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Home > Birth Injury Overview > Infant Skull Fracture > Infant Skull Fracture Causes
Last Updated: April 18, 2025

Infant Skull Fracture Causes

Page Medically Reviewed and Edited by Pierrette Mimi Poinsett, M.D.
Page Medically Reviewed and Edited by Pierrette Mimi Poinsett, M.D.

This article has been fact checked by a Board Certified Pediatrician. Sources of information for the article are listed at the bottom.

For any content issues please Contact Us.

Infant skull fracture causes include the use of instruments and excessive force during labor and delivery. Other possible causes are pressures from inside the womb, more likely if the baby is large or labor is long and difficult. Trauma caused by mishandling or abusing an infant can also result in a skull fracture.[1]

What Causes Infant Skull Fractures?

An infant’s skull can be fractured during labor and delivery by:

  • A difficult, prolonged labor
  • Natural pressure in the birth canal
  • Instruments, like forceps or vacuum extractors
  • Accidents that occur after labor and delivery

Infant skull fractures can result from medical negligence and malpractice.

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The Infant Skull

Babies are born with skulls that are still soft and not yet stitched together completely. This flexibility in the skull allows babies to fit through the birth canal with less risk of damage to the bone, but also allows for growth as the child ages.

The infant skull consists of several plates held together by sutures. The sutures are fibrous and flexible, allowing the plates to move and the skull to expand as it grows.

Although an infant’s soft skull helps it come through vaginal delivery with a lower risk of harm and injury, it is still vulnerable. Infants are more susceptible to fractures and resulting damage to the brain than the skull of an older child or an adult.

Fractures to the infant skull may be one of several types:[2]

  • A linear fracture is a simple split in the bone, but it does not lead to movement between the skull plates.
  • A basal fracture occurs at the base of the skull and can cause significant complications.
  • A depressed skull fracture occurs with an injury that causes an indentation in the skull. This can potentially cause serious injury to the brain.
  • A diastatic fracture is a separation along a suture, which can cause injury as a child’s brain grows and the skull and the fracture expand.

Symptoms of a skull fracture in an infant may be obvious or subtle. Any signs should be taken seriously, as the prognosis for this injury is better with immediate treatment.

Skull Damage Caused by Instruments

The most common cause of infant skull fractures is pressure from instruments used during childbirth. Doctors and others may use forceps or vacuum extractors to aid in delivering a baby.

A doctor may use forceps to grip the baby’s head and pull it from the womb. When used with too much force, this can crush or break the skull.

A vacuum extractor may have the same impact, although it pulls on the baby by suction. Either kind of force, when used excessively, can fracture the skull.

Natural Infant Skull Fracture Causes

Instruments are overwhelmingly the leading cause of fractures in infant skulls. These are often considered negligent or malpractice, even if the doctor tried to help. On the other hand, the skull can fracture naturally, with or without the use of instruments.

Delivery and birth are fraught with risks despite modern advances in obstetrics. The physical pressure that an infant is under during labor and delivery can be intense.

If the head of the baby is caught in the mother’s pelvis or gets stuck in the birth canal, that natural pressure may cause a skull fracture.[3]

Complicated Labor and Skull Fractures

Long and complicated labor is a common risk factor for an infant skull fracture. If labor is difficult, it is more likely that the doctor or other medical practitioners will use instruments. Using instruments automatically increases the risk that a baby will suffer a fracture.

Even if the doctor is not using instruments, they may feel pressured to get the baby delivered as soon as possible when there are complications.

For instance, if the doctor believes the baby is asphyxiating, they must act quickly. This rushed and forced delivery may lead to a skull fracture.

Unusual Presentation and Birth Weight

Specific complications of labor and delivery can also cause a skull fracture or lead to conditions in which a doctor may use instruments that can cause fractures.

For instance, if the baby is breech, with its bottom or legs emerging from the birth canal first, or if the baby is unusually large, labor is more complicated. Both the breech position and a large head can put more pressure on a baby’s skull and increase the risk of a fracture.

Spontaneous Skull Fractures

Although rare, a skull fracture may occur during what seems to be a standard delivery in which the use of instruments is not required. One case study described a woman who had a normal, uncomplicated delivery. She delivered a baby that, after two hours, appeared to be listless.[4]

The examination found that the baby had a hematoma, or a pooling of blood in a part of the brain caused by a minor linear fracture in the skull. The baby died a few days later from complications. Doctors could not determine the cause of the fracture.

Skull Fractures after Delivery

Newborn babies are very delicate and vulnerable to injury. If they are mishandled or even abused, injuries are likely, including skull fractures.

A nurse or other hospital worker may accidentally drop a baby, which can cause severe skull damage. Abuse, such as shaking or striking a crying baby, can also cause a skull fracture.

What Are My Legal Options if My Child Was Born With a Skull Fracture?

If you have a baby born with a skull fracture or who received a skull fracture in the hospital after birth, you have legal options to seek justice and compensation for your child. Infant skull fracture causes vary but often result from inappropriate use of instruments during delivery.

If your doctor or other caregiver fractured your infant’s skull in such a way that could have been prevented, you might have a solid case to sue and recover monetary damages.

The consequences for your baby with a skull fracture may range from mild to severe. Your baby may have permanent brain damage and other complications that will affect her for the rest of their life. They will need extra care and treatment and possibly even surgery to correct the damage.

Not many families can afford the extensive care needed for a disabled child, but you can file a lawsuit.  A successful lawsuit can help you get compensation for your child’s treatments and ongoing care.

You’ll be making a case that your healthcare providers were negligent and requesting a settlement. Let an experienced lawyer in medical malpractice and birth injuries help you make a case and fight the hospital that harmed your baby.

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References

  1. Ciurea, A.V., Gorgon, M.R., Tascu, A., Sandu, A.M., and Rizea, R.E. (2011, August 15). Traumatic Brain Injury in Infants and Toddlers, 0-3 Years Old. J. Med. Life. 4(3), 234-43.
    Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168813/
  2. McGrath, A. and Taylor, R.S. (2023, January 23). Pediatric Skull Fractures. StatPearls National Institutes of Health.
    Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK482218/
  3. Oh, C.K. and Yoon, S.H. (2010, May). The Significance of Incomplete Skull Fracture in the Birth Injury. Med. Hypotheses. 74(5), 898-900.
    Retrieved from: https://pubmed.ncbi.nlm.nih.gov/20005051/
  4. Acevedo, M., Ojeda, V. Kim, Y., Meislin, R., Bautista, J., and Tsai, M.C. (2014, September 8). Spontaneous Fetal Skull Fracture in an Apparently Uncomplicated Vaginal Delivery. Austin J. Obstet. Gynecol. 1(4), 2.
    Retrieved from: https://austinpublishinggroup.com/obstetrics-gynecology/fulltext/ajog-v1-id1020.php
View All References
Page Medically Reviewed and Edited by Pierrette Mimi Poinsett, M.D.

Page Medically Reviewed and Edited by Pierrette Mimi Poinsett, M.D.

Dr. Poinsett is a board certified pediatrician. She is a graduate of The University of Chicago, Pritzker School of Medicine, and has over 20 years of clinical experience. She has extensive experience in the case management of children with special mental health and physical health care needs, including developmental disabilities.

See Full Bio

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