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Why a Baby’s Head Can Change Shape During Labour
A newborn’s skull is made up of several bony plates joined by soft connective tissue called sutures and fontanelles. This design allows:- Overlapping of skull bones under pressure
- Temporary reshaping without injury
- Protection of the brain while allowing flexibility
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What Is Caput Succedaneum
Caput succedaneum refers to soft tissue swelling of the scalp, caused by pressure on the baby’s head during labour. This swelling develops above the skull bones, in the skin and subcutaneous tissue.What Causes Caput
- Prolonged pressure of the baby’s head against the cervix
- Early rupture of membranes, which removes the cushioning effect of amniotic fluid
- Long labours or slow descent
- Assisted vaginal deliveries (vacuum or forceps)
How Caput Looks and Feels
- Soft, puffy swelling on the scalp
- Often crosses suture lines
- May feel squishy or fluid-filled
- Usually visible immediately at birth
Is Caput Dangerous
Caput is benign and temporary. It does not involve bleeding, brain injury, or skull damage. In most cases:- Swelling reduces within 24–72 hours
- No treatment is required
- The scalp returns to its normal shape on its own
What Is Moulding
Moulding refers to the overlapping or shifting of the skull bones themselves as the baby passes through the birth canal. This is a structural adjustment, not a fluid swelling.What Causes Moulding
- Strong uterine contractions
- Tight pelvic fit
- Long or obstructed labour
- First vaginal births, where tissues are less stretched
How Moulding Looks and Feels
- Elongated or cone-shaped head
- Ridge-like edges where bones overlap
- Firmer than caput
- Does not cross suture lines
Is Moulding Dangerous
Physiological moulding is normal and protective.- It reduces the head diameter during birth
- It does not damage the brain
- Skull bones gradually realign within days to weeks
Caput vs Moulding: Key Differences
Here are the key differences between caput and moulding:| Feature | Caput Succedaneum | Moulding |
| Affects | Scalp soft tissue | Skull bones |
| Cause | Fluid accumulation | Bone overlap |
| Texture | Soft, puffy | Firm, ridged |
| Crosses sutures | Yes | No |
| Timing | Present at birth | It may become clearer after birth |
| Resolution | 1–3 days | Days to weeks |
| Risk | Benign | Benign when physiological |
Many babies have both caput and moulding, fluid swelling on top of reshaped bones.
Why These Changes Are More Common in Some Births
Certain labour situations increase pressure on the baby’s head:- First vaginal births, where descent takes longer
- Prolonged second stage of labour
- Early rupture of membranes
- Induced or augmented labour, which can intensify contractions
- Assisted deliveries, especially vacuum extraction
How Doctors Assess Head Changes at Birth
Immediately after birth, doctors examine the baby’s head to determine whether swelling is benign or needs monitoring. They check:- Texture and firmness
- Whether swelling crosses sutures
- Presence of bruising
- Baby’s neurological status
Conditions That Can Look Similar But Are Different
It’s important to distinguish caput and moulding from less common conditions.Cephalohematoma
- Bleeding under the periosteum
- Does not cross sutures
- Feels firm and well-defined
- Resolves over weeks
- Slightly higher risk of jaundice
Subgaleal Haemorrhage
- Rare but serious
- Extensive bleeding under the scalp
- Rapidly increasing head size
- Requires urgent care
What Parents Often Worry About and Why They Shouldn’t
It’s common to worry that an oddly shaped head means brain injury or permanent deformity. In reality:- The brain is well protected inside flexible bones
- Caput and moulding do not affect intelligence or development
- Head shape almost always normalises without intervention
How Long Does It Take for the Head to Look “Normal”
- Caput: noticeable improvement in 24–48 hours
- Moulding: gradual rounding over 1–2 weeks
- Full normalisation: may take up to 6 weeks in some babies
Does Head Shape Affect Breastfeeding or Comfort
Occasionally, babies with significant moulding may:- Prefer turning their head to one side
- Be slightly uncomfortable in certain positions
When Should You Ask the Doctor Again
While caput and moulding are normal, follow up if you notice:- Swelling increases after birth
- Redness, warmth, or signs of infection
- Poor feeding or unusual lethargy
- Head shape has not improved after several weeks
Emotional Context for Parents
Seeing your newborn’s head look swollen or misshapen can be unsettling, especially if you were not warned.Understanding that this is evidence of adaptation, not injury, often brings relief. Your baby’s head changed shape not because something went wrong, but because their body did exactly what it was designed to do.
Caput and moulding are not signs of trauma; they are signs of successful adaptation. As your baby navigates the narrow passage of birth, their head changes shape to protect the brain and allow safe delivery.
What looks unfamiliar in the first hours of life is usually temporary, harmless, and remarkably efficient biology at work. Within days to weeks, your baby’s head will settle into the round shape you expect, carrying no memory of the pressure it once endured.
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FAQs on Caput vs Moulding: How Your Baby’s Head Changes Shape During Labour
- Can caput or moulding cause long-term head shape problems?
No. Both resolve naturally without affecting skull growth or brain development. - Is moulding more common in long labours?
The longer the pressure, the more opportunity for skull bones to overlap. - Can a C-section baby have caput?
Caput can develop before surgery if labour progresses before the C-section.
