When does a baby skull close
About the fontanelle | Pregnancy Birth and Baby
About the fontanelle | Pregnancy Birth and Baby beginning of content5-minute read
Listen
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
Back To Top
Related pages
- Regular health checks for babies
- Knowing your baby is well - podcast
- How to know when your baby is well - video
- How your baby’s brain develops
Need more information?
Newborn baby essentials
Find out some of the essentials for looking after your newborn. Find out when your baby will need to have health checkups and immunisations. There is also lots of information on nappies, giving your baby a bath and teeth development.
Read more on Pregnancy, Birth & Baby website
Colic in infants - MyDr.com.au
Colic is a pattern of unexplained, excessive crying in an otherwise healthy and well-fed baby and happens to 1 in 5 Australian babies.
Read more on myDr website
Knowing your baby is well - podcast
Listen to Dianne Zalitis, midwife and Clinical Lead at Pregnancy, Birth and Baby, talk to Feed Play Love with Shevonne Hunt about signs your baby is well.
Read more on Pregnancy, Birth & Baby website
Common worries and fears for parents
New parents often worry that they don't know what to do. However, there are practical ways to deal with the challenges so you can enjoy your baby more.
Read more on Pregnancy, Birth & Baby website
Flattened head
Plagiocephaly (flattened or misshapen head) means an uneven or asymmetrical head shape. Plagiocephaly won't affect your baby's brain development but it should be treated.
Read more on Pregnancy, Birth & Baby website
Glossary of pregnancy and labour
Glossary of common terms and abbreviations used in pregnancy and labour.
Read more on Pregnancy, Birth & Baby website
Disclaimer
Pregnancy, Birth and Baby is not responsible for the content and advertising on the external website you are now entering.
OKNeed further advice or guidance from our maternal child health nurses?
1800 882 436
Video call
- Contact us
- About us
- A-Z topics
- Symptom Checker
- Service Finder
- Linking to us
- Information partners
- Terms of use
- Privacy
Pregnancy, Birth and Baby is funded by the Australian Government and operated by Healthdirect Australia.
Pregnancy, Birth and Baby is provided on behalf of the Department of Health
Pregnancy, Birth and Baby’s information and advice are developed and managed within a rigorous clinical governance framework. This website is certified by the Health On The Net (HON) foundation, the standard for trustworthy health information.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
This information is for your general information and use only and is not intended to be used as medical advice and should not be used to diagnose, treat, cure or prevent any medical condition, nor should it be used for therapeutic purposes.
The information is not a substitute for independent professional advice and should not be used as an alternative to professional health care. If you have a particular medical problem, please consult a healthcare professional.
Except as permitted under the Copyright Act 1968, this publication or any part of it may not be reproduced, altered, adapted, stored and/or distributed in any form or by any means without the prior written permission of Healthdirect Australia.
Support this browser is being discontinued for Pregnancy, Birth and Baby
Support for this browser is being discontinued for this site
- Internet Explorer 11 and lower
We currently support Microsoft Edge, Chrome, Firefox and Safari. For more information, please visit the links below:
- Chrome by Google
- Firefox by Mozilla
- Microsoft Edge
- Safari by Apple
You are welcome to continue browsing this site with this browser. Some features, tools or interaction may not work correctly.
When Does the Fontanelle Close?
- Download PDF Copy
By Cashmere Lashkari, B.Sc.Reviewed by Dr. Catherine Shaffer, Ph.D.
A newborn baby can look quite unlike what is usually seen in the media. The head looks misshaped, the skin is blotchy and there are many wrinkles. However, within a few days, the features begin to change and the baby begins to look like a tiny version of the parents.
The one part of the baby that still requires care is the fontanelle. Fontanelle, also spelled fontanel, is derived from the Latin term fonticulus as well as the Old French word fontaine, which means fountain or little spring. The presence of the fontanelle is essential for the protection and proper development of the baby’s brain.
Image Credit: Demkat/Shutterstock.com
What is the fontanel or fontanelle?
The skull of a baby is made up of six different bones that are held together by a flexible, elastic tissue called a suture. There is one frontal bone, one occipital bone, two parietal bones and two temporal bones. Sutures are present along the edges of all six bones and hold them together to form the cranium.
When you feel along a baby’s skull, there are soft places where the bones are not quite knit together. These soft areas are called the fontanelles. They are bordered by the suture lines which will eventually close and produce a solid skull.
