Do newborns develop scalp hematomas that need to be treated?

Some babies will have a soft mass on the scalp after birth, and it will feel like a large blister, and the doctor will tell you that this is a scalp hematoma.

This makes many new parents very worried, what is scalp hematoma? How did it come into being? Will it affect your baby's brain?

Today, pediatricians will talk in detail about scalp hematomas, which newborns are more likely to develop scalp hematomas, and how to deal with them.

01

Why does scalp hematoma occur?

When the baby is born, in order to squeeze the baby out, the uterus will have a strong contraction. When the baby's head is pushed to the mother's bone, due to the loose combination between the newborn's periosteum and bone, the huge pressure from the uterus during childbirth may cause the baby's small blood vessels under the periosteum to rupture, and blood accumulates under the periosteum to form a blood packet, which is the so-called scalp hematoma.

It is different from "intracranial hematoma" and belongs to "extracranial hematoma", so parents do not have to worry, it has no effect on the baby's nervous system.

02

Under what circumstances is scalp hematoma prone to occur?

When the baby's birth weight > 4000g, this is well understood, the baby is too strong, the uterus must be more forceful to squeeze the baby out;

Maternal obesity, first-time motherhood, short mother size, etc. increase the risk;

Incorrect fetal position, resulting in the need for the uterus to contract harder;

Vaginal midwifery – Clinicians use forceps or negative pressure devices to assist mothers in delivering the fetus, which may increase the chances of local compression of the scalp.

Image: Bigstock

03

What are the dangers of scalp hematomas?

Most scalp hematomas resolve spontaneously within 3-4 weeks, and care should not be made to break the hematoma before subsiding to avoid secondary infection. A very small number of hematomas may appear in the later stages of the machined or calcification, but most of the machined or calcifications are also slowly absorbed and disappear within 3 to 6 months.

The process of absorption of blood in the hematoma can lead to worsening of jaundice and prolonged duration of jaundice, so for babies with scalp hematomas, it is necessary to closely observe the condition of jaundice.

04

How to deal with scalp hematomas?

Be careful not to press, do not rub, protect your baby's head, and avoid being squeezed and bumped by external forces. Scalp hematomas that have just occurred can be treated with cold compresses to constrict local blood vessels to stop bleeding as soon as possible.

Do not apply a hot towel externally within 48 hours after birth, nor should you apply ointments that activate blood stasis and reduce hematoma, so as not to aggravate bleeding.

The condition of the hematoma needs to be closely observed at the same time as the above treatment:

Local skin color, pay attention to whether the skin at the hematoma site is particularly red, if so, it may be a co-infection, and see a doctor as soon as possible. If the skin color is normal, it can continue to be observed;

The size and shape of the hematoma, such as whether there is a significant increase, whether there is a rupture and whether the local skin is congested.

Image: Bigstock

05

Does a scalp hematoma need to have blood drawn?

According to evidence-based medical evidence, at present, there is a more unified view at home and abroad, it is not recommended to routinely perform hematoma puncture and suction, the vast majority of hematomas can be absorbed by themselves, and there is no impact on growth and development.

Many parents may not understand, do not draw the blood out, the back may lead to hematoma calcification or mechanization, with a needle to draw the blood inside the hematoma, the hematoma will not disappear? Aren't these follow-up questions solved? Why can't I smoke? What are the risks of suction?

As we all know, the blood vessels of newborns are particularly fragile, and there may be the following risks during the aspirate process:

The aspiration process may cause re-bleeding, enlarging the original hematoma. In addition, the process of drawing blood with a needle, as well as the needle opening left after suction, may lead to the occurrence of infection.

Once the hematoma is combined with infection, it may become an abscess that requires anti-infective therapy, puncture and drainage if necessary, and even incision and drainage, and what's more, once the infection spreads into the skull, leading to purulent meningitis is even more troublesome.

Although the probability of these terrible complications is very small, once they occur, the damage to the baby is greater, so weigh the pros and cons, or do not puncture and suck, and it is safer to wait for the hematoma to slowly absorb on its own.

Image: Bigstock

As for some people's belief that for large hematomas, in the case of ensuring the operation of norms and avoiding infection as much as possible, the blood of large hematomas is drawn to avoid the occurrence of calcification, which is still controversial and has no authoritative evidence to support it for the time being.

Even in case of calcification, because the calcification point is close to the outside of the skull, rather than inside the head, it will not lead to the impact on the baby's function, and it will rarely lead to obvious abnormalities in appearance, and it can gradually absorb and subside after calcification for about 3-6 months, rarely leading to long-term effects.

Pediatrician Summary

Scalp hematoma is a common injurious problem in newborns, the treatment of choice is conservative treatment, observation of hematoma changes, such as its self-absorption, not the first choice or routine puncture and blood pumping therapy. Unless the hematoma is concomitant with infection and becomes an abscess, it is necessary to puncture and drain in time, or even cut and drain the pus inside the hematoma.

Zhou Yuanli

Specialist Director of the Neonatal Intensive Care Unit

Pediatrician

Dr. Zhou Yuanli graduated from Sun Yat-sen University in 2009 with a master's degree in pediatrics.

Dr. Zhou has more than 10 years of clinical experience in pediatrics, and before joining Guangzhou United Family Hospital, he has been working in the Department of Pediatric Internal Medicine of Guangzhou Women and Children's Medical Center, especially in the diagnosis and treatment of pediatric respiratory, digestive, neonatal, renal, infectious, allergic and other diseases. In addition, Dr. Zhou has in-depth research on the daily care and health care of infants and young children, nutrition and development of premature infants, and has rich experience in the fields of child health care, child growth and development, children's behavioral development and intelligent development, and children's nutritional feeding. Dr. Zhou has worked in the neonatal intensive care unit for many years, has rich experience in the treatment of acute and critical illnesses, and is proficient in various clinical operation techniques.

Dr. Zhou has participated in the research of the Natural Science Foundation of Guangdong Province and has published several papers in core medical journals.