cephalohematoma

Its Spring Break, and hopefully my students are taking some time to relax, reacquaint themselves with their families, and get in some quality studying =)

There are so many other things on their minds, but I wanted to revisit a discussion we were having about cephalohematoma and the difference between it and caput on newborn babies.  Caput is swelling and crosses suture lines, cephalo is blood and does not, to put it simply.  We were talking about the fact that they both ‘go away’, which made me share my first born’s cephalohematoma story.  I’ll share it here, complete with pictures.

Here is Kai a few days after birth.  It actually took time for the cephalo to be noticeable, with all of the caput and molding.

3 days

As a nurse I was always taught it would go away, so I didn’t want to worry too much.  As a mom, I worried a lot, but consoled myself that it would go away.

17 days

It didn’t go away.  Everyone continued to say it would: nurse practitioners, family practice docs, midwives, nurses, pediatricians.  As I was working in a clinic at the time a lot of care providers were able to see him, and everyone assured us it would go away.  It did not.

2 months

I don’t remember the time frame, but eventually it started to harden.  Now I got really worried.  It wasn’t going to go away, so what did that mean for him?

We eventually got a referral for an ultrasound and a visit with a specialist at Gillette (I don’t remember how old Kai was, maybe 2 months?).  It was clear on the ultrasound that it had calcified.  The specialist was wonderful and incredibly reassuring.  He let us know that he saw this all the time and it was no big deal, without making us feel stupid for being there.

He said that Kai’s head would grow but the cephalo would not.  So would it ever really go away? No.  But soon it would not be noticeable, especially with hair (which he still didn’t have much of).  He also told us that if the cephalo was still noticeable when Kai’s getting ready to start school that we should bring him back.  In all the years he’s said that to parents only 1 child has come back.

4 months

Needless to say it was hardly noticeable before long…

9 months

4 1/2 years

So what should we say to a scared parent of a 1 or 2 day old with a cephalohematoma?  Should we say it will go away?  What do you think?


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25 Responses to cephalohematoma

  1. Erica Schaub says:

    Carrie,

    I think the standard thing to say is “It’s not harmful to the baby, and it will probably go away in 1-2 months, and we will continue to monitor at his/her well baby checkups” because most of them do go away. It’s important to NOT say that it definitely will go away, because there’s no way to predict what will happen.

  2. Tara says:

    I am very concerned because our baby girl was born April 30th and has this. She is now 14 day old and the swelling as not gone down at all. We took her to the doc today and we are being sent to a pediatrician about this. I am very scared it will calcify and stay there and never really go away. She is a beautiful angel in every other way, and this bump has ruined our first weeks home together, as my husband and I are both so worried.

  3. Tara,

    I’m hoping my story and the pictures bring you some comfort and decrease your worry. Have her checked out of course, but please don’t be scared about it calcifying and not going away. As you can see with the last picture of my beautiful 5 year old it cannot be seen at all (even though we can still feel it). It has caused him no harm whatsoever. The biggest harm it caused is the worry his parents had during his early days. I wish I could go back and tell myself what I know now. Then I could stop worrying and enjoy his beautiful little babyhood, because it goes by so fast.

    Please try to just enjoy and marvel in your little girl.

  4. Shannon says:

    My son is 3.5 weeks old now and he has 2, and they seem to be getting bigger. They used a vacuum during delivery which caused this, but it is upsetting since I had a schedules csection. The nurses and doctors all keep telling me it will go away. Sounds like they shouldn’t be making such a promise.

    • I agree that they shouldn’t be making such a promise, but most don’t know otherwise. Sometimes they need to use a vacuum even during a cesarean, though sadly its not usually discussed in advance. The fact that they are still getting bigger seems odd to me. If that truly is the case then I would make sure its thoroughly investigated, but it sounds like you’ve had him seen.

  5. Kym says:

    Thank you so much for this story, it’s nice to know you are not alone – even though I’m aware this happens all the time – I know nobody else that has experienced this with their child. My son was born with a cephalohematoma due to a super fast (unassisted) delivery (he was also 9 pounds so was a tight fit!) – he is turning 2 on the 22nd of this month and it is still there, it has been calcified since a few months old and I have been willing it to go away his entire life – for his sake! Everyone at first told me it would go away, except my GP who eventually said he would probably have a bump there forever. Luckily my son had a lot of hair from birth and you cannot see it – only feel it. I think if I had been told from the start it might not go away I wouldn’t have been so anxious about it when it didn’t. Your little boy is just gorgeous and you can’t tell it’s even there.

