by Nicole Evans M.D.

Created on: June 06, 2009   Last Updated: January 21, 2010

Worried about that soft lump on your newborn infant's head? Noticing that your 3 month old baby's head seems disproportionately large? Concerned about the flat spot in the back of your 5 month old's skull or the bulging forehead in your 12 month old?

Here's an overview of the conditions that affect head shape in infants. Some of these conditions are completely benign but others can have disastrous consequences if they are ignored.

Keep in mind that you should be attending regular well-baby checks with your pediatrician. At these appointments, your doctor will chart your infant's head circumference, length and weight. It is important to know if your child is within the normal growth curves for his or her age, but it is also important for your doctor to see how quickly or slowly these parameters are changing in your infant.

When to worry about a large but normally-shaped head in an infant:

Babies have heads that are naturally large in proportion to the rest of their body. Your physician may start to worry if he or she notices that the head circumference growth curve is too steep, in other words your baby's head is growing too quickly, or the head circumference is so large that it's well off the growth charts.

This is concerning for hormone imbalances and for increasing intracranial pressure (skull deformities inhibiting flow of cerebral spinal fluid, benign or malignant brain tumors).

Remember that an infant with a head circumference that is consistently a bit off the growth chart may simply be part of a family with large heads. Take note of head or hat size in the parents, siblings and grandparents and you may find a comforting answer to your baby's large head.

When to worry about a soft lump or hard bump in a newborn infant:

Many infants who are delivered vaginally will have some superficial blood vessels break in their scalp. The blood gathers into a soft, raised bruise called a hematoma. The hematoma may disappear quickly or may first turn into a firm bump on the infant's head and then become smaller and smaller till gone.

A hematoma that results from vaginal delivery is a normal and safe condition for your newborn. The only complication may be a mild hyperbilirubinemia from the break down of the old blood. Your pediatrician may need to monitor your newborn's bilirubin levels.

When to worry about a misshapen head in an infant:

The most common cause of a misshapen head in a newborn infant is vaginal birth. The birthing process squeezes the skull,

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