Marks From Vacuum Extraction
The short answer
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.
Parents everywhere have the same worry. You are doing the right thing by looking into it.
By Age
What to expect by age
After vacuum-assisted delivery, it is normal to see a raised, circular area of swelling on the scalp where the vacuum cup was applied (called a chignon). There may also be surrounding bruising. The swelling is caused by suction on the scalp tissue and typically resolves within 24-48 hours. The bruising takes 1-2 weeks to fade. In some cases, a cephalohematoma (collection of blood under the scalp bone covering) may develop, which appears as a firm, defined swelling that may take weeks to months to resolve. Your baby will be monitored for jaundice, as breakdown of the bruised blood produces bilirubin.
The immediate marks from vacuum delivery should be resolved by this time. If a cephalohematoma developed, it may still be present but gradually decreasing. The head shape should be normalizing. No long-term cosmetic or developmental issues are expected from vacuum delivery marks.
All external signs of vacuum delivery should be resolved. Any residual cephalohematoma should have reabsorbed. You may feel a slight ridge where the cephalohematoma calcified at its edges, which is normal and will smooth out over time.
There should be no remaining signs of vacuum-assisted delivery. Head shape and scalp should appear completely normal.
What Should You Do?
When to take action
- A circular raised area and bruising on the scalp at the vacuum application site
- The chignon (raised area) resolves within 24-48 hours
- Bruising that fades from purple to yellow over 1-2 weeks
- Baby is alert, feeding well, and behaving normally
- A firm swelling develops on the scalp that persists for more than a few days (possible cephalohematoma)
- Bruising seems excessive or is not fading as expected
- You have concerns about your baby's head shape
- A rapidly growing, soft swelling that crosses suture lines (which could indicate subgaleal hemorrhage, a rare but serious complication requiring emergency care)
- Baby becomes unusually lethargic, pale, feeds poorly, or develops signs of shock (rapid heart rate, mottled skin)
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.
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.
Cone-Shaped Head After Vaginal Birth (Head Molding)
A cone-shaped or elongated head after vaginal birth is very common and completely normal. It is called head molding and occurs because the bones of your baby's skull are not yet fused, allowing them to overlap and shift to fit through the birth canal. Your baby's head will round out naturally within a few days to weeks.
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.