Caput Succedaneum

When parents first see swelling on their newborn’s head after delivery, it can be alarming. Understanding what caused it, whether it’s serious, and what to expect in the coming days can help ease worry during those critical first hours and days with your baby. Caput succedaneum is one of the most common types of scalp swelling seen in newborns, and while it may look concerning, it is typically benign and resolves on its own without treatment.

This page explains what caput succedaneum is, why it happens, how doctors recognize and monitor it, and what families should know about recovery and follow-up care.

What is Caput Succedaneum?

Caput succedaneum is a type of swelling that affects the soft tissues of a newborn’s scalp. It appears as a puffy, fluid-filled area on the part of the baby’s head that passed through the birth canal first, usually at the top, crown, or back of the head.

This swelling develops as a result of pressure during labor and delivery. It is caused by the natural compression of the baby’s head against the mother’s cervix, vaginal walls, or pelvic bones, especially during prolonged or difficult labor. The swelling is made up of edema, which is fluid that collects under the scalp.

Caput succedaneum is present at birth and resolves quickly, usually within 48 hours. It does not involve the bones of the skull and does not affect brain development or long-term health.

Why Does Caput Succedaneum Happen?

The condition occurs when pressure is applied to the baby’s scalp during labor and delivery. This pressure disrupts normal fluid circulation in the scalp tissues, leading to localized swelling.

Several factors can increase the likelihood of caput succedaneum developing:

• Prolonged or difficult vaginal delivery
• Use of vacuum extraction or forceps during delivery
• First-time mothers, whose labor may be longer
• Low amniotic fluid (oligohydramnios)
• Premature rupture of membranes, which can lead to prolonged labor without the protective cushion of amniotic fluid
• Protracted active labor or slow progression through the birth canal
• Braxton-Hicks contractions before active labor begins

Vacuum-assisted delivery is one of the most significant risk factors, as the suction device can create localized pressure and fluid buildup on the scalp.

What Does Caput Succedaneum Look Like?

Parents and medical staff typically notice caput succedaneum immediately after birth. The swelling has distinct characteristics:

Appearance

The affected area appears soft, squishy, and fluid-filled, sometimes described as boggy or fluctuant. The swelling is usually between one and two centimeters deep and can feel like a cushion under the skin.

Location

It most often appears on the top or back of the head, corresponding to the part of the baby’s head that was lowest in the birth canal during delivery.

Crossing suture lines

Unlike some other scalp conditions, caput succedaneum can cross the suture lines of the skull. These are the natural seams between the bones of a baby’s skull. This feature helps doctors distinguish it from other types of birth-related head swelling.

Bruising

The swollen area may also show bruising or discoloration, which is common and not a cause for concern.

How is Caput Succedaneum Diagnosed?

Diagnosis is typically straightforward and based on physical examination. Pediatricians and neonatal care teams routinely examine newborns in the delivery room and during the first hours after birth.

The doctor will gently feel the baby’s scalp to assess the location, size, and texture of the swelling. Because caput succedaneum has clear physical characteristics and is present at birth, imaging tests like ultrasounds or X-rays are rarely needed.

In cases where the swelling is unusually large, prolonged, or accompanied by other symptoms, additional evaluation may be done to rule out more serious conditions or complications.

What is the Difference Between Caput Succedaneum and Cephalohematoma?

Both conditions involve swelling on a newborn’s head, but they are different in important ways.

Caput succedaneum is swelling of the soft tissue on top of the skull. It crosses suture lines, appears immediately at birth, and resolves within a day or two.

Cephalohematoma is a collection of blood between the skull bone and its outer covering. It does not cross suture lines, may not be visible until hours after birth, and takes weeks to resolve.

Understanding the difference helps families know what to expect in terms of recovery time and monitoring needs.

Does Caput Succedaneum Require Treatment?

No active treatment is needed. Caput succedaneum resolves on its own as the fluid is gradually reabsorbed by the baby’s body.

Parents should not attempt to massage, press, or drain the swelling. These actions do not speed recovery and can increase the risk of infection or injury.

Medical care focuses on monitoring and reassurance. Pediatricians will track the swelling during routine newborn exams to ensure it is resolving as expected and to watch for any signs of complications.

What Complications Can Occur?

Caput succedaneum is almost always harmless, but in rare cases, complications can develop.

Newborn jaundice

As the swelling resolves and the body breaks down the fluid and any associated bruising, bilirubin levels in the blood can rise. This may lead to mild jaundice, which causes a yellowish tint to the skin and eyes. Most cases are mild and resolve on their own, but doctors will monitor bilirubin levels if jaundice develops.

