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2 month old baby skull


Your Baby's Head - HealthyChildren.org

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​By Laura Jana, MD, FAAP & Jennifer Shu, MD, FAAP

Many parents have been mistakenly led to believe that all newborns are born picture-perfect, with pretty little round heads. Let us just say that for anyone who has gone through or will experience vaginal delivery, it is nothing short of a blessing that a baby’s skull is made up of soft bony plates that are capable of compressing and overlapping to fit through the narrow birth canal—a process referred to as molding.

Shaping up


For some babies—such as those who "drop" well in advance of being born (in other words, settle themselves head first deep into their mother’s pelvis well in advance of delivery), or those who must endure long labors and narrow birth canals—the result is often a newborn head shape that more closely resembles a cone than a nice round ball.

If you run your fingers over your newborn’s skull, you may also find that you can feel ridges along the areas where the bony plates of the skull have overlapped. In short, slightly misshapen heads are quite common right after birth. 

Fortunately, over the next several weeks the bones of your baby’s skull will almost assuredly round out and the ridges will disappear—assuming, that is, that your baby doesn’t spend too much time on their back with his head in any one position. This is a common but easily avoidable cause for the development of a flat back or side of the head known as plagiocephaly.

The soft spot

You will notice one to two areas on your baby’s head that seem to be lacking bony protection. These soft spots, referred to as fontanelles (anterior for the larger one in the front, posterior for the smaller and typically less noticeable one in the back), are normal gaps in a newborn’s skull that will allow your baby’s brain to grow rapidly throughout the next year.

Many parents are afraid to touch these soft spots, but you can rest assured that, despite their lack of a bony layer, they are well protected from typical day-to-day baby handling. Other things to know about the soft spot(s) include:

  • In young infants, a sunken soft spot (when combined with poor feeding and dry diapers) can suggest dehydration. Our advice to you: Don’t read too much into this because it can be a subtle finding or sometimes be present in normal babies. Instead, make sure you have a good grasp on how to recognize dehydration and check with your doctor if you have any concerns—with or without a sunken soft spot.
  • In some instances, the soft spot on the top of your baby’s head may seem to be pulsating. There is no need to worry—this movement is quite normal and simply reflects the visible pulsing of blood that corresponds to your baby’s heartbeat.

Bumps & bruises

In addition to molding, a bit of swelling or bruising of the scalp immediately following delivery is not uncommon for newborns. The swelling usually is most noticeable at the top back part of the head and is medically referred to as a caput (short for caput succedaneum). When bruising of the head occurs during delivery, the result can be a boggy-feeling area, called a cephalohematoma.

Bruising and swelling are usually harmless and go away on their own over the first days and weeks, but can be a contributing factor for jaundice.

Gone today, but hair tomorrow

Sure, babies are sometimes born with full heads of hair, but it’s far more likely for them to be born with little to none. And those with hair today are likely to find it gone tomorrow. That’s because any hair your baby is born with is likely to thin out significantly over the next few months before ultimately being replaced with "real" hair. It is also entirely possible that whatever hair your newborn does have will change color by several shades and several times over their lifetime.

More information


  • How Your Newborn Looks
  • Uneven Head Shape in Babies: Causes and Treatment of Craniosynostosis

About Dr.

Jana

Laura A. Jana, MD, FAAP, is a pediatrician and mother of 3 with a faculty appointment at the Penn State University Edna Bennett Pierce Prevention Research Center. She is the author of more than 30 parenting and children's books and serves as an early childhood expert/contributor for organizations including the Maternal and Child Health Bureau, Primrose Schools, and US News & World Report. She lives in Omaha, NE.

About Dr. Shu

Jennifer Shu, MD, FAAP serves as the medical editor of HealthyChildren.org and provides oversight and direction for the site in conjunction with the staff editor. Dr. Shu is a practicing pediatrician at Children's Medical Group in Atlanta, Georgia, and she is also a mom. She earned her medical degree at the Medical College of Virginia in Richmond and specialized in pediatrics at the University of California, San Francisco. Her experience includes working in private practice, as well as working in an academic medical center. She served as director of the normal newborn nursery at Dartmouth-Hitchcock Medical Center in New Hampshire. Dr. Shu is also co-author of Food Fights and Heading Home with Your Newborn published by the American Academy of Pediatrics.

