Dehydration baby soft spot

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.

Sunken Fontanelles: Causes, Diagnosis and Treatments

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Medically reviewed by Karen Gill, M. D. — By Krista O'Connell on February 29, 2016

What is a sunken fontanel?

A baby is born with several fontanels. These are more commonly known as soft spots. They provide the skull with the flexibility needed to pass through the birth canal. This flexibility also allows your baby’s brain and skull to grow during the first year of life. In newborns, soft spots are found on the top, back, and sides of the head.

The number of soft spots on your baby’s head depends on their age. The fontanel on the back of the head usually disappears by 1 to 2 months of age. You may never be able to feel or see this one. The one on the top of the head remains present until your baby is between 7 and 19 months old.

A baby’s soft spots should be relatively firm and curve ever so slightly inward. A soft spot with a noticeable inward curve is known as a sunken fontanel.

This condition requires immediate medical attention. It’s usually easy to treat.

What causes a sunken fontanel?

There are several potential causes of sunken fontanel.

Dehydration: Dehydration takes place when your body loses more fluid than you drink. The most common cause of water loss from the body is excessive sweating. Read more about dehydration here. This condition is considered a medical emergency. Urgent care may be required.
Kwashiorkor: Kwashiorkor is a serious form of malnutrition caused by a lack of protein. Learn how to spot this condition and how to prevent it.
Failure to thrive: A child is said to have failure to thrive when they don’t meet recognized standards of growth. Find out more about how failure to thrive is defined and treated here.
Toxic megacolon: Toxic megacolon is a rare, life-threatening widening of the large intestine and is usually a complication of inflammatory bowel disease (IBD). Learn about the symptoms, diagnosis, and treatment of toxic megacolon here. This condition is considered a medical emergency. Urgent care may be required.
Diabetes insipidus: Diabetes insipidus (DI) is not a form of diabetes. Instead, it’s a rare condition that occurs when your kidneys are not able to conserve water. Find out how this condition is diagnosed and treated.

How is a sunken fontanel diagnosed?

If your baby has a sunken fontanel, you should seek medical attention as soon as possible. This isn’t a symptom you should try to treat at home.

When the doctor examines your baby, they’ll first do a physical examination. This includes looking at and feeling the affected area. The doctor will also likely assess your baby’s skin elasticity, or turgor. Poor elasticity can also be a sign of low fluid levels. The amount of moisture in the eyes and mouth can also provide clues about your baby’s level of hydration.

Second, the doctor will ask you about your baby’s symptoms. It’s important to provide as much information as possible. The doctor will likely want to know when the problem appeared and how you would rank the severity of the symptom considering the normal appearance of your baby’s soft spots. Note whether the baby has been sick recently or if the baby recently had any bouts of vomiting or diarrhea. Tell the doctor if there was a recent period during which your baby perspired more than usual, if your baby seems thirsty, and whether your baby’s level of alertness seems normal.

The doctor may then order one or more tests. These might involve taking a blood or urine sample. Specific tests may include a complete blood count (CBC). This blood test measures the number of red and white blood cells as well as their components to detect infection or anemia, which can occur with dehydration. A urinalysis involves a number of tests to check urine for abnormalities that might indicate dehydration.

Another test you may need is a comprehensive metabolic panel. This blood analysis involves a number of tests that assess how well various chemicals in the body are breaking down and using food. It can help detect malnutrition.

What are the treatment options for a sunken fontanel?

If dehydration is the confirmed cause of a sunken fontanel, your baby will either receive fluids by mouth if they aren’t vomiting and are alert or through an intravenous (IV) line inserted into their arm. This will likely bring fluid levels in the body back up to where they should be. If malnutrition is the cause, your baby will likely receive oral or IV nutrients as well as fluids.

How can I prevent a sunken fontanel?

The best way to prevent a sunken fontanel is to prevent the most common cause of it, which is dehydration. Some tips to prevent dehydration include giving your child adequate amounts of fluids and seeking medical help if you have a sick baby who you believe is in danger of becoming dehydrated. You should also increase the amount of fluids given as soon as your baby vomits or has diarrhea.

Check with your child’s doctor if you have questions about breast-feeding or how much formula to give your baby. Talk to your doctor if you’re breast-feeding and you think you might have trouble with your breast-milk supply. You can also contact breast-feeding support groups or explore the option of supplementing your breast-milk supply with formula.

