Pulsating anterior fontanelle
Your Baby's Head - HealthyChildren.org
Log in | Register
Ages & Stages
Ages & Stages
Listen
Español
Text Size
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. JanaLaura 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. ShuJennifer 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.
All About Baby's Soft Spot
AddictionAllergies & AsthmaAmbulatoryAudiologyAutismAwardsBC4TeensBehavioral HealthBehind the ScenesBurn CenterCancerCardiologyCenter for Healthy Weight and NutritionCenter for Injury Research and PolicyChild BehaviorChild DevelopmentColorectal and Pelvic ReconstructionCommunity EducationCommunity ResourcesCoronavirusDentistryDermatologyDiseases & ConditionsDiversity and InclusionEndocrinologyENTEpilepsyEverything MattersFertility and Reproductive Health ProgramFundraising EventsGastroenterologyGeneticsGynecologyHematologyHomecareHospiceHospital NewsInfants & NewbornsInfectious DiseaseKids & TeensLaboratory ServicesMake Safe HappenMarathonNeonatologyNephrologyNeurologyNeurosurgeryNew HospitalNICUNutrition & FitnessOccupational TherapyOphthalmologyOrthopedicsOur PatientsOur staffPalliative CareParentingPediatric NewsPharmacyPhysical Therapy - Sports and OrthopedicPlastic SurgeryPopulation HealthPregnancyPrimary CarePsychologyPulmonaryRadiologyReach Out and ReadRehabilitationResearchRheumatologySafety & PreventionSports MedicineSurgical ServicesThe Center for Family Safety and HealingTherapeutic RecreationTherapyTHRIVE ProgramToddlers & PreschoolersUrgent CareUrology
Aaron Barber, AT, ATC, PESAbbie Roth, MWCAbby Orkis, MSW, LSWAdam Ostendorf, MDAdriane Baylis, PhD, CCC-SLPAdrienne M.
Flood, CPNP-ACAdvanced Healthcare Provider CouncilAila Co, MDAlaina White, AT, ATCAlana Milton, MDAlana Milton, MDAlecia Jayne, AuDAlena SchuckmannAlessandra Gasior, DOAlex Kemper, MDAlexandra Funk, PharmD, DABATAlexandra Sankovic, MDAlexis Klenke, RD, LDAlice Bass, CPNP-PCAlison PeggAllie DePoyAllison Rowland, AT, ATCAllison Strouse, MS, AT, ATCAmanda E. Graf, MDAmanda GoetzAmanda Smith, RN, BSN, CPNAmanda Sonk, LMTAmanda Whitaker, MDAmber Patterson, MDAmberle Prater, PhD, LPCCAmy Brown Schlegel, MDAmy Coleman, LISWAmy Dunn, MDAmy E. Valasek, MD, MScAmy Fanning, PT, DPTAmy Garee, CPNP-PCAmy Hahn, PhDAmy HessAmy Leber, PhDAmy LeRoy, CCLSAmy Moffett, CPNP-PCAmy Randall-McSorley, MMC, EdD CandidateAmy Thomas, BSN, RN, IBCLCAmy Wahl, APNAnastasia Fischer, MD, FACSMAndala HardyAndrea Brun, CPNP-PCAndrea M. Boerger, MEd, CCC-SLPAndrea Sattler, MDAndrea ShellowAndrew AxelsonAndrew Kroger, MD, MPHAndrew SchwadererAndria Haynes, RNAngela AbenaimAngela Billingslea, LISW-SAnn Pakalnis, MDAnna Lillis, MD, PhDAnnette Haban-BartzAnnie Drapeau, MDAnnie Temple, MS, CCC-SLP, CLCAnnie Truelove, MPHAnthony Audino, MDAnup D.
