Fontanelle on baby head
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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Baby Soft Spot: How to Care for Your Baby’s Head
As you spend hours gazing at your newborn and stroking his face, you’ll no doubt notice a couple of soft spots on his head.
These soft spots, called fontanelles, are perfectly normal and actually play an important role in your baby’s development.
Learn more about these soft spots, including how to protect them, when the bones of the skull will harden, and which warning signs to look out for by reading on.
What Are Baby Soft Spots and Where Are They?
All babies are born with two soft spots (fontanelles) on their heads: The larger soft spot (anterior fontanelle) is toward the front of the head, and the smaller soft spot (posterior fontanelle) is toward the back.
These softer areas are made up of immature skull bones that are still forming and expanding as your baby’s brain grows.
Why Do Babies Have Soft Spots?
The soft spots on babies' heads have two main functions:
They make it possible for the bony plates of the skull to compress and overlap as the head passes through the narrow birth canal during a vaginal delivery
They allow a baby’s skull to expand, making room for the rapid brain growth that happens in the first year.
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When Does a Baby's Soft Spot Close or Go Away?
In your baby’s first few months, both soft spots should be open and flat.
At about 2 to 3 months of age the soft spot at the back of your baby’s head may close. The soft spot at the front may close around the time your toddler turns 18 months old.
What Happens If You Touch the Soft Spot on Your Baby's Head?
As long as you touch your baby’s soft spots gently — for example, when you’re holding your baby and supporting his head and neck or when you’re washing your baby’s hair — you shouldn’t be afraid of hurting him.
There is a thick and durable membrane just under your baby’s scalp that protects her brain, so gently touching the fontanelles won’t hurt her.
To help ensure your baby’s head is protected, it’s a good idea to remind friends, family members, and caregivers to be careful and gentle with your baby’s head.
What Does It Mean When a Baby's Soft Spot Is Pulsating?
Sometimes it may appear that your baby’s soft spot is pulsating.
This is completely normal — blood is pulsing through your baby’s body, and this movement can sometimes be visible where the soft spot is. There’s no need to worry if you see your baby’s soft spot pulsing.
What Causes a Sunken Soft Spot on Your Baby’s Head?
A sunken soft spot may be due to dehydration, which can happen if your baby does not get enough breast milk or formula. Your baby may also be more likely to be dehydrated if she has a fever, has been vomiting, or has diarrhea.
Beyond a sunken soft spot, these are some of the other signs of dehydration:
Fewer wet diapers
Sunken eyes
A dry mouth
Cool skin
Drowsiness
Irritability.
Contact your baby’s healthcare provider right away if you’re concerned your newborn may be dehydrated.
Keep in mind, a sunken soft spot can sometimes occur in babies who are not dehydrated.
It’s safest for your baby’s healthcare provider to make a diagnosis.
What Should You Do If Your Baby Hits His Soft Spot?
Contact your baby’s healthcare provider if your baby hits his soft spot.
If you notice swelling/bulging of the soft spot and/or bruising around her eyes or behind her ears, it may be due to a concussion. Call 911 immediately.
Other signs of a head injury or trauma requiring immediate medical attention include:
Nonstop crying
Your baby being unwilling to feed
Vomiting
Seizures
Discharge or blood from ears or nose
Difficulty waking after sleep.
When Should You Be Concerned About Your Baby's Soft Spot?
The lack of soft spots on your baby’s head may be a sign of very rare condition called craniosynostosis, a birth defect in which your baby’s skull bones fuse together earlier than normal, resulting in a misshapen head.
Contact your baby’s healthcare provider if
your baby seems to lack soft spots
there are raised, firm edges where the skull plates meet
your baby’s skull shape seems misshapen and is not growing over time.
The Bottom Line
Although it might seem a little odd that your baby would have soft spots on her head, they actually serve two important purposes: to make it easier for your baby to pass through the birth canal during a vaginal delivery, and to ensure your baby’s skull can expand to make room for her growing brain.
By around 18 months, your baby’s fontanelles will have closed. In the meantime, be gentle with your baby’s head when holding her.
If your baby accidentally bumps or hits a soft spot, or if you’re concerned that one of the soft spots may be sunken or injured, contact your child’s healthcare provider right away.
When it comes to the shape of your little one’s head, if you’ve noticed flatter spots, it could be because your little one is spending too much time lying on his back looking the same way.
