When Does Caput Succedaneum (Newborn Conehead) Disappear?

Caput succedaneum is edema (swelling due to fluid) that occurs in the scalp of a newborn. While it may seem a cause for concern, variations in head shape are relatively common among newborns, given their journey through the birth canal during childbirth.

The swelling is most often linked to problems that occur during the process of childbirth. While it can appear severe, it is rarely a cause for concern.

The swelling often resolves on its own without treatment. It rarely causes severe or long-term issues.

This article describes caput succedaneum causes, symptoms, and prognosis. It also discusses how common aspects of the childbirth process can cause this problem.

"Caput Succedaneum": A Medical Term for "Conehead Baby"

Before birth and during the first two years, a baby's skull is made of several bones held together by strong tissues. The spaces between these bones are called sutures. These spaces allow the baby's skull bones to shift during the passage through the birth canal. This flexibility also allows room for the rapid brain growth that occurs after birth.

During a vaginal delivery, the baby is passed through the narrow birth canal, usually headfirst. This exerts immense pressure on the baby's head. Since the baby's head is so soft, it easily conforms to the shape of the birth canal as it is pushed through this passageway.

The pressure can temporarily change the shape of the baby's skull, causing an area of swelling and fluid collection called caput succedaneum. The swelling can be influenced by the shape of the birth canal, causing a head that looks like a cone, resulting in a "conehead baby."

There are many other causes of a bump or swelling on a newborn's head. Some of these causes are more serious. Causes include the following:

• Encephalitis (inflammation of the brain, usually caused by an infection)
• Hydrocephalus (a buildup of fluid inside the skull)
• Increased intracranial pressure (inside the skull)
• Meningitis (infection of the membranes covering the brain)
• Subgaleal hemorrhage (an accumulation of blood caused by rupture of the emissary veins)
• Other types of birth-related injuries on the head (including bruising or forceps marks, scalp laceration from vacuum extraction, cephalohematoma, which is an accumulation of blood under a newborn's scalp)
  

Why Do Some Newborns Have Caput Succedaneum?

Some newborns have caput succedaneum as a result of normal pressure and compression on the baby's head during labor and delivery in a headfirst vaginal birth. It occurs as the baby passes through the birth canal.

Caput succedaneum is most likely to occur in babies born after the rupture of the amniotic sac (when water breaks). When intact, the fluid in the amniotic sac cushions the baby's head. Without this protection, the baby's head is subject to more pressure from the pregnant person's pelvic bones during development and delivery.

Having a long or difficult delivery increases the baby's risk of having a bump or swelling on the head because it can extend the amount of time the head is subject to pressure in the birth canal. Caput succedaneum is also common in the following circumstances:

• Use of vacuum extraction (a vacuum device used to assist in delivery) during birth
• Low levels of amniotic fluid during pregnancy
• Fetuses positioned deep into their pregnant person's pelvis long before they are born
• Babies who have a higher than average birth weight
  

When Does Caput Head Swelling Disappear?

In most cases, caput head swelling resolves on its own within four to six days after birth, though every baby's case is unique. Treatment usually involves observation and monitoring of the baby's bump on the head since it is not always clear how long it will take to disappear.

In most cases, a complete recovery of caput head swelling occurs.

Intervention usually isn't necessary unless there are other signs of a fracture or other injury. While an evaluation via imaging is usually not required, it may be advised when the following circumstances exist:

• Large caput succedaneum that fails to reduce in size within 48 to 72 hours
• Enlargement of the swelling more than 24 hours after birth
• Neurological problems
• Hemodynamic instability (unstable blood flow in the body)

Symptoms and Risks in Caput Succedaneum Newborns

If you've never seen a baby with caput succedaneum, it is normal to think that the swelling is a permanent difference in the shape of the head. However, this condition is rarely serious, nor is it a sign of a long-term complication. It is typically harmless and resolves.

A baby with caput succedaneum can have the following symptoms during the newborn stage:

• Soft, puffy swelling on the scalp that may have pitting
• Possible color change or bruising on the swelled area of the scalp
• Possible facial bruising or swelling
• Swelling that can involve both sides of the baby's scalp, crossing suture lines
• Swelling that develops on the portion of the baby's head that presented first during birth
• An area of swelling that allows you to leave a temporary impression or dimple by pressing your finger on it

Complications that can form at the site of the caput succedaneum include the following:

• Long-term scarring at the site of the swelling
• Alopecia (hair loss)
• Halo scalp ring (a non-scarring band of alopecia that encircles the baby's head) after the swelling resolves

Though rare, a caput succedaneum can also increase your baby's risk of jaundice (yellowing of the skin and whites of the eyes caused by excess amounts of bilirubin, a pigment occurring during the breakdown of red blood cells), especially if bruising occurs with the swelling.

Summary

Caput succedaneum is a common issue that affects newborns. It involves swelling of the baby's scalp. While the problem can appear severe, it is usually harmless.

The swelling typically occurs after a prolonged or complex labor and delivery. It often results from the baby's head pressing against the birth canal for a long time. The swelling is more likely to happen when there is low amniotic fluid. Without this, the baby lacks a cushion to protect its head from the pressure of the birth canal.

Though it can be unsettling to new parents, this issue is rarely severe. Treatment is usually not needed because the issue is likely to resolve on its own without long-term effects.