Patel, MDAri Rabkin, PhDAriana Hoet, PhDArielle Sheftall, PhDArleen KarczewskiAshlee HallAshleigh Kussman, MDAshley Debeljack, PsyDAshley Ebersole, MDAshley EcksteinAshley Kroon Van DiestAshley M. Davidson, AT, ATC, MSAshley Minnick, MSAH, AT, ATCAshley Overall, FNPAshley Parikh, CPNP-PCAshley Parker MSW, LISW-SAshley Parker, LISW-SAshley Tuisku, CTRSAsuncion Mejias, MD, PhDAurelia Wood, MDBailey Young, DOBecky Corbitt, RNBelinda Mills, MDBenjamin Fields, PhD, MEdBenjamin Kopp, MDBernadette Burke, AT, ATC, MSBeth Martin, RNBeth Villanueva, OTD, OTR/LBethany Uhl, MDBethany Walker, PhDBhuvana Setty, MDBill Kulju, MS, ATBlake SkinnerBonnie Gourley, MSW, LSWBrad Childers, RRT, BSBrandi Cogdill, RN, BSN, CFRN, EMT-PBrandon MorganBreanne L. Bowers, PT, DPT, CHT, CFSTBrendan Boyle, MD, MPHBrian Boe, MDBrian K. Kaspar, PhDBrian Kellogg, MDBriana Crowe, PT, DPT, OCSBrigid Pargeon, MS, MT-BCBrittney Hardin, MOT, OTR/LBrooke Sims, LPCC, ATRCagri Toruner, MDCaitlin Bauer, RD, LDCaitlin TullyCaleb MosleyCallista DammannCallista PoppCami Winkelspecht, PhDCamille Wilson, PhDCanice Crerand, PhDCara Inglis, PsyDCarl H.
Backes, MDCarlo Di Lorenzo, MDCarly FawcettCarneshia EdwardsCarol Baumhardt, LMTCarolyn FigiCarrie Rhodes, CPST-I, MTSA, CHESCasey Cottrill, MD, MPHCasey TrimbleCassandra McNabb, RN-BSNCatherine Earlenbaugh, RNCatherine Sinclair, MDCatherine Trimble, FNPCatrina Litzenburg, PhDCharae Keys, MSW, LISW-SCharles Elmaraghy, MDChelsea Britton, MS, RD, LD, CLC Chelsea Kebodeaux, MDChelsie Doster, BSCheryl Boop, MS, OTR/LCheryl G. Baxter, CPNPCheryl Gariepy, MDChet Kaczor, PharmD, MBAChris MarreroChris Smith, RNChristina Ching, MDChristina DayChristine Johnson, MA, CCC-SLPChristine Koterba, PhDChristine Mansfield, PT, DPT, OCS, ATCChristine PrusaChristopher Goettee, PT, DPT, OCSChristopher Iobst, MDChristopher Ouellette, MDChristy Lumpkins, LISW-SCindy IskeClaire Kopko PT, DPT, OCS, NASM-PESCody Hostutler, PhDConnor McDanel, MSW, LSWCorey Rood, MDCorinne Syfers, CCLSCourtney Bishop. PA-CCourtney Brown, MDCourtney Hall, CPNP-PCCourtney Porter, RN, MSCristina Tomatis Souverbielle, MDCrystal MilnerCurt Daniels, MDCynthia Holland-Hall, MD, MPHDana Lenobel, FNPDana Noffsinger, CPNP-ACDane Snyder, MDDaniel Coury, MDDaniel DaJusta, MDDanielle Peifer, PT, DPTDavid A Wessells, PT, MHADavid Axelson, MDDavid Stukus, MDDean Lee, MD, PhDDebbie Terry, NPDeborah Hill, LSWDeborah Zerkle, LMTDeena Chisolm, PhDDeipanjan Nandi, MD MScDenis King, MDDenise EllDennis Cunningham, MDDennis McTigue, DDSDiane LangDominique R.
