When does a babies soft spot go away

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.

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.

Child development at different age stages

CHILD DEVELOPMENT AT DIFFERENT AGE STAGES
Infancy (first year of life)
When a child is born, it physically separates from its mother. He finds himself in completely different conditions: cold, bright light, an air environment that requires a different type of breathing, the need to change the type of food. To adapt to these new, alien conditions, the child is helped by hereditarily fixed mechanisms - unconditioned reflexes.

What kind of unconditioned reflexes does a newborn have?

This is, first of all, a system of food reflexes. When touching the corners of the lips or tongue, sucking movements appear, and all other movements are inhibited. Because the baby is completely focused on suckling, this response has been called "feeding focus".
Among the unconditioned reflexes, protective and indicative ones stand out. Some reflexes are atavistic - they are inherited from animal ancestors, but are useless for the child and soon disappear. So, for example, the reflex, sometimes called the "monkey", disappears already in the second month of life.

Unconditioned reflexes of the newborn

Stimuli Reflexes
Action of bright light Eyes close
Slap on the bridge of the nose Eyes close
Hand clap near the baby's head Eyes close
Turning the baby's head to the right Arms flex rapidly
Finger pressing on child's palm Child's toes clenching and unclenching
Finger pressing on child's soles Toes clenching
With a scratching movement, we draw a finger along the sole from the fingers to the heel The big toe rises, the rest are extended
Prick the sole with a pin Knee and foot bend
Raise the lying child with the stomach down The child tries to raise his head, stretches his legs
By the end of the first month of life, the first conditioned reflexes . In particular, the child begins to respond to the feeding position: as soon as he is in a certain position on the mother's lap. v him there are sucking movements. But in general, the formation of conditioned reflexes is characteristic of a later time.
How can you describe the mental life of a newborn? The brain of a small child continues to develop, it is not fully formed, therefore, mental life is associated mainly with subcortical centers, as well as an insufficiently mature cortex. The sensations of a newborn are undifferentiated and inextricably merged with emotions, which made it possible for L. S. Vygotsky to speak of “sensory emotional states or emotionally emphasized states of sensations.”
Important events in the child's mental life are the emergence of auditory and visual concentration. Auditory concentration appears at 2-3 weeks. A sharp sound, say, of a door slamming, causes a cessation of movements, the child freezes and becomes silent. Later, at 3-4 weeks, the same reaction occurs to the person's voice. At this time, the child not only focuses on the sound, but also turns his head towards its source. Visual concentration, which appears at 3-5 weeks, outwardly manifests itself in the same way: the child freezes and holds his gaze (of course, not for long) on a bright object.

Newborn spends time in sleep or drowsiness. Gradually, separate moments, short periods of wakefulness, begin to stand out from this drowsy state. Auditory and visual concentration give wakefulness an active character.
A child comes into this world weak and completely helpless. Such helplessness, complete dependence on an adult constitute the specifics of the social situation of the development of an infant.

The newborn, having acquired the ability to respond to the voice of the mother caring for him, to see her face, establishes new subtle emotional bonds with her. At about 1 month, the baby, when he sees his mother, stops looking at her face, throws up his arms, quickly moves his legs, makes loud noises and begins to smile. This stormy emotional reaction has been called the "revitalization complex". The revitalization complex, which includes a truly human feature - a smile - marks the appearance of the first social need - the need for communication. And the formation of a child's need for communication means that in his mental development he is moving into a new period. The transitional stage of the newborn is coming to an end. Infancy begins.

Infancy

The baby is growing rapidly. The growth of a healthy child during the first year of his life increases by about 1.5 times, and weight - by almost 2 times.
Physical development of the infant
Time of onset Motor development
1 month Raises chin
2 months Raises chest
3 months Reaches for an object, but usually misses
4 months Sitting with support
5-6 months Grasping objects
7 months Sitting no support
8 months Sitting up unaided
9 months Standing with support; crawls on stomach
10 months Crawls on hands and knees; walks with two hands
11 months Stands without support
12 months Walks with one hand

Perception . After the second month, the concentration becomes quite long, by 3 months its duration reaches 7-8 minutes. At 4 months, the child not only sees, but already looks: he actively reacts to what he sees, moves and squeals.
A child in infancy perceives the shape of objects, highlights the contour and their other elements.
It can be said that in infancy, children are already able to navigate in many parameters of objects. They are attracted by contrasts, the movement of observed objects and their other properties.

