Bruising From Forceps Delivery
Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist
Content reviewed against published AAP, NIH guidelines
Last reviewed:
If your baby has been diagnosed with or you suspect bruising from forceps delivery, here is what the evidence says.
The short answer
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.
Key takeaways
- 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.
- Usually normal when: Red marks or bruising on the cheeks or sides of the head where forceps were applied
- Call your doctor if: Signs of facial nerve palsy that does not improve within a few weeks, or difficulty with eye closure on one side
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to AAP, NIH guidelines, 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. At 0-1 month, after forceps-assisted delivery, it is common to see red marks, bruising, or slight indentations on the sides of the face or head where the forceps were applied. These marks may look concerning but are superficial and temporary. They typically fade within a few days, with bruising resolving within 1-2 weeks. In rare cases, forceps delivery can cause a facial nerve palsy (temporary weakness of facial muscles on one side), which usually resolves within a few weeks. Your baby will be examined after delivery to assess for any complications. It is generally considered normal when red marks or bruising on the cheeks or sides of the head where forceps were applied. However, you should contact your pediatrician promptly if signs of facial nerve palsy that does not improve within a few weeks, or difficulty with eye closure on one side.
Normal vs. Concerning
By Age
What to expect by age
0-1 month
After forceps-assisted delivery, it is common to see red marks, bruising, or slight indentations on the sides of the face or head where the forceps were applied. These marks may look concerning but are superficial and temporary. They typically fade within a few days, with bruising resolving within 1-2 weeks. In rare cases, forceps delivery can cause a facial nerve palsy (temporary weakness of facial muscles on one side), which usually resolves within a few weeks. Your baby will be examined after delivery to assess for any complications.
1-3 months
All forceps marks should be completely resolved by this time. The skin heals without scarring. If a facial nerve palsy occurred, it should be showing significant improvement or have fully resolved. If facial asymmetry persists beyond 4-6 weeks, further evaluation may be needed.
3-6 months
There should be no remaining signs of forceps delivery on the face or head. Your baby's appearance should be completely normal.
6-12 months
Forceps delivery marks have no lasting cosmetic or medical effects. Your baby should have no evidence of the delivery method.
What to Tell Your Pediatrician
- Describe when you first noticed bruising from forceps delivery and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if marks seem slow to fade or you notice any skin breakdown.
- Mention if you notice facial asymmetry, especially when baby cries (possible facial nerve palsy).
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Red marks or bruising on the cheeks or sides of the head where forceps were applied
- Marks that fade within a few days and bruising that resolves within 1-2 weeks
- Baby can move face symmetrically and feed without difficulty
- No open wounds or broken skin
- Marks seem slow to fade or you notice any skin breakdown
- You notice facial asymmetry, especially when baby cries (possible facial nerve palsy)
- You want reassurance about the marks your baby has from delivery
- Signs of facial nerve palsy that does not improve within a few weeks, or difficulty with eye closure on one side
- Any open wound, increasing swelling, or signs of infection at the forceps application site
What You Can Do at Home
- Keep track of when you notice bruising from forceps delivery — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that red marks or bruising on the cheeks or sides of the head where forceps were applied — this is generally within the range of normal.
- At 0-1 month, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
- While monitoring at home, seek immediate care if signs of facial nerve palsy that does not improve within a few weeks, or difficulty with eye closure on one side.
Related Conditions
Facial Nerve Damage at Birth
Facial nerve palsy in a newborn causes one side of the face to droop or not move as well, especially noticeable when the baby cries. It can result from pressure on the nerve during delivery (from forceps or passage through the birth canal) or, rarely, from developmental causes. Most cases from birth pressure resolve completely within a few weeks to months.
Bruising After Difficult Delivery
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.
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.
Related Resources
Frequently asked questions
Is bruising from forceps delivery normal?
When should I call the doctor about bruising from forceps delivery?
When is bruising from forceps delivery normal?
What causes bruising from forceps delivery?
What should I mention to my pediatrician about bruising from forceps delivery?
Is bruising from forceps delivery normal at 0-1 month?
Is bruising from forceps delivery normal at 1-3 months?
Should I go to the ER for bruising from forceps delivery?
Does bruising from forceps delivery go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Bruising From Forceps Delivery.
Things to mention
- Describe when you first noticed bruising from forceps delivery and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if marks seem slow to fade or you notice any skin breakdown.
- Mention if you notice facial asymmetry, especially when baby cries (possible facial nerve palsy).
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- Marks seem slow to fade or you notice any skin breakdown
- You notice facial asymmetry, especially when baby cries (possible facial nerve palsy)
- You want reassurance about the marks your baby has from delivery
Urgent signs to report immediately
- Signs of facial nerve palsy that does not improve within a few weeks, or difficulty with eye closure on one side
- Any open wound, increasing swelling, or signs of infection at the forceps application site
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of bruising from forceps delivery are normal. Talk to your pediatrician if signs of facial nerve palsy that does not improve within a few weeks, or difficulty with eye closure on one side.
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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Related Medical Concerns
Facial Nerve Damage at Birth
Facial nerve palsy in a newborn causes one side of the face to droop or not move as well, especially noticeable when the baby cries. It can result from pressure on the nerve during delivery (from forceps or passage through the birth canal) or, rarely, from developmental causes. Most cases from birth pressure resolve completely within a few weeks to months.
Bruising After Difficult Delivery
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.
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.
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.
Adenoid Hypertrophy and Breathing
Adenoids are lymphoid tissue located behind the nose that help fight infection in young children. When adenoids become enlarged (adenoid hypertrophy), they can block the nasal airway, causing chronic mouth breathing, snoring, nasal speech, and sleep-disordered breathing. Enlarged adenoids are most common between ages 2-7 and are a leading cause of obstructive sleep apnea in young children. Treatment ranges from watchful waiting and nasal steroids to surgical removal (adenoidectomy) if breathing or sleep is significantly affected.