Williams, MD, MPH, FAAP, Dipl ABOMDonna M. Trentel, MSA, CCLSDonna Ruch, PhDDonna TeachDoug WolfDouglas McLaughlin, MDDrew Duerson, MDEd MinerEdward Oberle, MD, RhMSUSEdward Shepherd, MDEileen Chaves, PhDElena CamachoElise Berlan, MDElise DawkinsElizabeth A. Cannon, LPCCElizabeth Cipollone, LPCC-SElizabeth Zmuda, DOEllyn Hamm, MM, MT-BCEmily A. Stuart, MDEmily Decker, MDEmily GetschmanEmma Wysocki, PharmD, RDNEric Butter, PhDEric Leighton, AT, ATCEric Sribnick, MD, PhDErica Domrose, RD, LDEricca L Lovegrove, RD, LDErika RobertsErin Gates, PT, DPTErin Johnson, M.Ed., C.S.C.S.Erin McKnight, MD, MPHErin Shann, BSN, RNErin TebbenFarah W. Brink, MDFatimah MasoodFrances Fei, MDGail Bagwell, DNP, APRN, CNSGail Besner, MDGail Swisher, ATGarey Noritz, MDGary A. Smith, MD, DrPHGeri Hewitt, MDGina Hounam, PhDGina McDowellGina MinotGrace Paul, MDGregory D. Pearson, MDGriffin Stout, MDGuliz Erdem, MDHailey Blosser, MA, CCC-SLPHanna MathessHeather Battles, MDHeather ClarkHeather L. Terry, MSN, RN, FNP-C, CUNPHeather Yardley, PhDHenry SpillerHenry Xiang, MD, MPH, PhDHerman Hundley, MS, AT, ATC, CSCSHilary Michel, MDHiren Patel, MDHolly Deckling, MSSW, LISWHoma Amini, DDS, MPH, MSHoward Jacobs, MDHunter Wernick, DOIbrahim Khansa, MDIhuoma Eneli, MDIlana Moss, PhDIlene Crabtree, PTIrene Mikhail, MDIrina Buhimschi, MDIvor Hill, MDJackie Cronau, RN, CWOCNJacqueline Wynn, PhD, BCBA-DJacquelyn Doxie King, PhDJaime-Dawn Twanow, MDJaimie D.
Nathan, MD, FACSJames Murakami, MDJames Popp, MDJames Ruda, MDJameson Mattingly, MDJamie Macklin, MDJamie ReedyJane AbelJanelle Huefner, MA, CCC-SLPJanice M. Moreland, CPNP-PC, DNPJanice Townsend, DDS, MSJared SylvesterJason JacksonJason P. Garee, PhDJaysson EicholtzJean Hruschak, MA, CCC/SLPJeff Sydes, CSCSJeffery Auletta, MDJeffrey Bennett, MD, PhDJeffrey Hoffman, MDJeffrey Leonard, MDJen Campbell, PT, MSPTJena HeckJenn Gonya, PhDJennie Aldrink, MDJennifer Borda, PT, DPTJennifer HofherrJennifer LockerJennifer PrinzJennifer Reese, PsyDJennifer Smith, MS, RD, CSP, LD, LMTJennifer Walton, MD, MPH, FAAPJenny Worthington, PT, DPTJerry R. Mendell, MDJessalyn Mayer, MSOT, OTR/LJessica Bailey, PsyDJessica Bogacik, MS, MT-BCJessica Bowman, MDJessica BrockJessica Bullock, MA/CCC-SLPJessica Buschmann, RDJessica Scherr, PhDJim O’Shea OT, MOT, CHTJoan Fraser, MSW, LISW-SJohn Ackerman, PhDJohn Caballero, PT, DPT, CSCSJohn Kovalchin, MDJonathan D. Thackeray, MDJonathan Finlay, MB, ChB, FRCPJonathan M.
Grischkan, MDJonathan Napolitano, MDJoshua Prudent, MDJoshua Watson, MDJulee Eing, CRA, RT(R)Julia Colman, MOT, OTR/LJulie ApthorpeJulie Lange, MDJulie Leonard, MD, MPHJulie Racine, PhDJulie Samora, MDJustin Indyk, MD, PhDKady LacyKaitrin Kramer, DDS, MS, PhDKaleigh Hague, MA, MT-BCKaleigh MatesickKamilah Twymon, LPCC-SKara Malone, MDKara Miller, OTR/LKaren A. Diefenbach, MDKaren Allen, MDKaren Days, MBAKaren Rachuba, RD, LD, CLCKari A. Meeks, OTKari Cardiff, ODKari Dubro, MS, RD, LD, CWWSKari Phang, MDKarla Vaz, MDKaryn L. Kassis, MD, MPHKasey Strothman, MDKatherine Deans, MDKatherine McCracken, MD FACOGKathleen (Katie) RoushKathryn Blocher, CPNP-PCKathryn J. Junge, RN, BSNKathryn Obrynba, MDKatia Camille Halabi, MDKatie Brind'Amour, MSKatie DonovanKatie Thomas, APRKatrina Hall, MA, CCLSKatrina Ruege, LPCC-SKatya Harfmann, MDKayla Zimpfer, PCCKaylan Guzman Schauer, LPCC-SKeli YoungKelley SwopeKelli Dilver, PT, DPTKelly AbramsKelly BooneKelly HustonKelly J. Kelleher, MDKelly McNally, PhDKelly N.
