Baby soft spot not closing
About the fontanelle | Pregnancy Birth and Baby
About the fontanelle | Pregnancy Birth and Baby beginning of content5-minute read
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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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5 Warning Signs From Your Baby’s Soft Spot – Cleveland Clinic
When you’re a new parent, you learn that you need to protect that soft spot, or fontanelle, on your baby’s head.
It rarely requires much attention, but it reminds you just how fragile your infant is.
That’s why, if something changes — is the soft spot sunken in a little? — you may worry there’s something wrong.
A change in the fontanelle isn’t always a major problem, but it can sometimes reveal internal issues, says Violette Recinos, MD, Section Head of Pediatric Neurosurgery at Cleveland Clinic.
“It is a good indicator of the baby’s potential hydration status and brain status,” she says. “It’s like an automatic pressure sensor.”
What is the fontanelle?
The fontanelle is the space between different plates of a baby’s skull that will eventually come together. This aspect of an infant’s skull structure typically allows for easy delivery through the birth canal and for rapid head growth during the first year of life, Dr. Recinos says.
There are actually two soft spots — one at the back of the head and another on top. The posterior one closes within a few months of birth, while the top fontanelle typically remains until just past a child’s first birthday.
Dr. Recinos explains what changes in the fontanelle can tell you about your infant’s health.
Sunken in soft spot
This is often a sign of dehydration, she says. It may occur if your child is sick and not getting enough fluids.
What you should do: See your pediatrician if the sunken appearance persists and you can’t get your baby to take in more fluids.
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Swollen soft spot
After a fall, a swollen soft spot (particularly if it’s accompanied by vomiting) is sometimes a sign of head trauma.
What you should do: Seek medical treatment right away.
Bulging soft spot
Fluid buildup (hydrocephalus) can cause rapid head growth and can make the soft spot look “full,” Dr. Recinos says.
A bulging fontanelle also might signal internal bleeding or a tumor or mass causing pressure in the head.
What you should do: If their soft spot is bulging, that’s a reason to seek care from your pediatrician, she says.
Seek emergency care if your infant exhibits fatigue, vomiting or unusual mental status along with the fontanelle’s fullness. Treatment for these conditions may include surgery to insert a shunt that relieves fluid buildup or to remove any underlying mass, Dr. Recinos says.
Disappearing soft spot
Most of the time the soft spot is obvious, particularly on a newborn. But at times it can seem to disappear quickly.
This may scare parents, but it typically means it’s just a “quiet fontanelle,” not that it has fused together prematurely, Dr. Recinos says.
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As long as your child’s head is growing normally, all is probably well, she says. But your pediatrician may suggest an imaging test to make sure the fontanelle is still open.
Occasionally, though, the skull bones do close earlier than normal on one side, causing craniosynostosis. Depending on which bones fused, the baby may develop an abnormal head shape. For example, sagittal craniosynostosis, the most common form, results in a longer head that is shaped somewhat like a football.
What you should do: Children with craniosynostosis may need surgery to open the fused bones and reshape the skull. In some cases, the child will wear a helmet afterward until the site heals and the head shape normalizes.
Soft spot that doesn’t close
If the soft spot stays big or doesn’t close after about a year, it is sometimes a sign of a genetic condition such as congenital hypothyroidism.
What you should do: Talk to your doctor about treatment options.
The bottom line? If you have any questions or concerns about your baby’s soft spot, it’s a good idea to check in with your pediatrician to make sure all is well.
Large fontanel in newborns. Examination IPM Clinic for Children Krasnoyarsk
The birth of a baby is a very important and joyful event in the life of young parents. After birth, there are a lot of questions about the health, care and proper development of the baby.
The very first questions are often asked about the fontanel.
Fontanelle - soft, non-ossified area of the cranial vault of newborn babies, consisting of the remnants of the membranous skeleton and connecting the bones of the skull. In the area of the fontanelles, a pulsation of the arteries of the brain and membranes is felt, which is why these areas are called pulsating, gushing. Fontanelles allow you to “compress” the cranial vault during childbirth for a better passage of the baby through the birth canal. Four of them close in the first days of a child's life, the fifth in the second month of life, and the sixth, the largest (anterior), closes from 3 to 24 or more months. Very often, fontanelles and the pace of their closure cause great concern to parents.
Role of the fontanel:
- The growth of the skull bones depends on the growth of the brain. The fontanelles provide elasticity to the skull during the most rapid growth. This period is from birth to two years of a child's life.