Alopecia (hair loss)

In rare instances, the pressure and swelling can damage hair follicles, leading to temporary or, very rarely, permanent hair loss in the affected area.

Halo scalp ring

Some babies may develop a ring-shaped area of scarring or discoloration on the scalp where the swelling was most severe. This is uncommon and typically cosmetic.

Infection

If the skin over the swelling is broken or if attempts are made to drain it, infection can occur. This is why hands-off management is recommended.

Kernicterus

This is an extremely rare and serious complication that occurs when untreated severe jaundice leads to brain damage. It is preventable with appropriate monitoring and treatment of jaundice.

Despite these potential complications, the overall prognosis for babies with caput succedaneum is excellent. Most recover fully within two days with no lasting effects.

What Should Parents Watch For?

While caput succedaneum resolves on its own, parents should be aware of signs that warrant a call to the pediatrician:

• Swelling that does not begin to improve within 48 hours
• Increasing swelling or hardness
• Yellowing of the skin or eyes (jaundice)
• Fever or signs of infection such as redness, warmth, or discharge from the scalp
• Excessive fussiness, poor feeding, or lethargy

These symptoms are uncommon but should be evaluated promptly to rule out complications or other conditions.

How Common is Caput Succedaneum?

Caput succedaneum is the most common type of birth-related scalp swelling. Studies estimate that it occurs in approximately 2% to 34% of all vaginal deliveries, with variation depending on the population studied and the use of assisted delivery techniques.

Vacuum extraction is associated with a significantly higher rate of caput succedaneum compared to spontaneous vaginal delivery or cesarean birth.

Medical Standards and Guidelines

Current pediatric and neonatology guidelines emphasize observation and parental education as the cornerstones of managing caput succedaneum.

Healthcare providers are expected to:

• Examine the newborn’s scalp as part of routine delivery room and neonatal assessments
• Clearly explain the condition to parents, emphasizing its benign nature
• Monitor for jaundice and other rare complications
• Avoid unnecessary interventions such as aspiration or drainage

Major hospitals and birth centers in New York, including Mount Sinai, NYU Langone, Columbia Presbyterian, and Albany Medical Center, follow these standards and routinely assess newborns for caput succedaneum as part of comprehensive postnatal care.

Support and Reassurance for Families

Seeing swelling or bruising on your baby’s head can be distressing, especially in the emotional and exhausting hours after delivery. It’s important to know that caput succedaneum is not a sign of injury to your baby’s brain or skull, and it does not cause developmental delays or long-term health problems.

The swelling will fade quickly, often within the first day or two at home. Your pediatrician will check your baby’s head during routine newborn visits and answer any questions you have.

If your baby also experienced a difficult delivery or required assistance with forceps or vacuum, you may have additional concerns about their health and recovery. Open communication with your healthcare team is essential. Don’t hesitate to ask questions or request follow-up if you feel uncertain or worried.

At nybirthinjury.com, we provide trusted, medically accurate information to help families understand birth injuries, recognize complications, and access the care and support they need. Whether you’re navigating a new diagnosis or simply want to learn more, you’re not alone.

Follow-Up Care

Most babies with caput succedaneum do not require any special follow-up beyond routine newborn care. However, if your baby develops jaundice, your pediatrician may schedule additional visits or lab work to monitor bilirubin levels.

If the swelling has not resolved after a few days, or if there are concerns about other injuries or complications from delivery, further evaluation may be recommended. This could include imaging studies or consultation with a specialist.

Parents should feel empowered to reach out to their pediatrician with any concerns, no matter how small they may seem.

Long-Term Outlook

The long-term outlook for babies with caput succedaneum is excellent. The condition has no impact on brain function, skull development, or overall growth and development. Once the swelling resolves, there are typically no visible signs that it occurred.

In the rare event that complications such as jaundice or hair loss develop, they are usually manageable and do not affect your child’s long-term health.

Dealing with a Caput Succedaneum Diagnosis

Caput succedaneum is a common, temporary, and harmless condition that affects many newborns after vaginal delivery. While it may cause concern in the moment, understanding what it is and how quickly it resolves can provide peace of mind during an already overwhelming time.

If you have questions about your baby’s condition, recovery, or any aspect of their birth experience, your healthcare team is your best resource. Trust your instincts, ask for the information you need, and know that your baby is resilient and on the path to a full recovery.