, but ossified nodules where bone has grown into the nodule may require surgery. Another possible complication is continued bleeding, which may lead to anemia and may require blood transfusions.
It is important to reiterate that cephalohematoma almost never needs treatment. The presence of a cephalohematoma does not, in most cases, suggest that there is permanent or any other form of brain damage. In some ways, it can be viewed as a specialized form of bruising that will almost always improve and eventually disappear over time, although it can take several months for this to happen.
Equally important is to recognize that one head injury during a traumatic birth could indicate others. Children with a cephalhematoma should be observed closely. Any evidence of failure to meet developmental milestones should be reported to physicians, and if these failures are common and a child appears not to be progressing at a normal rate, consultation with a pediatric neurologist is advised.
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