- Fontanelles also protect the baby's skull from injury: upon impact, the possibility of elastic deformation of the skull remains, which extinguishes all the kinetic energy of the blow and protects the child.
- The brain of a newborn baby is very sensitive to overheating, and a kind of natural “window” brings excess heat out and naturally cools the meninges, thereby playing an important role in the processes of heat transfer and thermoregulation of the body.
The size of the anterior (large) fontanel varies greatly. On average, the normal size of the fontanel at birth is 3.0 * 2.5 cm, it has a diamond shape.
With active growth and constant development of the baby, the free space between the bones gradually hardens and decreases in size, the pulsation becomes almost imperceptible.
Timing of fontanel closure may vary. On average, complete closure occurs by the year (normally also up to two years).
When the fontanel closes too slowly, the parents start to worry.
But premature closure also does not speak well.
Causes of the “big” fontanel:
- Achondroplasia (hereditary disease)
- Down Syndrome
- Hydrocephalus
- Premature birth
- Neonatal Hyphyeriosis
- RACHIT 9000,0006 RACHITS is one of the most common causes slow closure of the fontanel. Most often, rickets develops in premature babies and in children who do not receive preventive treatment with vitamin D. In a child with rickets, the edges of a large fontanel are flexible, the back of the head flattens, and characteristic bone thickenings form on both sides of the sternum.
The change in the appearance of the fontanel also indicates a number of certain problems:
- Furious fontignant occurs against the background of
- an increase in temperature to febrile numbers
- multiple vomiting
- diarrhea
- Burring of the native nourish
- meningitis
- encephalitis
- intracranial bleeding
- increased intracranial pressure
Many factors are affected by the Rodnichka:
- for mom:
- a balanced diet
- sufficient intake of calcium in the body
- polyvitamin complexes
- for the child:
- prescription of vitamin D 9000
— sunbathing
Dispensary examination of a child under one year old allows the pediatrician to examine the baby every month.
During the examination, a complete examination of the child is carried out, weighing, measuring height, head and chest circumference. The size of the large fontanel is also measured.
Be healthy!
Phone number for making an appointment with a pediatrician (391) 200-50-03
everything you need to know about fontanelles in newborns and children - Children - tsn.ua
they are a little worried: how to do everything correctly and accurately, without injuring the fragile bones of the baby? They are especially afraid of washing the head of the baby and combing the hair because of the fontanel. Maya Smolyar, head of the department of post-intensive nursing of premature newborns of the Zhytomyr Regional Perinatal Center, spoke about whether special care is needed for the fontanel and what changes in it should alert.
What is the fontanelle and what is it for
The fontanel is that part of the child's head where there is temporarily no complete ossification.
The largest fontanel is on the crown, where the bones do not converge together, leaving a diamond-shaped area. Physiologically, the child is designed so that during childbirth, these bones of the skull are slightly deformed, allowing the fetal head to pass through the birth canal. In addition, the fontanel is a kind of reserve, due to which the brain of a newborn child will then grow.
Normally, a child has 6 fontanelles. The largest is located on the crown, the second largest is the occipital, it is typical for premature babies. The smallest are located on the sides of the cranium.
When do fontanelles overgrow?
At the time of birth, a full-term baby has only one large fontanel on the crown of the head. All others must be closed. In extreme cases, traces of the occipital fontanel may remain, which should close within the first month. And the lateral fontanelles must be overgrown by the time of birth.
When does the parietal fontanel close?
Normally, a large fontanel closes in the period from one to 1.
5 years. If the closure occurs earlier, for example, at 6-8 months, then this may be a normal variant or a family predisposition, but this should be paid attention to and consulted with a pediatrician. Premature closure of the fontanel may indicate the manifestation of certain problems.
What should I do if the fontanel actively pulsates or sinks?
If the child's parietal fontanel pulsates when crying, you should not pay attention to it, but if the pulsation is noticeable in the child's calm state or during sleep, then you need to contact a pediatrician, who will refer you to a pediatric neurologist. Most likely, the child has increased intracranial pressure, or the so-called hydrocephalic syndrome.
Sometimes, the fontanel, on the contrary, sinks inward. This can only happen in children of the first month of life. And if it sinks after the first month, then this indicates that the child has lost fluid with diarrhea or is not eating enough. Parents should know that a normal fontanel should be at the level of the skull bones.
