What Parents Need to Know about Caput Succedaneum (Newborn Conehead)

If your baby has a swollen scalp right after birth, this is known as caput succedaneum (or newborn conehead). Today, we’ll cover everything parents need to know about caput succedaneum, including what causes it, what it looks like, and whether it’s a cause for concern.

What is caput succedaneum? What does it look like?

Caput succedaneum occurs when a baby’s scalp is swollen right after birth. 

  • As this swelling can sometimes cause baby’s head to appear pointy or cone-shaped, caput succedaneum is also called “newborn conehead.”
  • Caput succedaneum can also cause a soft lump, bump, or puffy spot to appear on baby’s head. 
  • The swollen area may seem a little bit darker or bruised.
  • It could be on one or both sides of the head (in other words, the swelling could cross the “midline” of the top of the head). 

Learn more about caput succedaneum (newborn conehead) from Mount Sinai Parenting Center: 

What causes caput succedaneum?

Newborn babies’ skull plates aren’t fused together yet – and that’s for good reason. Baby’s flexible skull (complete with soft spots) makes it easier for them to move out of the womb, exit through the cervix, and pass through the birth canal. 

Their skull plates move and overlap as needed, and the skull shape changes and molds as needed, so they can make this tight squeeze.

But sometimes, this squeeze can cause baby’s head to look cone-shaped, or otherwise have a swollen spot – especially if there was lots of pressure from the vaginal walls or dilated cervix during labor. This causes baby to be born with caput succedaneum. 

Caput succedaneum can also develop before labor, if baby sits in the womb in a way that makes the pelvic bones put prolonged pressure on their head. In these cases, doctors and nurses can spot the caput succedaneum using an ultrasound. 

What are some risk factors for caput succedaneum?

Some factors can make a baby more likely to have caput succedaneum, including:

  • A long and difficult labor that involves lots of pushing
  • The use of forceps or vacuum suction during delivery
  • Larger birth weight, which may make for a tighter squeeze through the birth canal
  • A narrower birth canal
  • Baby “drops” early, and their head makes contact with their mother’s pelvic bones for a longer period of time (putting pressure on the head)
  • Early “water breaking,” meaning there’s less amniotic fluid to cushion baby’s head. This can also lead to longer-term pressure on their head from their mother’s pelvic bones.
  • Not enough fluid (“water”) in the amniotic sac, leading to more pressure on baby’s head from their mother’s pelvic bones

Should I be concerned about caput succedaneum?

If baby is born with caput succedaneum, don’t be concerned. Because of what happens during the vaginal birth process, it’s perfectly normal for baby to have a swollen or differently-shaped head. In fact, this is relatively common for babies born vaginally. 

(Babies born via C-section usually won’t have caput succedaneum, since they don’t pass through the birth canal. In rare cases, though, some C-section babies still end up with newborn conehead because of pressure from the pelvic bones. This still isn’t a cause for concern.)

Newborn conehead won’t cause any growth problems or developmental delays, and it isn’t painful for your baby.

In fact, caput succedaneum will almost always resolve on its own after a few days to a few weeks, and baby’s head will have a more rounded shape. 

 

What to do about caput succedaneum?

If baby has caput succedaneum, the best thing to do is to wait. Enjoy your time with baby, don’t worry, and before you know it, baby’s head will be rounded.

If it’s a few weeks after birth, though, you may wonder if baby’s positioning might be contributing to newborn conehead. If this concerns you:

  • Give baby plenty of tummy time when they’re awake and you’re able to watch them. 
    • It’s important for all babies to have tummy time, because this helps them develop neck and shoulder muscles needed for motor development. 
    • Tummy time also helps babies gain better head control, so they won’t put too much pressure on any one part of their skull.
  • Encourage different head positions by moving toys around, or simply by facing baby in several different directions throughout the day.
  • Hold baby often.
  • Alternate the direction baby’s head faces when you put them down to sleep. (Remember: Always put baby to sleep on their back – just change their head position.)

Newborn Conehead vs. Other Head Shape Conditions

Does baby have caput succedaneum, or is something else affecting the shape of their head? Here’s how to tell the difference between caput succedaneum and other conditions:


Flat head syndrome

A baby with flat head syndrome has a flat spot on the back of their head. This is usually caused by positioning. Like with newborn conehead, it happens because baby’s skull plates haven’t fused together yet. But flat head syndrome is completely different from newborn conehead.


Cephalohematoma

This is localized bleeding on the head. It happens when a blood vessel breaks, and the blood builds up and pools under the scalp. 

It can cause swelling, but the swelling won’t be as pronounced as with newborn conehead. And while newborn conehead can cause swelling on either side of the head, cephalohematoma swelling will only stay on one side – it won’t cross the “midline” of the top of their head. 

Like newborn conehead, cephalohematoma will resolve on its own. Cephalohematoma could appear alongside caput succedaneum. 


Congenital torticollis

Congenital torticollis causes limited neck mobility, which makes baby’s head tip to one side. This can cause flattening of one side of the head. 

If baby has trouble moving their neck and head, and only tends to tilt their head in one direction, they likely have congenital torticollis. This doesn’t happen with caput succedaneum.


Craniosynostosis

Craniosynostosis causes the skull plates to fuse together too soon. This rare condition can affect brain growth, and requires surgery to fix. It can be painful to a baby, and cause symptoms like headaches and vomiting. 

If a baby’s head doesn’t become round on its own after several weeks, see a doctor to make sure craniosynostosis is not the cause.

When to see the doctor about caput succedaneum?

Although caput succedaneum is normal, it could become infected in rare cases. Call your doctor immediately if the swollen area on baby’s head looks infected, or baby has a fever. 

Caput succedaneum can also increase baby’s risk for jaundice. Although jaundice usually clears on its own after a few weeks, call your doctor if baby’s jaundice doesn’t improve within this timeframe. Untreated jaundice can sometimes lead to more serious complications.

You should also talk to a doctor if baby’s conehead hasn’t resolved after a few weeks. During the visit, your doctor will make sure that baby doesn’t have the more serious craniosynostosis.

 

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