Infant Hematoma

A hematoma is the buildup of blood between the layers of tissue that cover the part of the brain closest to the skull. While many cases of infant hematoma resolve themselves without any intervention, occasionally doctors will need to perform surgery to prevent complications.

Infant Hematomas Explained

An infant hematoma is a devastating birth injury caused by trauma to an infant’s head. In a hematoma, blood pools outside the blood vessels in the head. The pooled blood puts pressure on brain tissue. This leads to fatal complications or lifelong disability if not immediately diagnosed and treated.

Mild hematomas usually disappear on their own, but in more severe cases, the child may require surgery to drain the blood.

Fortunately, infant hematomas are relatively rare. However, there are a few risk factors that can increase the potential of your child having one. The main reported risk factor for an infant hematoma is using vacuum extractors or forceps. Other risk factors include prolonged labor and premature birth.

Common signs of infant hematomas include soft spots on your child’s head, seizures, tiredness and vomiting.

What Is an Infant Hematoma?

Infant or neonatal hematomas are caused by injuries that occur during delivery. These injuries cause blood to pool on top of a child’s brain, which creates pressure on their brain tissue.

There are two categories of infant hematoma:

  1. Acute Infant Hematoma: With an acute infant hematoma, symptoms appear soon after the injury. Your child will start showing signs immediately or within hours of delivery.
  2. Chronic Infant Hematoma: With a chronic infant hematoma, your child might not start showing any symptoms for days or weeks after birth.

While many cases of infant hematomas heal on their own, severe cases of infant hematomas can lead to complications and death if they are not treated immediately.

Doctors are aware of these risks. They should take steps to reduce them and monitor your child for a hematoma after delivery. If the doctor does not follow this protocol and your child does not receive quick medical intervention, it can be considered medical negligence. Misusing tools during delivery or failure to address the condition immediately can constitute medical malpractice.

What Causes an Infant Hematoma?

Head injuries that happen during birth cause infant hematomas. Sometimes infant hematomas occur because the baby’s head was pushed against their mother’s pelvis. Other times, infant hematomas happen due to the use of forceps or a vacuum to aid the delivery.

Infant Hematoma Risk Factors

Not all of the causes listed above are guaranteed to give your child a hematoma. Your child can be pressed against your bones or delivered with forceps without causing an infant hematoma. However, specific factors lead to an increased risk of developing infant hematoma. These are called risk factors.

Some risk factors that increase the chances of your child having an infant hematoma are:

  • A large baby
  • A long delivery
  • The mother is too weak to push the child through the birth canal (either due to exhaustion or medication)
  • The infant is in a breach or posterior position
  • Premature birth
  • Carrying multiple children

If you had an assisted delivery where the doctor used forceps or a vacuum, the chance of your child having a severe hematoma is much higher.

Infant Hematoma Symptoms

Your child may develop signs and symptoms of an infant hematoma right after the injury occurred. On the other hand, it may take days or weeks for symptoms to appear. The time between the injury and the appearance of symptoms is referred to as a lucid interval.

If you are concerned that your child may have a hematoma, signs and symptoms to watch for include:

  • Bulging fontanelles (soft spot)
  • Feeding difficulties
  • Seizures
  • High pitched cry
  • Increased head circumference
  • Lethargy
  • Persistent vomiting
  • Swelling
  • Pain

Sometimes bruises and hematomas can be mistaken for one another. As the blood pools in a hematoma, it can create a dark spot on your child’s skin, similar to a bruise. While bruises appear a few hours after your child has a minor injury like running into a wall, hematomas occur exclusively after head trauma.

Diagnosing Infant Hematomas

If your doctor suspects an infant hematoma, they will monitor your child’s head size to see if it is expanding more rapidly than it should. Your doctor will also check your child’s hematocrit level—the number of red blood cells compared to the rest of their blood’s volume—to see if it is lower than it should be.

Next, your doctor will likely order imaging scans. Most often, they will choose to do a CT scan. However, they may also recommend an X-ray or MRI. The imaging tests will help the doctor pinpoint the source of the bleeding and the size of the hematoma.

Infant Hematoma Treatment

If you suspect your child has an infant hematoma, seek immediate medical attention. Your child may need surgery to drain the blood, remove a large clot or tie off the bleeding vein. In cases where surgery is not needed, treatment involves a lot of rest. Speak with your doctor to learn their specific instructions for recovering from an infant hematoma.

Infant Hematoma Prognosis

The mortality rate for children with an acute infant hematoma is around 60%. Even if your child recovers, there is a high chance they will experience further challenges. For instance, they might suffer from chronic headaches, attention problems or anxiety.

However, many of these complications can be avoided or reduced if the injury is caught and treated early. If your doctor or nurse fails to address the signs of an infant hematoma quickly enough, it can be considered medical negligence.

Financial Compensation for Infant Hematomas

Since infant hematomas can be the result of a birth injury, financial compensation may be available to you. While this will not undo any harm caused to your child, the compensation can help you pay for your child’s ongoing treatment.

If you would like to work with an attorney experienced in birth injury cases, contact the Birth Injury Justice Center today at (800) 914-1562 to get a free medical case review.

Author:Birth Injury Justice Center
Birth Injury Justice Center

The Birth Injury Justice Center was founded in 2003 by a team of legal professionals to educate and empower victims and families affected by birth injuries. Our team is devoted to providing you with the best resources and legal information for all types of birth injuries.

Last modified: June 20, 2019

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