Bumps, ridges, and soft spots on a baby’s head. When should you worry?

Parents often worry about lumps and bumps on a baby’s head. Babies normally have bumps, ridges and soft spots on their head. When should you worry?

When should you worry about lumps, bumps, and flat spots on your baby's head? What about older kids?

Parents often worry about lumps and bumps on a baby’s head unnecessarily. Babies normally have ridges and soft spots on their head for a while after birth. Many have a type of swollen gland that parents can feel when rubbing the head. All of this is normal.

Skull anatomy

Let’s begin with a brief overview of a baby’s head. We are born with many bones in our skull. This allows the head to be squeezed out of the birth canal as the bony plates move together or even overlap one another.

Infant skull bones
Infant skull bones

Sometimes you don’t really notice much with these bones, but other times they overlap one another noticeably after birth. When a baby has a lot of head distortion due to overlapping of skull bones, we call it molding. It can make the head look pointed – which is often called cone head.  It can also make the head look flat on one side.

The good news? Even really odd looking heads are usually normal. Molding tends to resolve without intervention over the first few days of life.

Soft spots

There are 1-2 “soft spots” at birth. Usually the one on top to the head (the anterior fontanelle) remains open enough to feel for the first 18-24 months of life. The one towards the back of the head (the posterior fontanelle) is unable to be felt by about 2 months of age. It is often so small at birth that it’s not recognized.

Many parents fear that touching a soft spot will somehow damage the baby’s brain. Normal touching won’t hurt, even from a 2 year old sibling. There are several layers of skin and other tissues protecting the brain.

Doctors will feel the soft spots during routine check ups to be sure they are the right size for the growth of the baby’s head. There’s a lot of variation here, so if you question the size of your baby’s soft spot, discuss it at a visit with the doctor. He or she will need to not only feel the soft spot, but also will look at overall head growth, baby’s development, and the shape of the head.

Bruises and bleeding

Coming out of the birth canal can be traumatic for both mother and baby (and often for fathers too). Sometimes babies have a big soft or squishy bump on one side of the head, which usually is essentially a large bruise.

Bruises can cause yellow jaundice.

Any bruise can increase the risk of yellow jaundice in a newborn, so your doctor might watch your baby more carefully for this over the time that the blood is resorbed. This is because yellow jaundice is caused by breakdown of blood cells. Most babies show yellow color in their eyes and face. Even if it progresses to their chest and abdomen it can usually self-resolve with proper hydration, but it should be monitored. If the level gets too high it can be managed. Talk to your doctor if you’re concerned.

Cephalohematoma vs caput saccedaneum.

The two most common types of bruising are cephalohematoma and caput saccedaneum.

A cephalohematoma develops when there is bleeding between the skull and the bone lining called periosteum. Since it is outside the skull, it doesn’t affect the baby’s brain. It covers only one of the bones, and never crosses one of the suture lines.

Caput succedaneum is swelling of the scalp in a newborn. It develops from bleeding one layer above the periosteum in the skin. It can cross the bone areas since it’s not limited by the lining of the bone (periosteum). You will notice a soft, puffy swelling on the baby’s scalp, usually in the area that first came out during birth. Some will show bruising.

Both of these conditions can lead to increased risk of yellow jaundice due to breakdown of the blood collections, but usually self resolve without complications. If baby seems uncomfortable due to this area, discuss with your hospital nurse or doctor.

The picture below attempts to show the layers of bleeding described here and includes more uncommon (and more concerning) types of bleeding. Babies who have deeper bleeds need proper medical management. For information about subgaleal hematoma, see Seattle Children‘s website. Epidural hematomas are very rare in newborns.

Scalp hematomas

 

Flat spots

Flat spots are common, especially if babies prefer to always look to one side. This can cause the forehead to seem to bulge on one side or an ear to appear closer to the face than the other ear. This is usually due to baby laying one direction most of the time, allowing the brain to grow all directions but spot baby is laying on.

Babies always need to sleep on their back until they start to roll on their own, but this can encourage a flat head. It’s important to get baby to lay looking right sometimes, left other times. Supervised tummy time is helpful too. I recommend starting tummy time on day one. The earlier you start tummy time the less they seem to hate it!

When you hold and feed baby, alternate arms because they will look toward you and by simply holding in the right arm sometimes, left arm other times, they will turn their head. If your baby resists turning his head, check out this Torticollis information.

Lymph nodes

One of the most common head worries that brings parents to the office is a pea-sized (or bigger) movable bump on the back of baby’s (or even an older child’s) head. This is usually an occipital lymph node.

Lymph nodes of the head and neck
Lymph nodes of the head and neck

When I say it’s just a lymph node, some parents automatically worry about lymphoma.

Don’t go there.

Most of us remember having a swollen lymph node (AKA swollen gland) under our jaw or in our neck when we are sick. When they develop on the back of the head, it is usually from something irritating the scalp, like a scalp probe during labor, cradle cap, or bug bites in older kids. They can remain large for quite a while (often seeming to come and go when kids have scalp irritations), but unless they hurt to touch, enlarge rapidly, are red and hot, or a child looks sick otherwise, I don’t worry about them.

TL:DR

In short, most lumps and bumps on your baby’s head are normal. If you’re worried, bring your baby in to have your pediatrician look and feel.