Day, CPNP-PCKelly Pack, LISW-SKelly Tanner,PhD, OTR/L, BCPKelly Wesolowski, PsyDKelly Wise, PharmDKent Williams, MDKevin Bosse, PhDKevin Klingele, MDKim Bjorklund, MDKim Hammersmith, DDS, MPH, MSKimberly Bates, MDKimberly Sisto, PT, DPT, SCSKimberly Van Camp, PT, DPT, SCSKirk SabalkaKris Jatana, MD, FAAPKrista Winner, AuD, CCC-AKristen Armbrust, LISW-SKristen Cannon, MDKristen E. Beck, MDKristen Martin, OTR/LKristi Roberts, MS MPHKristina Booth, MSN, CFNPKristina Reber, MDKristol Das, MDKyle DavisLance Governale, MDLara McKenzie, PhD, MALaura Brubaker, BSN, RNLaura Dattner, MALaura Martin, MDLaurel Biever, LPCLauren Durinka, AuDLauren Garbacz, PhDLauren Justice, OTR/L, MOTLauren Madhoun, MS, CCC-SLPLauryn Rozum, MS, CCLSLeah Middelberg, MDLee Hlad, DPMLeena Nahata, MDLelia Emery, MT-BCLeslie Appiah, MDLinda Stoverock, DNP, RN NEA-BCLindsay Kneen, MDLindsay Pietruszewski, PT, DPTLindsay SchwartzLindsey Vater, PsyDLisa GoldenLisa Halloran, CNPLisa M. Humphrey, MDLogan Blankemeyer, MA, CCC-SLPLori Grisez PT, DPTLorraine Kelley-QuonLouis Bezold, MDLourdes Hill, LPCC-S Lubna Mazin, PharmDLuke Tipple, MS, CSCSLynda Wolfe, PhDLyndsey MillerLynn RosenthalLynne Ruess, MDMaggy Rule, MS, AT, ATCMahmoud Kallash, MDManmohan K Kamboj, MDMarc P.
Michalsky, MDMarcel J. Casavant, MDMarci Johnson, LISW-SMarcie RehmarMarco Corridore, MDMargaret Bassi, OTR/LMaria HaghnazariMaria Vegh, MSN, RN, CPNMarissa Condon, BSN, RNMarissa E. Larouere, MBA, BSN, RNMark E. Galantowicz, MDMark Smith, MS RT R (MR), ABMP PhysicistMarnie Wagner, MDMary Ann Abrams, MD, MPHMary Fristad, PhD, ABPPMary Kay SharrettMary Shull, MDMatthew Washam, MD, MPHMeagan Horn, MAMegan Brundrett, MDMegan Dominik, OTR/LMegan FrancisMegan Letson, MD, M.EdMeghan Cass, PT, DPTMeghan Fisher, BSN, RNMeika Eby, MDMelanie Fluellen, LPCCMelanie Luken, LISW-SMelissa and Mikael McLarenMelissa McMillen, CTRSMelissa Winterhalter, MDMeredith Merz Lind, MDMichael Flores, PhDMichael T. Brady, MDMichelle Ross, MHA, RD, LD, ALCMike Patrick, MDMindy Deno, PT, DPTMitch Ellinger, CPNP-PCMolly Dienhart, MDMolly Gardner, PhDMonica Ardura, DOMonica EllisMonique Goldschmidt, MDMotao Zhu, MD, MS, PhDMurugu Manickam, MDNancy AuerNancy Cunningham, PsyDNancy Wright, BS, RRT, RCP, AE-C Naomi Kertesz, MDNatalie DeBaccoNatalie I.
