Marks From Vacuum Extraction
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 marks from vacuum extraction, here is what the evidence says.
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.
Key takeaways
- 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.
- Usually normal when: A circular raised area and bruising on the scalp at the vacuum application site
- Call your doctor if: A rapidly growing, soft swelling that crosses suture lines (which could indicate subgaleal hemorrhage, a rare but serious complication requiring emergency care)
- Varies by age — see the age-by-age breakdown below
“Fever itself is not an illness — rather, it is a sign or symptom that the body is fighting an infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading bacteria.”
Parents everywhere have the same worry. You are doing the right thing by looking into it.
What Parents Should Know
According to AAP, NIH guidelines, 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. At 0-1 month, 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. It is generally considered normal when a circular raised area and bruising on the scalp at the vacuum application site. However, you should contact your pediatrician promptly if a rapidly growing, soft swelling that crosses suture lines (which could indicate subgaleal hemorrhage, a rare but serious complication requiring emergency care).
Normal vs. Concerning
By Age
What to expect by age
0-1 month
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.
1-3 months
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.
3-6 months
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.
6-12 months
There should be no remaining signs of vacuum-assisted delivery. Head shape and scalp should appear completely normal.
What to Tell Your Pediatrician
- Describe when you first noticed marks from vacuum extraction and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if a firm swelling develops on the scalp that persists for more than a few days (possible cephalohematoma).
- Mention if bruising seems excessive or is not fading as expected.
- 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
- 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)
What You Can Do at Home
- Keep track of when you notice marks from vacuum extraction — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that a circular raised area and bruising on the scalp at the vacuum application site — 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 a rapidly growing, soft swelling that crosses suture lines (which could indicate subgaleal hemorrhage, a rare but serious complication requiring emergency care).
Related Conditions
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.
Related Resources
Frequently asked questions
Is marks from vacuum extraction normal?
When should I call the doctor about marks from vacuum extraction?
When is marks from vacuum extraction normal?
What causes marks from vacuum extraction?
What should I mention to my pediatrician about marks from vacuum extraction?
Is marks from vacuum extraction normal at 0-1 month?
Is marks from vacuum extraction normal at 1-3 months?
Should I go to the ER for marks from vacuum extraction?
Does marks from vacuum extraction go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Marks From Vacuum Extraction.
Things to mention
- Describe when you first noticed marks from vacuum extraction and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if a firm swelling develops on the scalp that persists for more than a few days (possible cephalohematoma).
- Mention if bruising seems excessive or is not fading as expected.
- 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
- 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
Urgent signs to report immediately
- 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)
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 marks from vacuum extraction are normal. Talk to your pediatrician if a rapidly growing, soft swelling that crosses suture lines (which could indicate subgaleal hemorrhage, a rare but serious complication requiring emergency care).
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
Was this page helpful?
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.