Question

There’s a soft, spongy area on the top of my child’s head. When I gently push it, it feels like there’s fluid inside. It’s located between the scalp and skull, with the skull being hard and the soft area being about the size of my child’s palm. Have any experts encountered this phenomenon? Is it normal? Do I need to take my child to the doctor? Thank you!

Answer

Considering the possibility of a newborn scalp hematoma, it is generally understood that a newborn scalp hematoma occurs when there is bleeding between the newborn’s skull and the periosteum covering it, leading to the accumulation of blood. The borders are clear, and there is no indentation when pressed. It becomes apparent within two to three days after birth and typically disappears within 1 to 3 months. Regarding the care for scalp hematomas:

  1. In the early stages, apply localized cold compresses to prevent the hematoma from expanding.
  2. For larger hematomas, an X-ray should be taken to check for skull fractures, and blood tests should be conducted to assess coagulation function. Appropriate treatment should be provided if any abnormalities are detected.
  3. Allow the scalp hematoma to absorb naturally; do not rub or massage the hematoma, and avoid withdrawing blood from the hematoma to prevent infection. If infection occurs and a boil forms, timely incision and drainage should be performed.
  4. Children with hematomas should be moved less frequently, lie on their healthy side, and larger hematomas may require temporary artificial feeding. If the description of the scalp hematoma is severe, it is recommended to actively seek medical examination and treatment based on the size of the hematoma and its regression time.