Bruising After Difficult Delivery
The short answer
Bruising from delivery is common, especially after difficult or prolonged labors, vacuum-assisted deliveries, or forceps deliveries. The bruising typically appears on the face, scalp, or body and resolves on its own within 1-2 weeks. Birth-related bruising can contribute to newborn jaundice as the blood breaks down, so your baby's bilirubin levels may be monitored.
Parents everywhere have the same worry. You are doing the right thing by looking into it.
By Age
What to expect by age
Bruising from birth is common and can appear anywhere on the body that was compressed or subjected to pressure during delivery. The face is a common location for babies born face-first or after prolonged pushing. Bruising may look alarming but resolves without treatment as the body reabsorbs the blood. As the blood breaks down, it releases bilirubin, which can contribute to jaundice. Your baby's healthcare team may monitor bilirubin levels more closely if there is significant bruising. The bruising typically changes from purple to green to yellow before disappearing within 1-2 weeks.
All birth-related bruising should be completely resolved by this time. If you notice new, unexplained bruising at this age, particularly in unusual locations, consult your pediatrician, as bruising in non-mobile infants warrants evaluation.
Any bruising at this age is not related to birth. Occasional minor bruises from normal activity are possible but uncommon in non-mobile babies. Unexplained bruising should always be evaluated.
As babies become mobile, minor bumps and bruises from rolling, crawling, and pulling up are normal. Bruises on the shins, forehead, and knees are common in active babies. Bruises in unusual locations or without clear explanation should be discussed with your pediatrician.
What Should You Do?
When to take action
- Bruising on the face, scalp, or body present at birth or shortly after delivery
- Bruising that gradually changes color (purple to green to yellow) and fades within 1-2 weeks
- No associated swelling, bleeding, or neurological symptoms
- Baby is otherwise well, feeding normally, and alert
- Bruising is extensive and you are concerned about jaundice risk
- Bruising has not resolved within 2-3 weeks
- New bruising appears after the birth-related bruising has resolved
- Extensive bruising with a rapidly growing swelling on the head (which could indicate subgaleal hemorrhage, a serious condition)
- Baby becomes lethargic, jaundiced, or feeds poorly in conjunction with significant bruising
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Medical Concerns
Cephalohematoma
Cephalohematoma is a collection of blood between a skull bone and its periosteum (the membrane covering the bone), caused by pressure during delivery. It appears as a firm, raised bump on one side of the baby's head that does not cross suture lines. It is generally harmless and resolves on its own over weeks to months. It does not affect the brain, but the breakdown of blood can contribute to jaundice.
Subgaleal Hemorrhage
Subgaleal hemorrhage is a rare but serious condition where blood collects in the potential space between the scalp's connective tissue layer (galea aponeurotica) and the periosteum of the skull. Unlike caput succedaneum or cephalohematoma, subgaleal hemorrhage can cross suture lines, increase rapidly in size, and cause significant blood loss. It is a medical emergency that requires immediate hospital monitoring and treatment.
Marks From Vacuum Extraction
A circular bruise or swelling on the top of your baby's head after vacuum-assisted delivery is expected and temporary. The raised area (called a chignon) and surrounding bruising typically resolve within a few days to 2 weeks. Your baby's head shape will return to normal. The marks do not affect the brain or development.
Bruising From Forceps Delivery
Red marks or bruising on a baby's face or head from forceps delivery are common and temporary. These marks are caused by pressure from the forceps blades during delivery and typically fade within a few days to 2 weeks. They do not cause lasting marks or scars and do not affect brain development.
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.