Cephalhematoma in a Newborn is a collection of blood between a newborn’s skull bone and the periosteum (the membrane covering the bone). It occurs due to rupture of blood vessels during delivery, often from pressure on the baby’s head during labor or use of delivery instruments like forceps or vacuum extractors.

Key Features:

• Location: Always confined to one cranial bone, most commonly the parietal bone.

• Does not cross suture lines (a distinguishing feature from caput succedaneum).

• Appears several hours after birth, not immediately.

• Firm, well-defined swelling on the head.

• Skin over the swelling is not discolored, unlike in bruises.

Causes:

• Birth trauma from:

  • Vaginal delivery

  • Prolonged labor

  • Instrumental delivery (forceps or vacuum)

  • Large baby (macrosomia)

Diagnosis:

• Clinical examination is usually sufficient.

• Imaging (ultrasound or CT) is rarely needed unless complications or other skull injuries are suspected.

Course and Management:

• Benign and self-limiting — most resolve on their own over weeks to months.

• No aspiration is recommended due to risk of infection.

• Monitor for complications like:

  • Hyperbilirubinemia (due to breakdown of blood in the hematoma)

  • Anemia (rare)

  • Infection (very rare)