Questions?What Is Caput Succedaneum?
Caput succedaneum is a type of birth injury involving swelling of the scalp. The swelling (edema) often occurs when fluids found below the scalp build up before or during a child’s birth, usually due to pressure. The condition can result in a cone-shaped head that will feel soft and even puffy.
If your child was born with this condition, consult your doctor to see if medical treatment is needed. While the swelling often goes down within a couple of days, there may be a risk of more serious health problems.
Most notably, babies born with caput succedaneum are at risk of newborn jaundice or a buildup of a pigment (bilirubin) that, in severely high levels, can cause brain injuries.
Doctors play a critical role in preventing this condition and managing its treatment. However, when proper standards of care are not followed, medical errors can contribute to or even cause the condition.
Caput Succedaneum Causes
Caput succedaneum can be caused before the baby is born or during delivery.
Prenatal Causes
Before a child is born, caput succedaneum can result from the premature rupturing of membranes (PROM) in the mother’s womb.
Babies develop in a water-filled sac inside the womb — called the amniotic sac — which is sealed by membranes. These membranes normally rupture closer to the mother’s due date, an event commonly known as the water breaking.
However, if the membranes rupture and the fluids are released prematurely, the amniotic sac can no longer support the baby’s head. This subjects the head to more pressure from the pelvic bones and may cause fluid to build up underneath the scalp.
Causes During Delivery
Caput succedaneum is most commonly caused by a long delivery where pressure is placed on the infant’s head.
The typical vaginal delivery involves pushing the infant through the birth canal head-first. However, this can make the infant’s head the primary pressure point during the birth. Pressure commonly comes from the mother’s vaginal wall, cervix, and/or uterus.
While any baby may develop caput succedaneum during delivery, certain factors may increase the risk. For example, the pressure applied to the head is often greater in babies with higher birth weights (macrosomic infants) or those born overdue (over 41 weeks).
Other risk factors linked to this condition include:
- Insufficient amniotic fluid (oligohydramnios)
- Braxton Hicks contractions (false labor)
- Use of forceps or vacuum extraction during delivery
- C-sections
Medical Malpractice
Many of the causes of caput succedaneum are out of anyone’s control. Others, however, can be prevented with proper medical care.
For example, sometimes doctors rush through the birthing process or make mistakes when using delivery tools such as vacuum extractors or forceps.
“Some delivery practices, like using a vacuum too many times or both a vacuum and forceps, should not occur and may point to negligence.”
– Beth Carter, RN, On-Staff Legal Nurse Consultant Certified
What Are the Symptoms?
Symptoms of caput succedaneum include soft, swollen spots on the top of the infant’s scalp that are 1-2 centimeters deep. This softness might appear on one side of the infant’s head or across the scalp.
The swollen area usually appears on the portion of the head that first emerged from the birth canal. In some cases, there is also color alteration or bruising of the scalp.
Caput Succedaneum vs Cephalohematoma
The symptoms of caput succedaneum may be mistaken for those of other birth injuries, such as newborn cephalohematoma. Both conditions cause swelling in the head, but they are otherwise very different.
Learn more about the differences between caput succedaneum and cephalohematoma below.
| Caput Succedaneum | Cephalohematoma |
|---|---|
| Buildup of serosanguinous fluids (which are clear/yellow) below the scalp | Buildup of blood below the scalp |
| Typically heals in a few days | Heals over several weeks or months |
| Steadily decreases in size | May grow for 2-3 days after birth before starting to shrink |
| Not associated with skull fractures | May be a sign of a skull fracture |
| Crosses the midline of the occipital bone (towards the back of the skull) | Does not cross skull suture lines — forms between the skull bone and the skull bone's periosteum (a membrane that covers bones) |
Both conditions can be caused by a doctor’s use of a vacuum, forceps, or another tool that places pressure on the infant’s head to speed up the delivery.
Diagnosing Caput Succedaneum
Most medical professionals can recognize the condition immediately after the child is born. This is typically done by making a differential diagnosis, which compares the shared symptoms of two or more conditions to find out which one is the cause.
The Academy of Neonatal Nursing recommends that doctors compare possible signs of caput succedaneum with those of a cephalohematoma. This is important because cephalohematomas are more likely to lead to complications such as blood clots and anemia.
In some cases, doctors have also been able to diagnose caput succedaneum in unborn babies using an ultrasound.
Treatment Options
Most caput succedaneum cases do not require medical treatment, and the infant will make a full recovery within a couple of days after delivery. But in some cases, a pediatric specialist may need to drain fluid that has built up below the scalp to reduce the swelling.
If the infant’s head is bruised, there is also a risk that they will develop jaundice. Most cases of jaundice resolve on their own, but medical treatment may be needed in severe cases.
Infants who have jaundice may be treated with blood transfusions and phototherapy before the condition worsens into kernicterus.
Caput Succedaneum Prognosis
Prognosis describes the projected outcome doctors think the condition will have. In most cases of caput succedaneum, the baby is expected to make a full recovery even without treatment.
However, as previously noted, there is the potential for caput succedaneum to cause other medical problems.
These medical issues include:
- Hair loss (alopecia)
- Infection
- Jaundice
- Scarring
While some of these health issues clear up on their own, it’s best to seek medical attention if you are concerned about your child’s health. Some of these conditions may cause permanent damage without treatment.
For example, severe cases of untreated jaundice can cause kernicterus and brain damage. Kernicterus occurs when bilirubin builds up in the brain, causing deafness, cerebral palsy, and/or other lifelong disabilities.
Get Legal Help for Birth Injuries
If your baby was harmed at birth and you are concerned for their health, speak to your doctor today. Their condition may heal — but if it doesn’t, your child may be suffering from a more serious birth injury.
You can also learn more about birth injuries and their causes by speaking with one of our Patient Advocates. We can connect you to important health care and legal resources, such as a birth injury lawyer, if your baby suffers from caput succedaneum or another birth injury.
To see if you can access compensation for a preventable birth injury, get started with a free case review.
