Head Shape (Infants)

The head shape of a baby after vaginal birth can change because of the birthing process. The bones of a newborn baby’s skull are soft and flexible, with gaps between the plates of bone. These spaces between the bones allow the baby’s head to change shape and squeeze through the narrow birth canal without injury to mother or baby.

Molding

The heads of infants born by vaginal delivery often show some molding, which is when the skull bones shift and overlap, making the top of the infant’s head look long, stretched out, or even pointed at birth. This is temporary and usually goes away a few days after birth.

In addition to looking long, a newborn’s head may sometimes have a lump or two because of the trauma of delivery.

Caput Succedaneum

The pressure during a head-first (vertex) position on the uterus or vaginal wall delivery can result in a swelling of the scalp in the newborn called a caput succedaneum. This is especially true after the membranes have ruptured because the amniotic sac no longer provides a protective cushion for the baby’s head. Vacuum extraction can also increase the chances of caput succedaneum. This will fade over a few days.

Cephalohematoma

A cephalohematoma is a collection of blood that has seeped under the outer covering membrane of one of the skull bones. The pressure of the head against the mother’s pelvic bones during the birth can result in cephalohematoma.  The cephalohematoma lump is typically confined to one side of the top of the baby’s head and may take a week or two to disappear. The breakdown of the blood collected in a cephalohematoma may cause these infants to become somewhat more jaundiced than others during the first week of life.

It’s important to remember that both caput succedaneum and cephalohematoma occur due to trauma outside of the skull — they do not cause injury to the infant’s brain.

Fontanels (Soft Spots)

Because of the separation of your newborn’s skull bones, you’ll be able to feel (go ahead, you won’t harm anything) two fontanels, or soft spots, on the top of the head.

  • The larger fontanel is diamond-shaped at the front of the head.
  • The smaller fontanel is triangle-shaped at the back of the head.

You may notice that the fontanels bulge out when the infant cries or strains, or they seem to move up and down in time with the baby’s heartbeat. This is perfectly normal. The fontanels will eventually disappear as the skull bones close together — usually in about 12 to 18 months for the one in the front and about six months for the one in back.

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Last updated: 2019-08-06