Bumps, ridges, and soft spots on a baby's head is often normal - but when should you worry?
Bumps, ridges, and soft spots on a baby’s head is often normal – but when should you worry?

Author: DrStuppy

I am a pediatrician and mother of two teens. I have a passion for sharing health related information.

41 thoughts on “Bumps, ridges, and soft spots on a baby’s head. When should you worry?”

  1. I noticed my baby swells in the middle of the two eye blow (should I call it nasal bridge) am not sure how they call it but whenever she cries it swells as if there’s much meat there and it happened from birth,she’s now 3 years old but still happens is that normal????

    1. That is a question that is best answered by her doctor. Since it’s been there all her life, it is fine to wait until her next appointment unless it is getting worse. Make a note to bring it up at her next well child check!

  2. My child has been to the e.r, she has been seen by her pediatrician and has another appointment this friday. Its been about a month or so since i first noticed it, she has a solid disfigured lump on the back of her head that isnt moveable, as if it is a part of her skull. It appears that it has gotten much bigger since i first noticed it. She has another lump too, but this one you can kinda move around where as the other one you cant. I feel like 6 months is too long to wait to find out if she has something other then a swollen lymph node. I dont know what im asking exactly, i just want peace of mind and for these bumps to go away.

    1. It sounds like at least two physicians have already seen this and you’re doing a good job of being your child’s advocate. If you’re worried, you should bring it up again. If you get reassurance from multiple physicians, it is more likely something that you can continue to monitor. Without seeing your baby, I can’t offer any specific advice, but I’m glad you’re advocating for your baby!

  3. My son has like a thin long dent on the side of his head and it worrys me what can it be ? He has his soft spotvat the top of his head this is something diffrent.

  4. Hi I just discovered the lumps at around #8 as well. Was worried until I read this. But the lumps are on only on the right side and it’s 3. Is that normal? He doesn’t react when I press on them though, he’s 7months.

    1. If there aren’t other concerns, just show your doc the next time you’re in the office. If you’re worried, call your doctor’s office to discuss your concerns and see if you should have them checked out.

  5. Hi, thanks for this very useful blogs especially for us moms. I just gave birth last 26th Dec, and I found a very soft noticeable spot on the right part of my baby’s head, seems like it has water in it. I am very worried and scared, and tried to search online for some explanation and getting ready myself for our visit on Doctor tomorrow, I hope everything will be fine. In Gods name, amen.

        1. We all can get what my mom called “swollen glands” when we’re sick. The number doesn’t matter as much as all the symptoms. If he has a lot of pain or rapid swelling of the area, he should be seen. Any of the illness symptoms that concern you should be assessed, such as difficulty breathing or not drinking enough. You can always contact your doctor if you’re concerned. If you don’t have a doctor, call a nurse advice line.

  6. Thank you for this. I just found a small bump around #8 on my 14 month old daughter. It seems just to appear suddenly. She recently had a bad cold and still has. I can’t be sure if runny nose is the cold or a “symptom” of some sort. It moves around and it doesn’t seem to bother her warn I push on it. How long until these bumps go away on there own?

    1. Lymph nodes can remain for months, sometimes people will feel them for years. I always suggest showing them to your child’s doctor at her next routine visit and sooner if there are other concerns, such as fever, pain, increasing size, or just that parent’s intuition and worry!

  7. Hi!! My 3 month old just had a CT scan to rule out craniosynostosis and my pediatrician said it came back clear. But she has a ridge on her Sagittal suture and protruding forehead. How easy is it to see a Sagittal suture on a CT scan? And are ridges common still at 3 months?

    1. Hi! My 1yr old son has a ridge from his head down to his forehead. I noticed it since he was 4mos old i think. At first his pediatrician order to do CT but i was terrified and cried infront of him and he came back in a few mins and change his mind he said that lets monitor until 6mos and so after that he just required him to have a helmet beacuse of his flat spot and never do CT because his head size is normal. But until now he still has the ridge i cant help but worry everyday because i think its getting noticeable evrytime i look at him.. any advice? Thank you

    2. My son has staggial cranio CT is best option to diagnose cranio you can have ridges with sutures open hope this helps

    3. How did you make out? My 10 day old has a ridge in the same spot the pediatrician is watching it closely and will do x Ray’s if needed

  8. Thank you! I have made an appointment with our GP in 2 days, but reading this and knowing bubs has no showing symptoms has made me comfortable in my decision not to rush her to the ED.

  9. This helped so much. My 1 and a half month old daughter has 2 lumps around #8 on both sides, right and left. But after reading, I feel safe enough to wait until her next routinely check up to ask her pediatrician!

  10. My 10 month old daughter has a lump on the #8. Should I take her to the ER? It seems to bug her when I touch it & it kinda moves & she has a runny nose as well.

  11. oh my gosh my infant has 2 lumps on the occipital areeea. i am worried so much despite that we are financially unable to go see his doctor

    1. If the above images and description don’t answer your question, you should ask your pediatrician. Since I cannot see your baby, I cannot offer specific advice.

    1. If you’re worried, bring it up the next time you’re at the doctor’s office. If your baby has other concerning sympotoms or you are worrying a lot, schedule a visit soon to discuss it.

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