From the Research
Cephalohematoma in newborns typically requires minimal intervention and should be managed with watchful waiting in most cases, as the most recent and highest quality study suggests that early surgical intervention or aspiration may not be necessary unless there are signs of infection or significant complications 1.
Management of Cephalohematoma
The management of cephalohematoma in newborns involves:
- Monitoring the cephalohematoma for signs of infection such as increased redness, warmth, or swelling
- Positioning the baby's head to avoid constant pressure on the affected area during sleep
- Consulting with a pediatrician for pain management, who may recommend acetaminophen (Tylenol) at appropriate infant dosing
- Routine follow-up with the pediatrician to ensure proper resolution
Signs of Infection
Signs of infection that may require further evaluation and treatment include:
- Increased redness or warmth around the cephalohematoma
- Swelling or fluctuance of the cephalohematoma
- Fever or other signs of systemic infection
- In these cases, diagnostic tap or aspiration of the cephalohematoma may be necessary to rule out infection, as suggested by 2 and 1
Large or Persistent Cephalohematoma
In rare cases where the cephalohematoma is very large or persists beyond 3-4 months, additional evaluation may be needed to rule out underlying skull fracture or to check for significant hyperbilirubinemia (jaundice), which can occur as the blood breaks down, as noted in 3 and 4
Recent Studies
Recent studies, such as 1 and 5, suggest that early needle aspiration or surgical evacuation may be considered in cases of large or persistent cephalohematoma, but the risks and benefits of these procedures should be carefully weighed, and the decision should be made on a case-by-case basis, prioritizing the reduction of morbidity, mortality, and improvement of quality of life.