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What Causes Caput Succedaneum (Swelling On The Head) In Newborns?

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The swelling of the baby’s scalp immediately after delivery is called caput succedaneum. It is an indication that the baby went through a difficult delivery. Pediatricians may look for other signs and symptoms of brain injury since difficult delivery may result in oxygen deprivation.

Scalp swelling and other birth injuries occur due to the pressure exerted on the head during delivery. This is not a life-threatening condition. However, babies may have slight discomfort and, in some cases, may develop jaundice.

Read this post to know more about the causes, signs, complications, diagnosis, and treatment of caput succedaneumin babies.

Causes Of Caput Succedaneum

The following factors may increase the risk of caput succedaneum in babies (1).

  • The most common cause of caput succedaneum is a long and difficult delivery. Usually, a baby’s head is not protected by the amniotic sac after the membranes rupture. If delivery is delayed after the amniotic sac rupture, the chances of caput succedaneum are higher than usual.
  • Early rupture of the amniotic membrane may even cause swelling of the head in utero due to lack of cushioning. This is noticeable during a prenatal ultrasound.
  • It is usually more common during vertex delivery, where the baby’s head emerges first.
  • Babies born through C-section may also develop caput since the baby’s head is susceptible to external pressure.
  • Macrosomia, a condition where a full-term or post-term baby is larger than average for their gestational age, could be at a higher risk due to their large head size.
  • The use of forceps or vacuum to assist delivery may also result in caput succedaneum in some cases. This may often happen if more pressure is applied during extraction or the techniques are incorrect.

Irrespective of the cause of scalp edema in the newborn, it usually does not cause any significant problems on its own. Pediatricians may monitor the baby for any bruising associated with caput since that may result in jaundice.

Signs And Symptoms Of Caput Succedaneum

You may notice the following signs and symptoms if your baby has caput succedaneum (2).

  • Swelling of the scalp (most common symptom)
  • Color changes of the scalp
  • Bruising of the scalp
  • Scalp swelling across the suture lines
  • Increased molding(abnormal shape) of the head
  • Swelling on both sides of the scalp

In most babies, caput succedaneum may occur in the part of the head that first emerges from the mother’s birth canal. These symptoms can also be present in other conditions, so you may seek an expert examination to confirm the diagnosis.

Diagnosis Of Caput Succedaneum

Caput succedaneum can be diagnosed through physical examination and evaluation of the signs and symptoms. Special tests are not usually required for the diagnosis. However, if the pediatrician wants to exclude the possibility of other conditions, such as cephalohematoma, hydrocephalus, and skull fractures, they may order further tests.

Although cephalohematoma has similar causes, it is usually diagnosed based on the location and type of bleeding. In cephalohematoma, the blood is collected in the skull’s periosteum (outer layer of the skull bone) and not along the suture lines. It is a rare condition.

Treatment For Caput Succedaneum

Caput succedaneum does not usually require any treatment and resolves on its own within a few days (3). Trying to drain the scalp swelling by poking may result in infections.

If the baby has bruising due to caput succedaneum, the risk of developing jaundice increases. Pediatricians may prescribe medication to avoid jaundice and its complications, such as brain damage.

Complications Of Caput Succedaneum

Jaundice may emerge due to bruising in caput succedaneum. Untreated jaundice may lead to severe complications, such as kernicterus, where the body has very high bilirubin levels. Kernicterus may cause the following damages.

  • Hearing loss
  • Cerebral palsy (a movement disorder)
  • Upward gaze
  • Poor development of the enamel of the teeth

Although some babies may have noticeably large heads due to swelling shortly after birth, this is not a significant cause of worry. Pediatricians can assess and immediately respond to caput succedaneum since this is noticeable during the hospital stay. Usually, most of the babies recover completely without any complications and long-term effects.

References:

1. Caput Succedaneum; Birth Injury Help Center
2. Caput Succedaneum; MedlinePlus; US National Library Of Medicine
3. Caput Succedaneum; The University of Illinois at Urbana–Champaign