In newborn babies, caput succedaneum causes swelling and bruising of the scalp. Most of the time, this condition is harmless and resolves on its own within a few days or weeks. However, it may also be a sign of a more serious problem, such as bleeding under the skull or infection. Thus, it is imperative that you understand caput succedaneum's causes, symptoms, diagnosis, treatment, and prevention.
Caput succedaneum is caused by pressure on the baby’s head during delivery. This may happen due to:
A long or difficult labor, especially if the baby is large or in an abnormal position
The use of forceps or vacuum extraction to assist the delivery
The rupture of the amniotic sac before labor, resulting in less cushioning for the baby’s head
The presence of excess fluid in the scalp tissues, which may be due to maternal or fetal factors
The main symptom of caput succedaneum is a soft, puffy swelling on the baby's scalp, typically the part of the head that emerged from the birth canal first. In addition to swelling, the affected area may also feel spongy or rubbery to the touch, and there may be small bruises or abrasions. The swelling can extend to the face and eyes, changing shape or color depending on the baby's position.
The caput succedaneum rarely causes pain or discomfort to the baby, nor does it affect the baby's development or brain function. However, some babies may experience other symptoms, such as:
Jaundice, or yellowing of the skin and eyes, due to the breakdown of red blood cells in the bruised area
Anemia, or low levels of red blood cells, due to the same reason
Infection, or inflammation of the scalp tissues, due to bacteria entering through the skin breaks
Bleeding under the skull, or subdural hematoma, due to the rupture of blood vessels in the brain
If the baby is born with caput succedaneum, the doctor or nurse will look for symptoms of swelling and bruising, as well as any signs of infection or bleeding. They may also ask about the details of the delivery, such as the duration, the use of instruments, and the position of the baby.
In some cases, the doctor or nurse may order some tests to rule out or confirm any complications, such as:
Blood tests, to check for the levels of red blood cells, bilirubin, and infection markers
Ultrasound, to look for any fluid or blood collections under the skull
X-ray, to look for any fractures or deformities of the skull bones
It is usually not necessary to treat caput succedaneum in advance, as it usually resolves on its own within a few days or weeks. The swelling and bruising will gradually subside as the excess fluid and blood is reabsorbed by the body. In addition to monitoring the baby's condition, the doctor or nurse will provide supportive care, including:
Keeping the baby’s head elevated and changing the position frequently, to reduce the pressure and improve the blood flow
Applying ice packs or cold compresses to the affected area, to reduce the swelling and inflammation
Applying gentle pressure or massage to the affected area, to help drain the fluid and blood
Cleaning and dressing any skin breaks, to prevent infection
Giving pain relievers, such as acetaminophen, to the baby if needed, to reduce any discomfort
Giving fluids, supplements, or transfusions to the baby if needed, to correct any anemia or jaundice
If the baby has any complications, such as infection or bleeding, the doctor or nurse will provide appropriate treatment, such as:
Giving antibiotics, to treat any bacterial infection
Giving anti-inflammatory drugs, such as steroids, to reduce any brain swelling
Performing surgery, to drain any blood collections or repair any skull fractures
Caput succedaneum cannot always be prevented as it is influenced by many factors that are beyond the control of the mother or the doctor. However, the following measures may help reduce the risk of or severity of caput succedaneum:
Having regular prenatal check-ups, to monitor the baby’s growth, position, and health
Having a healthy diet and lifestyle, to avoid any maternal or fetal conditions that may cause excess fluid in the scalp tissues
Having a natural delivery, if possible, to avoid the use of forceps or vacuum extraction
Having a timely delivery, to avoid prolonged labor or rupture of the amniotic sac
Having a skilled and experienced doctor or nurse, to assist the delivery and handle any complications