Last medically reviewed on March 1, 2016

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How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Anatomy of the newborn skull. (n.d.)
chw.org/medical-care/craniofacial-disorders/craniofacial-disorder-conditions/craniofacial-anomalies/anatomy-of-the-newborn-skull/
Dehydration. (2015, April 13)
nhs.uk/Conditions/Dehydration/Pages/Introduction.aspx
Kiesler, J., & Ricer, R. (2003, June 15). The abnormal fontanel. American Family Physician, 67(12), 2547–2552
aafp.org/afp/2003/0615/p2547.html

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Mar 1, 2016

Written By

Krista O'Connell

Edited By

Nizam Khan (TechSpace)

Medically Reviewed By

Karen Richardson Gill, MD

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Medically reviewed by Karen Gill, M. D. — By Krista O'Connell on February 29, 2016

Dehydration in a child: symptoms and prevention

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Dehydration in a child: symptoms and prevention

Dehydration is a pathological condition in which the body loses fluid and, along with it, salts and minerals. Infants and young children are especially at risk of dehydration because they lose fluid faster than adults. nine0014

Causes of dehydration

1. Difficulty in the flow of fluid into the body. This situation is rare. This may be the refusal of the child to drink liquid, for example, due to pain when swallowing. Or these are severe pathological conditions in which the child cannot swallow on his own.

2. Increased excretion of water and minerals by the body, when the loss of fluid exceeds its intake. This situation is observed in acute infections, food poisoning, parasitic damage, overheating, burns. nine0003

Signs of dehydration in a child: dry mucous membranes, shallow breathing, rapid pulse, low blood pressure, lethargy and irritability; decreased frequency of urination, deformation of the fontanel, lack of tears when crying.

Dehydration is a very dangerous condition, especially for children. Its most common cause is a viral infection with the following manifestations: high fever, loss of appetite, loose stools, vomiting.

In many cases, the infection is caused by rotaviruses.

Dehydration can also be the result of the formation of wounds in the child's mouth, because they are also the result of the entry of the virus into the body. Painful mouth ulcers make it difficult for a child to eat and drink normally. Dehydration can also occur as a result of intense sweating, so on hot days you should make sure that the child consumes more fluids than usual. Always carry a bottle of water with you. nine0003

2. Symptoms of dehydration in children

The first symptoms of dehydration in infants and children are as follows: chills, weakness, crying without tears, dry mouth. In severe cases, symptoms include dry skin, a change in the smell and color of urine, and a decrease in the amount of urination. Having recognized these symptoms, it is worth thinking about how to restore the water balance of the body as soon as possible.

How to quench a child's thirst?

Water

Pediatricians always recommend water to quench your thirst. Drinking water will not cause a child to lose their appetite and will not have problems with tooth decay and obesity in the future, unlike the consequences of drinking sugary drinks. nine0003

A baby only needs a few teaspoons of water a day. When he shows that he is no longer thirsty, stop the process and give the next dose in a few hours.

The water given to the child should be boiled and cooled. Even tap water filtered with special filters is not suitable for direct consumption by a child, as it contains many chemicals and metals that can be harmful to health.

Teas nine0003

Teas are also recommended for children, but only in small amounts, as babies often like the sweetened drink. You can also give your child juices, preferably diluted 1:1 with water. The most useful are low-sugar juices containing pulp, without dyes and preservatives. They are meant to be safe for children to consume.

How to avoid dehydration?

If you have already experienced the annoying problem of dehydration in your child, do not rush to panic! Read the detailed description of actions on how to avoid this phenomenon. nine0003

Give your child a small amount of water several times a day

Breastfeed your baby more often, especially in hot weather

Use drinking water, chamomile tea and light fruit infusions

Check the temperature of drinks before serving it to the child - it should be at room temperature

Remember that hot days can be dangerous not only for your baby, but also for you. At this time, be sure to have a bottle of water with you separately for yourself and your baby. When a child's dehydration is so severe that he looks visibly weak and lethargic, see a doctor as soon as possible. nine0003

In extreme cases of dehydration (accompanied by fever and diarrhoea), we are talking about inpatient treatment and the installation of a dropper under the supervision of doctors

What Diet Should You Follow During Dehydration?

