What Is a Cephalohematoma?

Cephalohematoma, sometimes abbreviated as “CH,” describes a condition where a layer of blood forms between a baby’s scalp and their skull. This happens when blood vessels on the head are damaged and release blood that pools below the skin. Because this blood is on top of the skull and not inside it, the baby’s brain is not affected by CH, and it is not considered to be a dangerous condition.

The extreme forces present during labor and delivery can often cause blood vessels to rupture and form cephalohematomas. The Birth Injury Guide estimates that cephalohematoma occurs in 1 to 2% of all live births.

Symptoms of Cephalohematoma

The first and most obvious sign that a baby has developed cephalohematoma will be a strange, soft bulge on the baby’s skull (usually located on the back of the head). Since the accumulation of blood is gradual, CH is usually not evident at birth, but it will become apparent in the hours or days following labor. 

Over several weeks, this bulge may harden as the blood inside calcifies. Soon after, it will shrink. Sometimes, the center part of the bulge will disappear before the edges, giving it a crater-like appearance. 

Infants with CH may also display symptoms including:

  • Anemia — low red blood cell counts
  • Jaundice — a yellowing of the skin and eyes that occurs when red blood cells break down and release high levels of bilirubin, a yellow pigment
  • Infection

Unless there is a serious infection in the affected area, cephalohematoma should not cause any obvious behavioral differences or serious symptoms. 

Risk Factors for Cephalohematoma

Cephalohematoma occurs most often during or after labor and delivery. Some factors that can increase an infant’s risk of developing CH include:

  • The use of birth assisting tools like forceps
  • The infant’s head is larger than the mother’s pelvis
  • Macrosomia (the infant is significantly larger than average)
  • Difficult or prolonged labor
  • Weak or ineffective contractions
  • Abnormal fetal presentation 
  • First pregnancies

Generally speaking, any birth scenario that places increased pressure on the infant’s head will heighten its risk of developing cephalohematoma.


In most cases, cephalohematoma will heal on its own within several weeks or months (some injuries may take up to three months to heal on their own). Aspirating or draining cephalohematomas is not recommended — aspiration is not effective since the blood has clotted, and draining it with a needle increases the risk of infection and abscess formation. Instead, doctors typically recommend leaving the area alone and giving the infant’s body time to heal on its own and reabsorb the collected fluid. 

In some cases, the baby may need to receive treatment for conditions that are caused by CH. For example, if the blood builds up so much that the infant’s red blood cell count drops below healthy levels (i.e., develops anemia), they may require a blood transfusion. If the blood breaks down and releases excessively high levels of bilirubin, the baby may need phytotherapy to treat jaundice. In rare cases, the infant may need to be treated for an infection. 

Typically, however, cephalohematoma will not require any specialized treatment. Parents of infants with CH are advised to monitor the lump over the first few weeks, and doctors should be alerted if there is an increase in the size of the lump or any behavioral changes like increased sleepiness, crying, or a refusal to eat. 

Most babies will not have any long-term complications or developmental delays because of cephalohematoma. However, if you find an unexplained lump or bulge on your baby’s head, do not assume that it is cephalohematoma and will go away on its own. It could be symptomatic of a more serious condition. 

You should always consult with a medical professional to make sure that your baby is receiving the care they need.

Trust Murphy Falcon & Murphy With Your Birth Injury Case

If you believe that your infant may have developed cephalohematoma as a result of negligence or the use of excessive force during labor, then contact the experienced birth injury attorneys at Murphy Falcon & Murphy. Our team has won millions for our clients through powerful, effective litigation, and we can help you recover damages for birth trauma.

Contact us today by phone for a free consultation. Our Baltimore personal injury law firm is here to help.