Last Updated
12/31/2021
Source
Heading Home With Your Newborn, 4th Edition (Copyright 2020 American Academy of Pediatrics)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

About the fontanelle | Pregnancy Birth and Baby

About the fontanelle | Pregnancy Birth and Baby beginning of content

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What is a fontanelle?

A fontanelle is a ‘soft spot’ of a newborn baby’s skull. It is a unique feature that is important for the normal growth and development of your baby’s brain and skull. Your health team will check your baby’s fontanelles during routine visits.

If you touch the top of your baby’s head you can feel a soft spot in between the bones — this is a fontanelle.

A newborn baby’s skull is made up of sections of bone known as plates that are joined together by fibrous joints called sutures. The sutures provide some flexibility and allow your baby’s head to narrow slightly as it travels through the birth canal. The sutures also enable your baby’s head to grow in the first years of life.

There are 2 fontanelles on your baby’s skull. These are the skin-covered gaps where the skull plates meet. The anterior fontanelle is at the top of your baby’s head, and the posterior fontanelle is located at the back of your baby’s head.

Illustration showing the anterior and posterior (front and back) fontanelles of a baby's skull.

When will my baby’s fontanelles close?

The posterior fontanelle usually closes by the time your baby is 2 months old. The anterior fontanelle can close any time between 4 and 26 months of age. Around 1 in every 2 babies will have a closed fontanelle by the time they are 14 months old.

Can I touch my baby’s fontanelles?

Yes, you can gently touch your baby’s fontanelles. If you run your fingers softly along your baby’s head you are can probably feel them. Your doctor will touch your baby’s fontanelles as part of their routine medical examination. There is no need to be concerned or worried about touching your baby’s fontanelles as long as you are gentle.

What does a normal fontanelle look like?

Your baby’s fontanelle should feel soft and flat. If you softly touch a fontanelle, you may at times feel a slight pulsation — this is normal. If a fontanelle changes, or feels different to how it usually does, show your doctor or midwife as it may be a sign that your baby’s health may need to be checked.

Sunken fontanelle

If you notice that your baby’s fontanelles are low or sunken, your baby may be dehydrated.

However, you may notice other signs of dehydration in your baby before their fontanelles becomes sunken.

Other signs of dehydration include:

  • having fewer wet nappies
  • not feeding well
  • loosing fluids from vomiting or diarrhoea
  • perspiration (or sweating) in very hot weather
  • being less alert or floppy

Bulging fontanelle

A bulging or swollen fontanelle may be a sign of a number of serious but rare conditions including meningitis or encephalitis (infections in the brain), cerebral haemorrhage (bleeding in the brain), hydrocephalus, an abscess or another cause of increased pressure in the brain.

If you think that your baby’s fontanelles are bulging or sunken, seek medical advice immediately.

What if a fontanelle closes too soon?

Your baby’s fontanelles may close early. This can happen for several reasons. Your baby may have hyperthyroidism (high levels of the thyroid hormone) or hyperparathyroidism (high levels of parathyroid hormone). Another cause of early fontanelle closure is a condition known as craniosynostosis. Craniosynostosis occurs when one or more of the fibrous joints (sutures) between the bone plates in a baby’s skull fuse too early, before the brain has finished growing. As the brain continues to grow, it pushes on the skull from the inside but cannot expand into the closed over area. This causes the skull to have an unusual shape.

If you notice that your baby’s fontanelles seem to have closed early, if you can feel a ridge along your baby’s skull, or if you think that your baby’s head has an unusual shape, take your baby to see their GP or paediatrician.

What if a fontanelle doesn’t close?

Your baby’s fontanelles may not close on time for several reasons. Common reasons for delayed fontanelle closure include congenital hypothyroidism (low thyroid hormones from birth), Down syndrome, increased pressure inside the brain, rickets and familial macrocephaly (a genetic tendency to have a large head).

If one or both of your baby’s fontanelles haves not closed by the time they are 2 years old, speak to your GP or paediatrician.

If you have any concerns about your baby’s fontanelles you should make an appointment to see your child health nurse, GP or paediatrician.

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

Sources:
Children’s Health Queensland Hospital and Health Service (Craniosynostosis), American Family Physician (The Abnormal Fontanel), Australian Family Physician (The 6 week check - An opportunity for continuity of care), WA Health (Bulging Anterior Fontanelle), The Royal Children's Hospital Melbourne (Clinical Practice Guidelines: Dehydration)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: February 2022


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