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Head Molding After Delivery

more about Head Molding After Delivery

Caput succedaneum, in some cases, Cephalohematoma, in some cases

  • When a baby is born vaginally (through the birth canal), its head may be slightly cone-shaped for the first few days.  Also, a bit of scalp bleeding sometimes occurs.  This too, changes the shape of the baby's head for the first few days.

  • The cone shape to the back of the head is called a caput succedaneum.  It has this shape because blood and tissue swollen with water (edema fluid) collects in the area that was pushing against the mother's cervix.  Also, the skull bones can override each other a little bit, conforming to the cone shape that the fetal head must push against.
  • Cephalohematoma: another type of head molding occurs if passage down the birth canal produces pressure in a localized spot.  In cephalhematoma,  a bleeding point develops only directly over a skull bone, and the bleeding occurs only into the space between the bone and its outer lining (the periosteum).  This will leave the baby with a bump over one of the skull bones (usually a parietal bone on the right or left side of the skull) where the baby's head was pressing against the mother's pelvic bones in the birth canal.
  • The cephalohematoma might even be right and left sided, showing 2 humps on the baby's skull.
  • The cephalohematoma could occur in the same location as a caput, but the difference is that the caput's bleeding and swelling does not stop at the outline of a particular bone.
  • The cephalohematoma occurs less frequently than the caput succedaneum.

  • The infant's head is compressed, passing through the maternal pelvis during vaginal delivery.  Therefore, head molding occurs.  Babies are usually born head-first, and the region toward the back of the head is usually the first part to pass through the narrow space of the birth canal, and it becomes a little compressed.  Sometimes, the baby is born with a little bit of a cone-shape to the back of the head.  The bones in the newborn's skull are usually not fused.  This allows the skull to conform to the shape of the birth canal during childbirth, and form the cone shape.
  • As the rest of the head (and the shoulders, and the trunk) passes through the birth canal, the mother's pelvic ligaments and pelvic muscles relax.  The rest of the baby does not usually become molded.
  • While in the uterus, there may be pressure on the fetal head or body from the position of the fetus in the uterus.  The baby may be born with a slight distortion or molding of the face or head because of this.  After a few weeks or months, this usually resolves.

  • The cone shape of the caput, and the fact that its outline is not confined to the outline of one skull bone, lets the physician make the diagnosis.
  • The cephalohematoma is a mass exactly overlying one of the skull bones.  If there is just a little blood in it, the mass feels soft.  If there is much blood in it, the mass feels quite firm.

  • Large head
  • Large infant
  • Vaginal delivery
  • Forceps delivery

  • Caput succedaneum and cephalohematoma: usually both conditions resolve with no treatment.  Physicians try to avoid tapping the blood collection with a needle, because that might introduce infection (even with sterile technique).

  • Caput succedaneum and cephalohematoma: if a large amount of blood collects here, the baby suffers the equivalent of blood loss, which occasionally is a severe amount of blood loss, needing a transfusion
  • Sometimes infection occurs in the pool of blood, and needs injections of antibiotics or I.V. antibiotics for treatment.
  • The blood in a cephalohematoma may harden and collect calcium in it, making a deformity, but this will eventually disappear without treatment.
  • A small Fracture of a skull bone may be complication of a cephalohematoma.  If the Fracture is not depressed into the brain tissue, it will heal without needing treatment (which is the usual case).
  • If the head or face or a body part is deformed because of pressure on the fetus in-utero, this will need careful assessment to see if nerve damage or damage to important body parts has occurred from the prolonged pressure.  This is different from the short-lasting caput succedaneum or short -lasting cephalohematoma.

  • The caput and the cephalohematoma usually resolve, but follow up with your physician to see if anemia or jaundice (from the breakdown products of all the trapped blood) or infection might occur.

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