  6. Natasha says:

    My little girl is almost a year and has a calcified cephalohemtoma. Up until 2 months ago her pediatrician was sure it would go away. We went to a pediatric cranal specialist, who confirmed it was not going to go away and has recommended surgery to shave away the excess. My husband and I are seriously debating it, especially after reading your story and seeing your picture. While I doubt she will ever shave her head, I’m concerned about other kids seeing the bump while swimming…we live in Florida so swimming is pretty common. How does your son’s bump look whe his hair is wet? No kids poke fun?! I know kids can be cruel and would not want her to be teased for something that I can correct now! Thanks for sharing your story!!!

    • Its completely unnoticeable, even when wet. Surgery sounds so extreme to me, but it also seems like that’s an option that can be done at any time. Could you wait 3-4 years and if its still a problem then do it? The other option is to get a second opinion (not a different doctor in that same medical group, but a different group entirely). Good luck!

  7. loraine brady says:

    I worry so much about my six month olds she is so beautiful and it makes me anxious when people ask why she has a bump. I feel it could have been avoided too,I had a terrible delivery.

    • I remember that anxiety well. I just reassured people that it didn’t hurt him at all. I’m sorry you had a terrible birth. I had a rough labor as my son’s head was cocked to the side and turned the wrong way. He took a long time to be born, but I was grateful that I had amazing support and was given the time I needed and allowed to do the things I needed to do to get him out (walk, change positions, etc). Though it was a rough labor it was an amazing birth, and in my case it was not at all preventable.

  8. Lara says:

    I just want to say thank you so much for your story and pictures, your little boy is gorgeous! My little girl was born pretty fast with an unassisted delivery, she is now almost 4 months old, she also has a calcified hepatoma which looks identical to your sons, at 6 weeks my doc sent me to a paediatrician for a second opinion as he had never seen one calcify and they normally resolved by 6-8 weeks, the paed did an X-ray to double check and said the same thing. I could tell that he didn’t really want to tell me that it wasn’t going to go away but i did find his response really honest and at the same time comforting he said that as her head grows and moulds the bump would not get bigger but it would appear smaller smaller as her head got bigger and moulded. He did say that surgery was an option but very invasive and that he wouldn’t recommend it for only cosmetic reasons. I was happy after I saw him but doubt myself every now and then because it seems other people (even health nurse) notice it more than I do and say because she’s a girl I should think about surgery…. But I just look at your story and pics again and just enjoy her!!! Knowing its probably not going to be noticeable at all in a few years.. So thank you!

  9. Stacy says:

    Thank you for your pics and story. I have been looking everywhere to find info for what my daughter is going through. She has a lump similar to your sons and we took her to a cranial specialist. We were told it would go away and that she’d grow into it but that was 5 mos. ago and it is still here. She’s 10 mos old now and we were wondering if it would ever go away or if we need to do more. Everything you read says it could go away in a few weeks or mos, but when it hasn’t, and instead has calcified you wonder what’s the next step – if there is one. We want to take care of it now if something can be done, but from what you’re saying is that it will eventually resolve, but it takes years, not mos. It’s just on her cowlick so it looks funny and our concern is mostly cosmetic, but I guess I should not worry too much. Thanks for helping me to understand the time frame a little better and put my mind at ease.

  10. Stacy says:

    Just found your post after doing a google search. Our son is 10 wks old with a calcified cephalo. Hearing and seeung your experience is reassuring. We have been to a craniofacial clinic and their advice is the same..wait it out. In time it will be less noticeable. I have worried a lot over this but came to the conclusion that spending time with my healthy baby was a gift and didn’t want to waste these precious first months in worry. Thanks for your post

  11. Glad my post could be helpful to you Stacy. I also congratulate you on coming to the point long before I did– enjoy your healthy baby and don’t worry!

  12. Chee Lan says:

    Hi, my boy also has cephalo. It was noted on day 1 of life on the right side. Later I found that there was also a smaller squishy bump on the left side too on day 7 of life, which was noted at all earlier. The only thing that keep me worry further is that both are separated in the middle, so Dr said its bilateral. But I wonder why the left side only ‘grow’ later, I can only hope its not something more complicated. He is day 8 of life today and under phototherapy at home for jaundice.

