Medical Conditions

Caput Succedaneum

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If your baby has been diagnosed with or you suspect caput succedaneum, here is what the evidence says.

The short answer

Caput succedaneum is a diffuse, soft swelling of the scalp that occurs during vaginal delivery due to pressure on the baby's head. It is very common, harmless, and resolves on its own within a few days. The swelling crosses suture lines (unlike cephalohematoma), may be accompanied by bruising, and does not require any treatment.

Key takeaways

  • Caput succedaneum is a diffuse, soft swelling of the scalp that occurs during vaginal delivery due to pressure on the baby's head. It is very common, harmless, and resolves on its own within a few days. The swelling crosses suture lines (unlike cephalohematoma), may be accompanied by bruising, and does not require any treatment.
  • Usually normal when: Soft, puffy scalp swelling present at birth that is gradually decreasing over the first 2-3 days
  • Call your doctor if: The swelling on the head is rapidly increasing in size, the baby is becoming pale, or the fontanelle is bulging, as these could indicate a subgaleal hemorrhage, which is a rare but serious condition involving ongoing bleeding under the scalp
  • Varies by age — see the age-by-age breakdown below
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Fever and Your Child, American Academy of Pediatrics (AAP)

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By Age

What to expect by age

0-24 hours

Caput succedaneum is visible at birth as a soft, puffy, boggy swelling on the part of the baby's head that presented first during delivery. It is most common after prolonged labor, vacuum-assisted delivery, or when membranes ruptured early. The swelling may feel squishy and crosses the midline and suture lines of the skull, which distinguishes it from cephalohematoma. There may be overlying bruising or discoloration. The baby's head may also appear elongated or "cone-shaped" (molding), which is a separate normal finding from the skull bones overlapping during delivery.

1-3 days

The swelling from caput succedaneum typically begins to decrease within the first day or two. By day 2-3, you should notice the puffiness going down significantly. Any bruising may become more visible before fading, going through color changes from purple to green to yellow. The molded (cone-shaped) head will also gradually round out. No treatment is needed. The medical team may monitor for jaundice, as the breakdown of blood from bruising can contribute to elevated bilirubin levels.

3-7 days

Caput succedaneum should be largely or fully resolved by this point. The head shape should be becoming more rounded as the skull bones shift back into normal position. If swelling persists or appears to be getting firmer rather than softer, mention it to your pediatrician, as it may need to be distinguished from a cephalohematoma or, rarely, a subgaleal hemorrhage. Watch for increasing jaundice (yellow skin color), as the bruising associated with caput can increase bilirubin levels.

1-4 weeks

By this time, any residual effects from caput succedaneum should be completely resolved. The head shape should be normal. If you notice any persistent lumps or irregularities on the skull, these may be from a different cause such as a cephalohematoma (which can persist for weeks to months before resolving). Caput succedaneum has no long-term consequences and does not affect brain development.

What Should You Do?

When to take action

Probably normal when...
  • Soft, puffy scalp swelling present at birth that is gradually decreasing over the first 2-3 days
  • Bruising on the scalp that is changing colors (purple to green to yellow) as it resolves
  • An elongated or cone-shaped head that is gradually rounding out
  • Your pediatrician has examined the swelling and confirmed it is caput succedaneum
Mention at your next visit when...
  • The swelling has not decreased after 3-4 days or seems to be getting firmer
  • You notice increasing yellow skin color (jaundice) in your baby
  • You see a new or growing lump on the head that was not present at birth
Act now when...
  • The swelling on the head is rapidly increasing in size, the baby is becoming pale, or the fontanelle is bulging, as these could indicate a subgaleal hemorrhage, which is a rare but serious condition involving ongoing bleeding under the scalp
  • Your baby is excessively sleepy, not feeding, vomiting, or has a high-pitched cry, as these could be signs of increased intracranial pressure or other serious complications

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Caput Succedaneum.