By 2-3 months, babies usually show interest in objects that are somewhat different from those they have seen before.
The child distinguishes visually perceived objects by shape, complexity and color. An active interest in color appears later, from 6 months.
Spatial perception also develops, in particular depth perception. American psychologists conducted a beautiful experiment with a "cliff": the baby was placed on a glass table, under which there were two large boards attached at different levels. The difference in the levels of these boards, covered with bright, large-sized fabric, created the illusion of a cliff. A small child, tactilely feeling the smooth surface of the glass, crawls to the mother, not noticing the depth. After 8 months, most babies avoid the "cliff" and start crying.
Movement and action. The movements of the baby's hands directed to the object, the palpation of the object appear at about the fourth month of life. At 5-6 months, the child can already grasp an object, which requires complex visual-motor coordination. Grasping is the first purposeful action of the child, it is a prerequisite, the basis for mastering manipulations with objects.

In the second half of the year, hand movements and corresponding actions are intensively developed. The child swings the objects he has grasped, knocks, throws and picks them up again, bites, shifts from hand to hand, etc. Chains of identical, repetitive actions unfold, which Jean Piaget called circular reactions. After 7 months there are "correlating" actions: the child puts small objects into large ones, opens and closes the lids of the boxes. After 10 months, the first functional actions appear, allowing relatively correct use of objects, imitating the actions of adults. The child rolls the car, beats the drum, brings a cup of juice to his mouth.

By the end of the year, the child begins to explore the world of human objects and learn the rules of action with them. A variety of actions lead him to the discovery of more and more new properties of the objects surrounding him. Focusing on the surrounding reality, he is interested not only in "what it is", but also in "what can be done with it."
Perception and action is the basis that makes it possible to judge the initial forms of visual-active thinking in infancy.
By the end of the 1st year, the child is involved in rather complex actions of the game.
Memory. The cognitive development of an infant involves the inclusion of memory mechanisms, of course, its simplest types. Recognition comes first. At 3-4 months old, he recognizes the toy that the adult showed him, preferring it to others that are in his field of vision, a 4-month-old child distinguishes a familiar face from an unfamiliar one.
After 8 months, reproduction appears - the restoration of an image in the memory when there is no similar object in front of the child.
Along with cognitive development, emotional development is also observed during infancy. This line of development also directly depends on communication with close adults. In the first 3-4 months, children manifest a variety of emotional states: surprise in response to the unexpected (slowing down of movements, a decrease in heart rate), anxiety in case of physical discomfort (increased movements, increased heart rate, closing eyes, crying), relaxation when a need is satisfied.
After 3-4 months, he smiles at acquaintances, but is somewhat lost at the sight of an unfamiliar adult. At 7-8 months, anxiety increases sharply when strangers appear.

Approximately at the same time, between 7 and 11 months, the so-called "fear of parting" appears - sadness or acute fright at the disappearance of the mother (when she is gone for a long time or she just went out for a while).
Communicating with mother or other close person, by the end of 1 year the baby strives not only for purely emotional contacts, but also for joint actions.
Begins in infancy and speech development. In the first half of the year, speech hearing is formed, and the child himself, with joyful animation, makes sounds, usually called humming. In the second half of the year, babbling appears, in which one can distinguish some repetitive sound combinations, most often associated with the actions of the child. Babble is usually combined with expressive gestures. By the end of 1 year, the child understands 10-20 words spoken by adults, and he himself pronounces one or several of his first words, similar in sound to the words of adult speech. With the appearance of the first words, a new stage in the mental development of the child begins.

Crisis of 1 year

The transition period between infancy and early childhood is commonly referred to as the crisis of 1 year. Like any crisis, it is associated with a surge of independence, the emergence of affective reactions. Affective outbursts in a child usually occur when adults do not understand his desires, his words, his gestures and facial expressions, or understand, but do not do what he wants. The word "impossible" in a crisis period is of particular relevance.
The main acquisition of the transitional period is a kind of children's speech, which L. S. Vygotsky called autonomous. It differs significantly from adult speech both in sound form (phonetic structure) and in meaning (semantic side). The child has his own logic, and his words become ambiguous and situational.
A young child's language is agrammatic. Words do not combine into sentences, but pass into each other like interjections, resembling a series of incoherent exclamations.
Children's speech is understandable only to the closest people who are constantly next to the child and understand the meaning of his words.
So, a one-year-old child, entering a new period - early childhood - already can do a lot: he walks, or at least tries to walk; performs various actions with objects; his actions and perceptions can be organized with the help of speech, since he understands the words of adults addressed to him. He begins to speak and, although his speech is situational and ambiguous, incomprehensible to most of those around him, his opportunities for communicating with loved ones are greatly expanded. The cognitive and emotional development of the child is based primarily on the need to communicate with adults - the central neoplasm of this age period.