Prolonged pressure on the softer skull bones can flatten out the area. Find out more about flat head syndrome and what you can do to treat or prevent it.
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 impact 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.
reasons for the “big” fontanel:
- Achondroplasia (hereditary disease)
- Down Syndrome
- Hydrocephalus
- Premature birth
- Neonatal Hypoteriosis
- RACHITS
RACHITS is one of the most common rickets 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 fontanel occurs against the background of
- an increase in temperature to febrile numbers
- multiple vomiting
- diarrhea
- Brutcher
- meningitis
- encephalitis
- intracranial bleeding
- increased intracranial pressure
Many factors are affected on the pace of ossification:
- for mom:
- a balanced diet
- sufficient intake of calcium in the body
- polyvitamin complexes
- for the child:
- the appointment of vitamin Ditamin D
— 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 for making an appointment with a pediatrician (391) 200-50-03
A baby's fontanel. All you need to know about the fontanel for young parents - Articles
Baby's fontanel. All you need to know about the fontanel for young parents
02/15/2017
Education and development
The baby's fontanel often worries young parents. This gentle pulsating place on the top of the head gives rise to many questions related to care, health and proper development. And everyone is worried about the correct timing of the closure of the fontanel. In order not to worry and worry in vain, parents should know what a fontanel is and why it is needed.
The structure of the fontanel in a baby
In a newborn baby, the skull consists of separate bones, between which there are small gaps. So nature took care of mom and baby. Thanks to the movable bones of the skull, at the time of birth, the baby's head, changing its shape, can pass through the narrow birth canal.
After birth, when the child begins to develop intensively - the head develops rapidly - the bones of the skull begin to grow together. In the area of the connection of two bones of the skull, a seam is formed, and where three or more bones are connected, small gaps are formed, covered with a strong membrane. Such gaps are called fontanelles. A gentle pulsating place on the top of the crumbs is the fontanel.
As the fontanelle grows and develops, the connective tissue hardens at the edges. So there is a complete closure of the space connecting the bones of the skull.
A newborn has 6 fontanelles in total. The 4 smallest ones close before the baby is born or in the first 3 days of the baby's life. The other two are a bit later. The posterior (small) fontanelle is triangular in shape, located at the junction of the occipital and parietal bones. It has a tiny size and completely closes up to three months of life. The anterior (large) diamond-shaped fontanel is located at the junction of the parietal and frontal ossicles.
This is the largest fontanel in a baby, which requires special attention in the development process.
Development of the skull and the importance of the fontanel in a baby's life
A child's brain develops rapidly in the first two years of life. The bones of the skull develop and form along with the enlargement of the brain. The presence of fontanelles is not of particular importance in the formation of the cranium. The bones continue to grow in the central part and along the edges until the final formation of the skull.
The main ability of the fontanelles is the ability to shrink and change the shape of the head during birth and in the first years of life. The fontanelles help the bones of the head move and adjust to the mother's birth canal during birth. Therefore, the head of a newborn may be slightly flattened, elongated or egg-shaped. In a few days, thanks to the spaces between the bones of the skull, the head of the crumbs will have a normal appearance.
Until the age of two, children actively explore the world and often fall and hit their heads. "Soft crown" allows the bones of the skull to be elastic and avoid serious damage to the head during impacts. By the time the fontanel closes, the baby will already be more confident in owning his body, which will allow him to be less injured.
Another function of the fontanelles is to help in the body's thermoregulation. In infants, hypothermia and overheating can often occur. If the baby is hot from too warm clothes, then you can free the head from the cap and normalize body temperature.
Due to the soft area on the parietal region of the head, it is possible to do an ultrasound of the brain - neurosonography. This is a very important and completely harmless study for children, which allows you to identify congenital brain problems and assess your health at the moment.
What should a baby's fontanel look like?
According to the rules, pediatricians assess the condition of the posterior (small) and anterior (large) fontanelles in a newborn and at further examinations.
The posterior fontanel of newborns most often does not exceed 0.7 cm. Closing of such a fontanel occurs by the third month of life.
The sizes and rates of closing of the anterior fontanelle in children are different. The “soft crown” closes with some features that are outlined below:
- All children are born with different sizes of the anterior fontanel. The extreme limits of the norm correspond to 0.6 and 3.6 cm.