Things to mention

  • The swelling has not decreased after 3-4 days or seems to be getting firmer
  • You notice increasing yellow skin color (jaundice) in your baby
  • You see a new or growing lump on the head that was not present at birth

Observations to share

  • The swelling has not decreased after 3-4 days or seems to be getting firmer
  • You notice increasing yellow skin color (jaundice) in your baby
  • You see a new or growing lump on the head that was not present at birth

Urgent signs to report immediately

  • The swelling on the head is rapidly increasing in size, the baby is becoming pale, or the fontanelle is bulging, as these could indicate a subgaleal hemorrhage, which is a rare but serious condition involving ongoing bleeding under the scalp
  • Your baby is excessively sleepy, not feeding, vomiting, or has a high-pitched cry, as these could be signs of increased intracranial pressure or other serious complications

My notes

From ismybabyalright.com — free, evidence-based baby health guides

Frequently asked questions

Is caput succedaneum normal?
Caput succedaneum is a diffuse, soft swelling of the scalp that occurs during vaginal delivery due to pressure on the baby's head. It is very common, harmless, and resolves on its own within a few days. The swelling crosses suture lines (unlike cephalohematoma), may be accompanied by bruising, and does not require any treatment.
When should I call the doctor about caput succedaneum?
The swelling on the head is rapidly increasing in size, the baby is becoming pale, or the fontanelle is bulging, as these could indicate a subgaleal hemorrhage, which is a rare but serious condition involving ongoing bleeding under the scalp Your baby is excessively sleepy, not feeding, vomiting, or has a high-pitched cry, as these could be signs of increased intracranial pressure or other serious complications
When is caput succedaneum normal?
Soft, puffy scalp swelling present at birth that is gradually decreasing over the first 2-3 days Bruising on the scalp that is changing colors (purple to green to yellow) as it resolves An elongated or cone-shaped head that is gradually rounding out
What causes caput succedaneum?
Caput succedaneum is a diffuse, soft swelling of the scalp that occurs during vaginal delivery due to pressure on the baby's head. It is very common, harmless, and resolves on its own within a few days. The swelling crosses suture lines (unlike cephalohematoma), may be accompanied by bruising, and does not require any treatment. Common explanations include: Soft, puffy scalp swelling present at birth that is gradually decreasing over the first 2-3 days. Bruising on the scalp that is changing colors (purple to green to yellow) as it resolves.
What should I mention to my pediatrician about caput succedaneum?
You should mention caput succedaneum at your next visit if: The swelling has not decreased after 3-4 days or seems to be getting firmer. You notice increasing yellow skin color (jaundice) in your baby. You see a new or growing lump on the head that was not present at birth.
Is caput succedaneum normal at 0-24 hours?
Caput succedaneum is visible at birth as a soft, puffy, boggy swelling on the part of the baby's head that presented first during delivery. It is most common after prolonged labor, vacuum-assisted delivery, or when membranes ruptured early. The swelling may feel squishy and crosses the midline and suture lines of the skull, which distinguishes it from cephalohematoma. There may be overlying bruising or discoloration. The baby's head may also appear elongated or "cone-shaped" (molding), which is a separate normal finding from the skull bones overlapping during delivery.
Is caput succedaneum normal at 1-3 days?
The swelling from caput succedaneum typically begins to decrease within the first day or two. By day 2-3, you should notice the puffiness going down significantly. Any bruising may become more visible before fading, going through color changes from purple to green to yellow. The molded (cone-shaped) head will also gradually round out. No treatment is needed. The medical team may monitor for jaundice, as the breakdown of blood from bruising can contribute to elevated bilirubin levels.
Should I go to the ER for caput succedaneum?
Seek emergency care if the swelling on the head is rapidly increasing in size, the baby is becoming pale, or the fontanelle is bulging, as these could indicate a subgaleal hemorrhage, which is a rare but serious condition involving ongoing bleeding under the scalp, or if your baby is excessively sleepy, not feeding, vomiting, or has a high-pitched cry, as these could be signs of increased intracranial pressure or other serious complications. When in doubt, call your pediatrician's after-hours line for guidance.
Does caput succedaneum go away on its own?
In many cases, caput succedaneum resolves on its own, especially when soft, puffy scalp swelling present at birth that is gradually decreasing over the first 2-3 days. By 1-4 weeks, by this time, any residual effects from caput succedaneum should be completely resolved. The head shape should be normal. If you notice any persistent lumps or irregularities on the skull, these may be from a different cause such as a cephalohematoma (which can persist for weeks to months before resolving). Caput succedaneum has no long-term consequences and does not affect brain development.

References

  1. [1]American Academy of Pediatrics. Birth Injuries. HealthyChildren.org. AAP
  2. [2]MedlinePlus. Caput Succedaneum. National Library of Medicine. NIH

All content follows our editorial policy and is reviewed against published clinical guidelines.

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Bottom line

Most cases of caput succedaneum are normal. Talk to your pediatrician if the swelling on the head is rapidly increasing in size, the baby is becoming pale, or the fontanelle is bulging, as these could indicate a subgaleal hemorrhage, which is a rare but serious condition involving ongoing bleeding under the scalp.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.

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