Which swelling crosses suture lines in a newborn?

• A. Cephalohematoma crosses sutures.
• B. Caput succedaneum crosses sutures.
• C. Molding crosses sutures.
• D. Bulging fontanel crosses sutures.

Answer: (B)

When assessing newborn scalp swellings, where the swelling lies relative to the skull bones matters: soft-tissue edema will cross suture lines, while a bleed between bone and periosteum will stay confined by sutures. Caput succedaneum is diffuse edema of the scalp from labor pressure that spreads over the scalp and crosses sutures, so it appears as generalized swelling across the head and is common at birth, typically resolving in a day or two. Cephalohematoma is a subperiosteal bleed that remains limited by the sutures and does not cross them, often appearing after birth and resolving slowly over weeks to months. Molding refers to temporary overlapping of the cranial bones from birth trauma and is not a true swelling across sutures. A bulging fontanel indicates increased intracranial pressure rather than a scalp swelling. Caput succedaneum crossing sutures is the best match.