- Anterior fontanel in a baby may slightly increase in the first months. This is due to the rapid development and increase in brain volume.
- There is no specific deadline for the closure of a large fontanel. For all children, this happens at different times. This is due to the individual characteristics of development. Observations have shown that in 1% of healthy children the fontanel closes by 3 months, in 40% of babies - by the year, and by about 2 years the fontanel is closed in 95% of babies. It is noticed that in girls the closure of the soft area is slower than in boys.
- The speed of fontanel closure does not depend on the intake of vitamin D and calcium from food. If the fontanel, according to doctors, closed ahead of time, you should not stop taking the vitamin and do not exclude calcium-rich foods from the diet. Knowing that the fontanel normally closes from 3 to 24 months, be sure that there is most likely no quick closure. In this case, it will be much more dangerous for a child not to close the fontanel, but to refuse vitamin D, which is used to prevent rickets.
What does a healthy baby's fontanel look like?
A large fontanel in a healthy baby has a diamond shape; it can sink quite a bit or protrude above the scalp. The pulsation of the fontanel reflects the work of the child's heart and should not alert parents.
Some new parents feel that the soft spot on the head is fragile and can be damaged, and therefore they are afraid to even lightly touch the baby's head.
Gentle stroking and light combing will not harm the baby, as a strong membrane reliably protects the brain from external influences. Also, there is no need to worry when a pediatrician carefully feels the baby’s head at the reception, this will not harm him.
External changes in the baby's fontanel, indicating illness
External indicators of the fontanel, its size, can tell a lot about the health of children. At preventive examinations, pediatricians must examine the head and evaluate the type of fontanel.
Large volume of anterior fontanel
If the doctor determines that the fontanel is very large in relation to other indicators, this indicates slow closure and indicates the following problems:
- Rickets is a possible cause of long overgrowth of the soft area. Premature babies who have little exposure to the sun and do not receive vitamin D therapy are at risk. When the diagnosis is confirmed, sunlight exposure and vitamin therapy are usually prescribed.
- Congenital hypothyroidism is a disease in which the thyroid function of the newborn is reduced. Since thyroid hormones are important for the formation of the skeletal system, a sign of this pathology may be the slow overgrowth of the fontanel. Other symptoms of hypothyroidism include: lethargy, persistent constipation, swelling, and poor appetite. This disease is treated with thyroid hormone preparations.
- Down's syndrome is established almost immediately after the baby is born according to characteristic signs. One of these signs is a large fontanel and its slow overgrowth. Children with Down syndrome should be under special supervision.
Other rare pathologies in the development of the skeletal system also affect the long overgrowth of the fontanel and its size. The final diagnosis of such diseases is established after examination in special medical institutions.
Small size of the anterior fontanel
In the event that the space between the bones of the skull is completely overgrown before the age of three months, then a rapid closure of the fontanel can be diagnosed.
To correctly assess the development of the fontanel in a baby, you need to take into account the size of the soft area in relation to the circumference of the baby's head. If the fontanel decreases before three months, but its size corresponds to the circumference of the head, then such a closure of the fontanel up to three months can be considered the norm.
Rapid closure of the fontanel indicates such problems as:
- Craniosynostosis is a rare pathology of bone tissue. It can be congenital or acquired as a result of endocrine disorders. With this pathology, early ossification of the membrane of the soft spot on the crown and sutures of the skull occurs. Signs of this disease will be a small volume of the head, a violation of the growth of the skeletal system and various other signs. The diagnosis of this disease is established in a medical institution after a thorough diagnosis.
Another reason for the rapid ossification of the soft area may be an anomaly in the development of the brain.
Such a pathology is treated in the neurological departments of medical institutions.
A sunken or bulging fontanel in a baby
The state of some functions of a child's body can be reflected in the appearance of the fontanel.
If the anterior fontanelle looks sunken and too soft, then the baby is most likely dehydrated due to an intestinal infection. Dehydration develops against the background of vomiting, diarrhea and fever. Such a condition can be very dangerous to life and health, therefore, with a sunken soft spot on the head, it is very important to provide the baby with plenty of fluids and urgently show the pediatrician.
The fontanel may bulge a little, pulsate noticeably when the baby cries, and this will be the norm. But if a fontanel is observed at rest, which is constantly tense, then this will indicate intracranial pressure, which is a symptom of various neurological diseases. Seek immediate medical attention to determine the cause.
