One page summary: Cephalohematoma in newborns

In two sentences

A cephalohematoma is a collection of blood between a skull bone and the membrane covering it. It shows as a firm swelling on one part of the head that does not cross the suture lines. ¹

It is usually minor and resolves over weeks to months without treatment. The two things that need attention are jaundice, because the collected blood breaks down into bilirubin, and telling it apart from a subgaleal hemorrhage bleed, which is an emergency. ²

The numbers, with their sources

• What it is. Blood between a skull bone and the tough membrane that covers it, called the periosteum ¹
• Why it stops at the sutures. The covering membrane is attached at the edges of each skull bone, so the blood cannot spread past them. This is the key feature that distinguishes it from more serious bleeding ¹
• When it appears. Usually hours after birth rather than immediately, because the bleeding is slow ¹
• How long it lasts. Weeks to months. A firm rim of calcified bone can form around the edge and take longer to remodel ¹
• The main association. Instrument-assisted birth, particularly vacuum extraction, and prolonged labor ³
• What needs monitoring. Bilirubin, because the collected blood breaks down and can push jaundice higher several days after birth ²

What to do this week

1. Ask whether the swelling crosses the suture lines. If it does, ask about subgaleal hemorrhage bleeding.
2. Ask for the bilirubin plan in writing: the current level, the threshold, and when the next check is.
3. Ask who checks bilirubin after discharge and when.
4. Do not press on or massage the swelling.
5. Ask what to do if it grows, or if redness or fever appears.
6. If an instrument was used, ask which one and how many attempts, and request the operative note.
7. Expect a firm rim during healing and ask when it should fade.

Questions to take with you

Take these with you. Write the answers down in the moment, because you will not remember them later.

For the pediatrician

• Does this cross the suture lines?
• What is the bilirubin level and what is the threshold for my baby right now?
• When is the next bilirubin check, and who does it?
• Should we do a blood count?
• When should this be gone, and what should I report before then?

For the obstetric team

• Was an instrument used, and which one?
• How many attempts, and did the vacuum cup detach?
• What was the indication?

You can also build a printable list with the question generator.

Where to read more

The full page on this condition covers how it happens, causes split into what happens even with perfect care and what is associated with gaps in care, signs by age, diagnosis, treatment, outlook, daily life and lifetime cost.

Read the full page on Cephalohematoma in newborns

Related pages are listed at the bottom of it, including the events that can lead to this condition and the guides that cover therapy, school and money.