The most important rule during dehydration is the constant filling of the body with fluid. Not only oral rehydration fluids play a key role in solving this problem, but also some changes in the diet.

Fruits and vegetables are best for consumption. Liquid products are also ideal.

It is very important to provide the child's body with the necessary nutrients that enter it with food. Your baby's diet should be free of complex carbohydrates (potatoes, rice, whole wheat bread, cereals), lean meats, and yogurt. The diet should be appropriate for the age of the child.

Prevention of conditions that contribute to dehydration.

First of all, you need to try to protect the baby from intestinal infections. Vaccination is a specific preventive measure. A vaccine against rotavirus infection has now been developed. It is administered to a child from 2 to 8 months of age three times. And it protects the baby's body in 85% of cases from infection and in 100% of cases from a severe course. nine0003

Nonspecific prevention of intestinal infection is the observance of hygiene measures: frequent hand washing, reducing contact with sick children.

If the infection could not be avoided, then the child should be shown to the pediatrician. And start to solder with water on your own, even before the doctor arrives.

Dehydration in children: how to prevent and recognize

Why are children at risk and more likely to become dehydrated?

Children, along with the elderly, are at risk and more than susceptible to getting dehydrated due to a combination of several factors:

First because they are a group of people who older adults are more likely to suffer from infections, which can cause fever and gastrointestinal symptoms such as vomiting or diarrhea that lead to fluid loss in the body. However, dehydration can occur not only with gastroenteritis, but with other infections, such as respiratory (colds, sinusitis, pneumonia, bronchitis) or urinary tract infections. nine0003

Second , because in the child's body a higher percentage of water . In a newborn, for example, about 70% of his body weight is water. This percentage gradually decreases as the child grows up, until it reaches 50-60% in adulthood, depending on age and gender.

Thirdly, , because with a smaller body volume, the ratio between body surface and weight is higher than . This means that in children, the loss of moisture through the skin and mucous membranes by evaporation is proportionally greater than in adults. nine0003

It should also be added that the compensation mechanisms that the body starts when it begins to lose moisture, more are underdeveloped at an early age of life. The ability to concentrate urine and thereby reduce water loss is less in a newborn than in a school-age child or adult, making young children more vulnerable in these situations.

Finally, in the case of young children, they have limited access to fluids because they0093 cannot drink on their own and depend on adults to provide them with water to drink in situations of dehydration due to illness or hot weather.

Thus, newborns and infants are most at risk of dehydration.

Dehydration and medications for chronic conditions

Although children often need to take medications for chronic illnesses, be aware that some medications can exacerbate symptoms of dehydration . An obvious example of this type of drug is the diuretics (furosemide, spironolactone...) which increase the loss of water through the urine to compensate for problems with the heart, kidneys, etc.

It should also be taken into account that if a child is taking any medications for chronic diseases, their blood levels, as well as their therapeutic effects (both beneficial and adverse), may temporarily change when a situation of dehydration occurs. This does not mean that we should be worried, but we should consider it, for example, in the case of children receiving antiepileptic drugs , since in a situation of dehydration, the drugs will no longer work and the epilepsy may temporarily decompensate.

What are the symptoms of dehydration?

On the one hand, symptoms are associated with the loss of fluid and electrolytes (mineral salts), and on the other hand, with compensation mechanisms that the body triggers to restore the loss of moisture. Some of the symptoms of dehydration: it is important to see a doctor as soon as possible .

How can dehydration be prevented?

In the situations of symptoms described above (fever, vomiting, diarrhea), it is very important to offer the child plenty of fluids to maintain a normal state of hydration. In addition to water, the liquid you offer your child should contain glucose (sugar) and mineral salts because not only water is lost during vomiting and diarrhea, but also sugar and minerals such as sodium, potassium and chlorine. These substances are vital for maintaining the functioning of the organs and systems of our body. Often their levels change in situations of dehydration (hyper or hyponatremia, hypoglycemia ...), which can aggravate the symptoms of the disease. Therefore , it is recommended to replenish fluid loss by using oral rehydration serum , which can be purchased at pharmacies.

In other situations where the loss of moisture in the body is increased due to perspiration, such as during summer and during prolonged physical activity, it is recommended to use water as the main rehydrator , accompanied by foods that contain carbohydrates, mineral salts and water, such as like fruits.