    • One of the hallmarks of a cephalohematoma is that it doesn’t cross the suture lines of the skull. It is possible that with all of the molding of the skull for the birth (when the skull actually shapes itself to the pelvis), the left sided bumps wasn’t noticed even though it was there. We can’t know for sure, of course, but that’s a possibility. Was he a vacuum birth? How is he doing now?

  13. Chee Lan says:

    Ya, he was delivered via vacuum which likely explain the first noticeable cephalo on the right side. Currently he is still jaundice, bilirubin was 330 on day21 of life, then 325 today ( day 24 of life). Cephalo on both sides are resolving, Thank God!

  14. Ashley says:

    This has put my mind at rest! My boy is 4 months with no sign of change and I think like your sons it will never completely go. X

  15. Jennifer says:

    My last three babies have had cephalos. There were all rop before birth, in labor turned quickly and were born in 1 or 2 pushes. All three developed with 24 hours after birth and continued to grow for 4-5 days. Two of them did have purplish discoloration after about a week. They grew quite large. We did a lot of explaining to people those next few weeks! Hats didn’t fit, so we learned to *embrace the bump*. My sons lasted 4.5months and quite a calcification for months afterwards, like your son. My daughters left overnight as well, at about a month and now, I have a two weeks old daughter with hers and I am totally NOT worried anymore. We watch that it does not cross suture lines and we watch for jaundice. Nursing is made difficult as the baby will not lay on the bump side of the head and so I need to use the football hold on one side, cradle on the other. I hope this might help someone!

  16. Christina says:

    Our daughter has a cephalohematoma at the age of 18months. At first, we worried like crazy. We didn’t even know what a hematoma was. I did research and became even more worried. Her doctor sent us to Children’s Hospital and we had a x-ray done just to classify what kind of hematoma it was. When we found out what kind it was, we became less worried. We were told that it would go away but it hasn’t. I can admit, I am still a little worried. You can’t tell that our little girl has it but I feel it everyday to just see if its going down. I thank you for this story. Its nice to know we aren’t alone.

  17. Annie Barnett says:

    I was told the exact same thing about my son. It will go away, it will go away. He’s 13 years old. It never went away. It never bothered him as far as hurting or causing any brain damage, however now the hair that grows from it is starting to feel abnormal, almost bristle like. Now don’t think I’m a bad mother. I asked every pediatrician we saw and they said as long as it’s not bothering him, I wouldn’t worry about it. Well it’s always been a worry, but now even more so now that the texture of the hair seems to be changing. I know surgery is an option, but at this point I’m just disgusted with all those professionals that kept telling me it would go away.

    • stacy says:

      I was told that most go away,but that some don’t. After it solidified,the doctors said that it would not “go away”,but that it would become smaller as his head grew. Sure enough,he is 14 months old and I can still tell it is there but it has improved a great deal. No one else notices and in time,they seem to blend into the shape of the head. As a new mom I was incredibly worried,so I want to give some reassurance to other new moms experiencing this. My doctor said my son’s hematoma was the largest he had seen and it all worked out

      • sara says:

        Thank you for sharing your story. My son has a cephal hematoma and is four months old. Since birth his Dr said it would go away. It’s very large and has not gone down at all. I’m worried how he will be treated in life with such a visible bump on his head. I’m a teacher and I have seen first hand how cruel kids can be. He’s such a beautiful boy and it makes me sad to think about him being teased. We are seeing the ped Dr this week and asking for a referral to the craniofacial specialist. It’s great to hear that even if it never goes away it becomes less noticeable.

  18. Laura says:

    Did your son ever have an MRI or CT scan? My son was born with a cephlahematoma. It’s was soft right after birth. He is now 2.5 months and has a hard lump on his head. We had an MRI to rule out any soft tissue tumors and now Pediatrician is recommending a CT to rule out any rare bone growths or fracture. I’m not sure I want to expose my son to this much radiation.

    • No, just the ultrasound. You might just ask for a referral to a pediatric cranial specialist. They were very reassuring and know a lot more about this stuff, I found, then primary care providers. Pediatricians, Family Practice docs, and even an NP had me worried far more than necessary. Not that everyone’s experience will be the same…

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