Rine, PharmD, BCPS, BCCCPNatalie Powell, LPCC-S, LICDC-CSNatalie Rose, BSN, RNNathalie Maitre, MD, PhDNationwide Children's HospitalNationwide Children's Hospital Behavioral Health ExpertsNeetu Bali, MD, MPHNehal Parikh, DO, MSNichole Mayer, OTR/L, MOTNicole Caldwell, MDNicole Dempster, PhDNicole Greenwood, MDNicole Parente, LSWNicole Powell, PsyD, BCBA-DNina WestNkeiruka Orajiaka, MBBSOctavio Ramilo, MDOliver Adunka, MD, FACSOlivia Stranges, CPNP-PCOlivia Thomas, MDOmar Khalid, MD, FAAP, FACCOnnalisa Nash, CPNP-PCOula KhouryPaige Duly, CTRSParker Huston, PhDPatrick C. Walz, MDPatrick Queen, BSN, RNPedro Weisleder, MDPeter Minneci, MDPeter White, PhDPitty JenningsPreeti Jaggi, MDPriyal Patel, DORachael Morocco-Zanotti, DORachel D’Amico, MDRachel Schrader, CPNP-PCRachel Tyson, LSWRajan Thakkar, MDRaymond Troy, MDRebecca Fisher, PTRebecca Hicks, CCLSRebecca Lewis, AuD, CCC-ARebecca M. Romero, RD, LD, CLC Reggie Ash Jr.Reno Ravindran, MDRichard Kirschner, MDRichard Wood, MDRobert A. Kowatch, MD, Ph.
D.Robert Hoffman, MDRochelle Krouse, CTRSRohan Henry, MD, MSRose Ayoob, MDRose Schroedl, PhDRosemary Martoma, MDRoss Maltz, MDRyan Ingley AT, ATCSamanta Boddapati, PhDSamantha MaloneSammy CygnorSandra C. Kim, MDSara Bentley, MT-BCSara Bode, MDSara Breidigan, MS, AT, ATCSara N. Smith, MSN, APRNSara O'Rourke, MOT, OTR/L, Clinical LeadSara Schroder, MDSarah A. Denny, MDSarah Cline, CRA, RT(R)Sarah Driesbach, CPN, APNSarah GreenbergSarah Hastie, BSN, RNC-NIC Sarah Keim, PhDSarah MyersSarah O'Brien, MDSarah SaxbeSarah Schmidt, LISW-SSarah ScottSarah TraceySarah VerLee, PhDSasigarn Bowden, MDSatya Gedela, MD, MRCP(UK)Scott Coven, DO, MPHScott Hickey, MDSean EingSean Rose, MDSeth Alpert, MDShalini C. Reshmi, PhD, FACMGShana Moore, MA, CCC-AShannon Reinhart, LISW-SShari UncapherSharon Wrona, DNP, PNP, PMHSShaun Coffman PT, DPT, OCSShawn Pitcher, BS, RD, USAWShawNaye Scott-MillerShea SmoskeSheena PaceSheila GilesShelly BrackmanSimon Lee, MDSini James, MDStacy Ardoin, MDStacy Whiteside APRN, MS, CPNP-AC/PC, CPONStefanie Bester, MDStefanie Hirota, OTR/LStephanie Burkhardt, MPH, CCRCStephanie CannonStephanie Santoro, MDStephanie Vyrostek BSN, RNStephen Hersey, MDSteve Allen, MDSteven C.
Matson, MDSteven Ciciora, MDSteven CuffSuellen Sharp, OTR/L, MOTSurlina AsamoaSusan Colace, MDSusan Creary, MDSwaroop Pinto, MDTabatha BallardTabbetha GrecoTabi Evans, PsyDTabitha Jones-McKnight, DOTahagod Mohamed, MDTamara MappTammi Young-Saleme, PhDTaylor Hartlaub, MD, MPHTenelle JonesTerry Barber, MDTerry Bravender, MD, MPHTerry Laurila, MS, RPhTheresa Miller, BA, RRT, RCP, AE-C, CPFTThomas Pommering, DOTiasha Letostak, PhDTiffanie Ryan, BCBA Tim RobinsonTim Smith, MDTimothy Cripe, MD, PhDTimothy Landers PhD RN APRN-CNP CIC FAANTracey L. Sisk, RN, BSN, MHATracie Steinke RD, LD, CDETracy Mehan, MATravis Gallagher, ATTrevor MillerTria Shadeed, NNPTyanna Snider, PsyDTyler Congrove, ATValencia Walker, MD, MPH, FAAPVanessa Shanks, MD, FAAPVenkata Rama Jayanthi, MDVidu Garg, MDVidya Raman, MDW. Garrett Hunt, MDWalter Samora, MDWarren D. Lo, MDWendy Anderson, MDWendy Cleveland, MA, LPCC-SWhitney McCormick, CTRSWhitney Raglin Bignall, PhDWilliam Cotton, MDWilliam J. Barson, MDWilliam Ray, PhDWilliam W.
