What Is Caput Succedaneum?
Caput succedaneum is a type of birth injury involving swelling of the scalp. The swelling (edema) often occurs when subcutaneous fluids, found below the scalp, build up before or during a child’s birth, usually due to pressure.
Caput succedaneum can result in a cone-shaped head. If touched, a caput succedaneum will feel soft and even puffy, according to the U.S. National Library of Medicine.
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 can cause brain injuries.
Doctors can play a big role in preventing caput succedaneum or recommending treatments. However, they can also be responsible for medical malpractice that causes the condition.
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Caput Succedaneum Causes
Caput succedaneum can be caused before the baby is born or during delivery.
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 toward 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 fetus’ 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 weight (macrosomic infants) or those born overdue.
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
Medical Malpractice & Caput Succedaneum
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.
If these errors cause your child to be born with severe caput succedaneum, the doctor may have committed medical negligence.
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Caput Succedaneum 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 along the skin 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.
|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 caput succedaneum and cephalohematoma 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. Both conditions can also cause jaundice.
Caput Succedaneum Diagnosis
Most medical professionals can recognize a case of caput succedaneum right 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 cause complications like blood clotting and anemia.
In some cases, doctors have also been able to diagnose caput succedaneum in unborn babies using an ultrasound.
Caput Succedaneum Treatment
Most caput succedaneum cases do not require medical treatment, and the infant will make a full recovery 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 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.
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Caput Succedaneum Prognosis
The prognosis for caput succedaneum 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 (halo formation around the scalp)
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.
Next Steps After a Caput Succedaneum Diagnosis
If your baby was born with caput succedaneum and you are concerned for their health, speak to your doctor today. It’s likely that the condition will quickly heal — but if it doesn’t, your child may be suffering from a more serious birth injury.
You also can 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 birth injuries like caput succedaneum, get started with a free case review.