Infant cephalohematoma is an accumulation of blood cells in the space between an infant’s scalp and the skull. Though it has similar causes to caput succedaneum, it is different because it involves swelling within the skin, instead of below it. Both types of swelling are normally not dangerous for a newborn and will naturally fade away over time. Because both types of injuries occur above the skull, there is no risk of brain damage or hemorrhaging.
Infant cephalohematoma causes small swelling on the top of the head. In some cases, this swelling will initially get harder before it disappears. Because cephalohematomas are a swelling of blood, they may also cause a small case of jaundice and discoloration as the blood is reabsorbed by the newborn’s skin. There are a number of different causes of infant cephalohematoma. Typically, it is caused by birth injuries and trauma during the delivery.
Infant Cephalohematoma Causes Related to Labor
When a child is being born, the head and body experience a large amount of stress as the baby travels through the birth canal and past the pelvis. Even in a perfectly normal labor, this stress and compression placed on the baby can lead to bruising, swelling, and cephalohematoma.
Generally, cephalohematoma is a sign of a long and difficult delivery. The longer it takes to deliver the baby, the longer the baby’s head is being compressed by the birth canal, and this increases the risk of cephalohematoma. Typically, a long second stage of delivery is the cause of a difficult delivery and the cause of cephalohematoma. Depending on the circumstances, an unusually long delivery can be dangerous for a baby, but infant cephalohematoma causes no serious health problems.
Infant Cephalohematoma Causes Related to Infant Size
If a fetus is very large, there is a greater risk of cephalohematoma. This is because a large fetus will be under greater amounts of stress and compression as it molds to the size of the birth canal and travels between the pelvic bones. Larger fetuses typically take longer to deliver, and this also can increase the risk of cephalohematoma.
Even if the fetus is moderately sized, if the mother has a pelvis that is smaller than normal, this can result in cephalohematoma. The relationship between the size of the infant’s head and the size of the mother’s pelvis is called cephalopelvic disproportion, and the more disproportionate it is, the more likely there will be swelling, bruising, and cephalohematoma as the fetus tries to squeeze between the bones of the pelvis. Research has also shown first pregnancies are more likely to cause cephalohematoma, and this may be related to the size of the birth canal and pelvis.
Infant Cephalohematoma Causes Related to Assisted-Delivery Tools
When a delivery is more difficult or is taking too long, the physician may decide to use tools such as forceps or vacuum extraction. Though these tools can help deliver the baby and reduce the length of the delivery, they sometimes put more pressure on the baby’s head and skull. Use of forceps and vacuum extraction may cause cephalohematoma in some circumstances. In fact, vacuum extraction doubles the risk of cephalohematoma developing in the baby.
Medical Malpractice and Misconduct
In some cases, cephalohematoma is caused by preventable birth injuries and mistakes made by the medical staff. For example, if there is an extreme case of cephalopelvic disproportion, the medical staff should recognize this before the delivery and perform a C-section instead. Not providing enough care to the baby as it is being delivered or misuse of forceps and vacuum extraction can also result in bruising, skull fractures, swelling, and cephalohematoma.