Long, MD
Why does the fontanel pulsate in the baby: the causes of the phenomenon
What is a crown or fontanel? This is a hole in the cranium of the baby, located between the bones of the skull and closed by a thin membrane. During fetal development, the fetus has 6 fontanelles. By the time of birth, there are only two of them - one in the occipital part of the head (on the border of the junction of the occipital and parietal bones), and the second in the region of the crown (between the parietal and frontal bones). The first fontanel is called small (its size should not exceed 1 cm), the second - large (normally - about 2.5 cm). Thanks to these fontanelles, the child is born without injury, since these holes allow the baby's head to slightly shrink and deform, as a result of which the baby can freely pass through the mother's birth canal. If the fontanelles overgrow during the intrauterine development of the baby, this may indicate the presence of pathologies, and can also lead to trauma to the crumbs during childbirth.
But if the child was born healthy, what can the phenomenon indicate when the fontanel pulsates in the baby? nine0003
Should the fontanel pulsate?
I immediately want to reassure parents that the pulsating fontanel in a newborn is a physiological feature of the structure of the skull of babies. First of all, this phenomenon is explained by the fact that the pulsation occurs in time with the heartbeat of the baby. With each new contraction of the heart muscle, blood rushes to the baby's head, which can be seen in a small area with a thin skin membrane.
Another reason why the fontanel can pulsate is the movement of the cerebrospinal fluid, i.e. fluid that surrounds the brain of a newborn. Liquor, in turn, begins to fluctuate due to the pulsation of intracranial vessels. After the temechko is tightened (as a rule, this happens by the end of the 1st year of life), its pulsation stops. Therefore, this process is quite normal and natural, which means that it should not cause any concern.
nine0003
However, there are situations when the fontanel begins to sink or bulge outward. Such symptoms cannot be ignored in any way, because they indicate the development of a serious pathology. With treatment in this case, it is categorically not recommended to delay.
Fontanel growth rates by months
The child in the first year of life develops quite intensively. Normally, the fontanel is tightened to a certain size every month, so the characteristics of its pulsations will be different. Parents should monitor these changes and note them, monitor the health of the baby, noticing problems in a timely manner. nine0003
| Age | Breast size (average), mm | Pulsation characteristic |
| Month from birth | 26-28 | The fontanelle should clearly pulsate, the rhythm is frequent and clearly visible, since the heartbeat in children, unlike adults, is rapid. |
| 2 months from birth | 22-23 | The pulsation of the fontanel remains active, clearly visible. If the baby cries or screams, the oscillations of the site become more frequent and intensified, but everything stabilizes as soon as the newborn baby calms down. nine0022 |
| 3 months after birth | 20-21 | Pulsation is visible, but it is uniform, more calm. The rhythm remains clear and constant. |
| 4 month old baby | 16-18 | Pulsation is easy to see when the baby is crying. In the normal state, fluctuations are practically not noticeable. |
| 5 month old baby | 16-18 | The speed and frequency of the pulsation is reduced, the oscillations are barely noticeable. nine0022 |
| Six-month-old baby | 16-18 | It is difficult to notice the ripple, but it should be mandatory. |
At the age of 6 months, it is difficult to notice the pulsation of the fontanelle in an infant, but it is possible. Temechko itself at this age is not yet completely overgrown.
When the baby is excited and crying, the fontanel can pulsate strongly - this is quite normal. By the age of two, the thin membrane will disappear completely: a strong cranial bone forms in place of the fontanel. nine0003
When should I see a doctor?