How a newborn baby changes - articles from the specialists of the clinic "Mother and Child"

Babin Evgeny Alexandrovich

Children's surgeon, Orthopedic traumatologist, Children's orthopedic surgeon

Clinic "Mother and Child" Southwest, Clinic "Mother and Child" Kuntsevo,

The baby was born, and we expect him to look like beautiful and pink babies from advertising pictures. And he is some kind of red, then suddenly turned yellow, on the skin or a rash, or peeling. In addition, the weight is still unstable, the chair is incomprehensible - is the child healthy? Healthy, and all these changes are the so-called transient (transitional) states. Where do they come from, what do they look like and what to do with it all?

The child sat in the mother's stomach for nine months, swam in the water and received oxygen through the placenta. As soon as the baby was born, his world immediately became different: instead of water around him, air, the ambient temperature dropped from 36.6-37 ° C to 22-25 ° C, plus gravity, sounds, smells, bright light. And now you have to breathe (lungs) yourself, eat differently, and then also remove metabolic products. And just like that, it is not easy for a newborn to immediately switch from one lifestyle to another, it takes time. That is why, from the point of view of physiology, in the first month of life, “something happens all the time” with children, and much more often and brighter than in later life. These are the transitory (transitional, boundary) states. All of them surprise and even frighten young parents, especially since transition states appear and disappear very quickly. But for newborns, they are completely natural. What moms and dads see most often are transitional states of skin, stool, weight, plus or minus a couple more conditions.

How the skin changes

The child was born, and we see that he is all sort of bluish-purple, and then his skin color immediately turns red. On the second day after birth, the baby "blushes" the brightest. Doctors call this redness "erythema simple" and it appears due to the fact that the skin adapts to a new environment. Then the child's skin turns pale and by the end of the first week of life it becomes the pale pink color we are used to.

But that's not all. On the third or fifth day of life, the baby's skin may begin to peel off, especially on the abdomen and chest. What's this? Does the child lack vitamins, something with nutrition, is the air too dry in the house? No, this is also a transitional state - physiological peeling, and it is also associated with the fact that the skin is adapting to a new life. The skin flakes for about a week, and then everything goes away. You don't need to do anything with it. Of course, you can treat the skin with various softening lotions and creams, but there will be no significant effect from them. Very soon, the baby's skin will become smooth and soft on its own.

Most of all, parents are afraid of a rash on the baby's skin, which does not often, but sometimes still appears in the first week of life. This is the so-called toxic erythema - spots with grayish-yellow seals in the center. The rash is most often located on the extensor surfaces of the arms and legs around the joints, on the chest. Less often, such spots can be on the whole body (except for the palms, feet and mucous membranes). “Maybe it’s chickenpox, rubella, or some other disease?” parents are afraid. No, this is a kind of reaction of the skin of a newly born baby to its environment, especially to hypothermia, overheating, contact with clothes, food. Within one to three days, new spots may appear, but more often two or three days after the onset, they all disappear without a trace. At the same time, the child’s well-being is not disturbed, the body temperature is normal and he does not need any medication. The only thing is that you need to take care of the bubbles on the skin: for example, gently blot them after bathing. And you also need to make sure that the bubbles do not rub and they do not burst (otherwise an infection may join them).

Physiological jaundice

The changes that are visible on the skin do not end there. Very often (in 60-70% of children) on the second or third day of life, the skin turns yellow, the maximum of yellowness occurs on the third or fourth day, and by the end of the first week it disappears. This is how physiological jaundice of a newborn is manifested - a condition in which the amount of bile pigment, bilirubin, increases in a child. In some children, jaundice is similar to a light tan (parents may not notice it), while in others, the skin will turn bright yellow. Very quickly, the level of bilirubin returns to normal and the skin color becomes normal again. If jaundice is mild and passes quickly, then no additional treatment is needed. But if jaundice does not disappear or the skin color is intense yellow, you should consult a doctor.

