the 2 parietal bones and 1 occipital bone. It is small, triangular shaped, and less
pulsatile. It normally closes at 1 1/2 to 3 months of age. The anterior fontanel is the
larger of the two.
c. Cephalhematoma. This is a collection of blood between a cranial bone and
its overlying periosteum (see figure 7-4). Bleeding is limited to the surface of the
particular bone. It is caused by pressure of the fetal head against the maternal pelvis
during a prolonged or difficult labor. This pressure loosens the periosteum from the
underlying bone, therefore rupturing capillaries and causing bleeding. It may be
apparent at birth but sometimes are not seen until 24 to 48 hours of life because
subperiosteal bleeding is slow. It varies in size, rather firm to the touch and tends to
increase in size from 1 to 3 days and then become softer and more fluctuant. Most
cephalhematomas are absorbed within several weeks. No treatment is required in the
absence of unexplained neurologic abnormalities.
d. Caput Succedaneum. This is an abnormal collection of fluid under the scalp
on top of the skull that may or may not cross the suture lines, depending on the size.
Pressure on the presenting part of the fetal head against the cervix during labor may
cause edema of the scalp (see figure 7-4). This diffuse swelling is temporary and will
be absorbed within 2 or 3 days.
Figure 7-4. Cephalhematoma and caput succedaneum.
CHARACTERISTICS OF THE NEWBORN INFANT'S EYES AND EARS
a. Eyes. The infant's eyes may be folded and creased and may seem out of
shape because they contain little hardened cartilage. The infant's eyes may not track
properly and may cross (strabismus) or twitch (nystagmus). This will cause concern if it
extends beyond six months.