Parents should be alerted by such signs as:
- Bulging of the fontanel outward. This phenomenon may indicate the presence of diseases such as meningitis, hydrocephalus, increased intracranial pressure, and a brain tumor in the baby. If the bulging of the fontanel is accompanied by convulsions and fever, you need to urgently call an ambulance or go to the hospital for help.
- Retraction of the fontanel. If the crown begins to sink, doctors may suspect that the child has a pathology of the cardiovascular system. In this case, an ultrasound examination is prescribed to exclude the presence of congenital heart defects, and an examination by a cardiologist. If, when the fontanel sinks, its pulsation is felt very weakly, treatment is prescribed immediately.
nine0086 - Excessively active ripple. Uneven and too fast pulsation of the fontanel with a ragged irregular rhythm may indicate the development of pathologies of the heart of the baby. In this case, the child is prescribed an ECG, ultrasound of the heart, ultrasound of the brain and other additional examinations.
- Rapid tightening of the fontanel - the risk of developing microcephaly.
- Softening of the bone edges, which affects the period of overgrowth of the fontanel, may indicate the development of rickets in a child. nine0086
Characteristics of the fontanel pulsation allows you to learn more about the baby's condition. So, if the child is only a month old, the vibrations of the parietal membrane can change depending on his mood: he cries, pushes or is excited. Any deviations from the norm should alert parents and become a reason for contacting specialists. Be attentive to your kids, and then many problems can be avoided.
← The first signs of chickenpox in a child, how to recognize chickenpox, symptoms? What does the increased body temperature after mantoux in a child indicate? →
Other materials of heading
Fontanelle in children.
Many may find the chosen topic of the article boring and uninteresting. But among parents, and among doctors, there are a number of myths about the fontanel, which I will try to dispel today. I will also answer the most frequently asked questions to a neurologist about a children's fontanel.
Fontanelle — non-ossified area of the cranial vault of a newborn, covered with connective tissue, and on top with skin. Unlike an adult, the bones of the skull in a newborn are mobile and connected to each other with sutures and fontanelles. This is necessary so that the child's skull can be deformed during childbirth, and also subsequently, during the intensive growth of the brain, it helps to increase the size of the child's head. By the time of birth (in full-term children), the anterior (large) fontanel remains open, and in some children, the posterior or small fontanel may be open, which overgrows in the first months of life.
nine0003
Most often, mothers ask a neurologist: is it possible to touch a child's fontanel? Can I damage the fontanel if I brush or wash my baby's hair? Dear mothers, you can feel the fontanel yourself without fear, you can perform all the necessary hygiene procedures. Nature made sure that the connective tissue membrane that covers it was strong enough.
What size fontanel should a newborn have? The size of a child's fontanel can vary greatly - on average from a centimeter to 3 cm in transverse dimension. And I will immediately dispel your fears! If the doctor told you that the fontanel is smaller or larger than normal, do not immediately be afraid of this! By itself, the size of the fontanel (if there are no other complaints and symptoms) does not affect anything. And there is no directly proportional relationship between the size of the fontanel and the speed of its closure. nine0003
Another question often asked to a neurologist: if the fontanel has not closed by the age of one, is it bad? The timing of the closure of a large fontanelle varies greatly.
Yes, most often the fontanel overgrows in children by the age of one, but closure is considered normal up to one and a half years, and according to some medical sources, even up to 20-22 months, if the child develops normally, when examined by a neurologist, there are no other symptoms (normal head size in a child, there is no bulging of the fontanel, etc.), and also the pediatrician does not detect rickets or other metabolic disorders (hypothyroidism, for example) - you should not worry about this. And I’ll immediately say that in this regard, not only parents, but also doctors have a myth - if the fontanel slowly overgrows (longer than a year), you need to increase the dosage of vitamin D to the child. This is the wrong approach! Vitamin D is prescribed by a pediatrician (not a preventive, but a therapeutic dosage) if he finds signs of rickets in a child, or on the basis of a blood test. And there is no need to treat where there is no disease. nine0100 If the fontanel closes early enough (in the first six months), this requires a mandatory consultation with a neurologist in order to exclude a number of neurological diseases (microcephaly, craniostenosis).