Weight loss

Do you think the baby will immediately be born well-fed, with folds and cute roundness? No, right after birth, this is still far away. In the first days of life, an already not too well-fed newborn will lose even more weight. Such weight loss is a natural process, the so-called physiological weight loss. Weight decreases because immediately after birth, the baby loses part of the water through the skin, its umbilical cord dries out, meconium (the first feces) and urine are excreted, and also because the baby still eats a small amount of milk. Maximum weight loss usually occurs by the third or fifth day and is normally no more than 6-8% of birth weight. At this time, mother and baby are usually discharged from the hospital, but there is no need to worry. By the seventh or tenth day of life, a healthy baby will restore its previous parameters.

chair changes

On the first or second day, all newborns pass the original stool (meconium): it is thick, viscous and dark green in color. Time passes, the baby begins to receive colostrum, and on the third or fourth day of life, a transitional stool appears. Now areas of dark green color alternate with greenish and yellow ones, and some lumps, mucus are also visible in the stool. It all looks like some kind of intestinal disorder, but it's not. It's just that the gastrointestinal tract is moving to a new job, now it's ready to digest food. By the end of the first week of life, the stool in most children is yellow, similar to gruel, and it will continue to be so.

Warm-cold

A typical fear of all grandmothers is that the child is freezing! Yes, indeed, in newborns, the body temperature regulation processes are still imperfect, so babies easily cool down, but they also overheat just as easily. For example, if a newborn is dressed too warmly or placed next to a heating battery, he will quickly overheat, even if this is the usual temperature in the room. At the same time, the child easily loses heat when he is undressed for a long time or he lies in wet clothes. Therefore, in the room where there is a newborn, the air temperature should be adequate - 20-22 ° C. And if she rises higher, and the child is warmly dressed, then this will also not be good.

Sometimes, very rarely (in 1% of newborns), body temperature on the third or fifth day may temporarily rise to 38–39 °C. There are no other symptoms of the disease, the body temperature quickly returns to normal, but the parents have time to get scared. It’s difficult to figure out what it is - temporary hyperthermia or still a disease - it’s difficult, so it’s better to call a doctor.

Hormonal crisis

An uncommon occurrence, but it also occurs occasionally. In some children, on the third or fourth day of life, the mammary glands become engorged (in both girls and boys). They increase as much as possible by the seventh or eighth day, and liquid discharge may even appear from them. Some girls have very little bloody discharge from the vagina for a very short time. This is the so-called hormonal crisis - it occurs due to the action of maternal hormones - estrogens (they penetrate through the placenta during childbirth). At the peak of estrogen action, the signs of a hormonal crisis are maximum, then the hormones are removed from the body and the symptoms gradually disappear. Therefore, you don’t need to apply a cabbage leaf to your chest, make compresses with camphor or something else: everything will pass by itself.

Usually, all these transitional states are pronounced in the first week of life, less often, but it happens that they drag on for up to three to four weeks. One more thing - it is not necessary that the child will show all transitional states, but almost everyone has physiological weight loss and transitional stools. And many of the transitional states are completely invisible to parents, but they also exist, they can simply be identified only by laboratory methods.

So we are not in a hurry to be frightened, noticing that the child’s skin suddenly began to peel off or he turned slightly yellow. We remember that he must adapt to a new life, that in the first time after birth, the baby has the right to some changes. Especially if, with all this, the baby is cheerful, calm and eats well. Well, if you are still somehow anxious, ask your pediatrician questions. He will definitely be able to put everything in its place.

Incision

The maximum weight loss in a newborn usually occurs by the third or fifth day and normally amounts to no more than 6-8% of body weight at birth.

From the point of view of physiology, in the first month of life, “something happens all the time” with children, and much more often and brighter than in later life. These are the transitory (transitional, boundary) states.

In infants, the body temperature regulation processes are still imperfect, so they easily become overcooled and overheated. In this regard, in the room where there is a newborn, the air temperature should be about - 20–22 ° C.

Physiological jaundice of the newborn:

occurs on the 2-3rd day of the baby's life, reaches a maximum on the 4-5th day, and disappears by the 10th day;
the general condition of the child does not suffer;
the level of bilirubin in the blood does not exceed 180 µmol/l.

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