If the sealing of the suture is done along the sagittal suture that runs the length of the skull, a long and narrow head is produced. Should the permanent seal take place along the coronal suture, which tends to run from side to side on the skull, it will produce a short and wide-shaped head.
Different types of fontanelle in newborn babies
When the six skull bones are bound by suture lines, six fontanelles are formed along them. The two primary fontanelles are the a nterior fontanelle and posterior fontanelle. The anterior fontanelle is found between the frontal bone and parietal bones. The posterior fontanelle is located between the pair of parietal bones and the occipital bone.
In addition to these two larger-sized fontanelles, there are four smaller fontanelles along the sutures of the remaining bones. Two are known as sphenoid fontanelles and the remaining two are called mastoid fontanelles.
The sphenoid fontanelles are on the front side of the skull between the sphenoid bone and the parietal bone. The mastoid fontanelles are found between the temporal bone and the occipital bone. This fontanelle lies towards the rear of the skull.
Time taken after birth for the fontanelles to close
The anterior fontanelle takes the longest time after birth to close. It will take between 12 to 18 months for the sutures to solidify here. The fontanelle is usually closed by the time the baby completes its second birthday.
The posterior fontanelle closes much earlier. By the third month after the baby’s birth the soft spot on the rear of the skull is usually sealed up as the suture knits the bones together. As the suture solidifies, the back of the skull is closed completely.
The sphenoid and mastoid fontanelles also close up within a couple of months of the birth of the baby. They are small and so are not noticed by most parents as soft spots on the baby’s skull.
Skull fontanelles
Precautions to take while fontanelles are open
The soft bones and flexible sutures can cause the head of the baby to flatten out. Should the flat area appear at the back of the head it is known as plagiocephaly, while if the flatness appears on the side of the head it is referred to as brachycephaly.
The appearance of this flatness is directly related to the position the baby’s head lies in when he sleeps. Parents should encourage the baby to sleep on the back and when awake to rest the rounder part of her head on a pillow. A rolled-up towel or a pillow in the shape of a doughnut may also be used to take the weight off the bones.
To get the baby to look from one side to the other, change the position of a favorite toy. As the neck muscles grow stronger make him lie on his stomach. As the baby grows older and can turn his head and sit up the pressure on the skull will decrease and the flatness will round out into a regular skull shape.
Should the shape of the head still appear abnormal after the baby has reached the toddler stage, discuss it with the doctor. He may perform a physical examination of the fontanelles to see if there is any development issue with the cranial bones. Should a problem exist a physiotherapist may be able to help correct it.
References- Medline Plus, Cranial Sutures, https://medlineplus.gov/ency/article/002320.htm
- BabyCenter, Soft Spots, http://www.babycentre.co.uk/x552709/what-are-the-soft-spots-on-my-newborns-head
- American Family Physician, The Abnormal Fontanelle, http://www.aafp.org/afp/2003/0615/p2547.html
- Kidshealth, http://kidshealth.org/en/parents/newborn-variations.html
Further Reading
- All Fontanelle Content
- What are Fontanelles?
Last Updated: Mar 31, 2021
- Download PDF Copy
Please use one of the following formats to cite this article in your essay, paper or report:
APA
Lashkari, Cashmere. (2021, March 31). When Does the Fontanelle Close?. News-Medical. Retrieved on December 11, 2022 from https://www.news-medical.net/health/When-Does-the-Fontanelle-Close.aspx.
MLA
Lashkari, Cashmere. "When Does the Fontanelle Close?". News-Medical. 11 December 2022. <https://www.news-medical.net/health/When-Does-the-Fontanelle-Close.aspx>.
Chicago
Lashkari, Cashmere. "When Does the Fontanelle Close?". News-Medical. https://www.news-medical.net/health/When-Does-the-Fontanelle-Close.aspx. (accessed December 11, 2022).
Harvard
Lashkari, Cashmere. 2021. When Does the Fontanelle Close?. News-Medical, viewed 11 December 2022, https://www.news-medical.net/health/When-Does-the-Fontanelle-Close.aspx.
Large fontanel in newborns. Examination IPM Clinic for Children Krasnoyarsk
The birth of a baby is a very important and joyful event in the life of young parents. After birth, there are a lot of questions about the health, care and proper development of the baby. The very first questions are often asked about the fontanel.
Fontanelle - soft, non-ossified area of the cranial vault of newborn babies, consisting of the remnants of the membranous skeleton and connecting the bones of the skull. In the area of the fontanelles, a pulsation of the arteries of the brain and membranes is felt, which is why these areas are called pulsating, gushing. Fontanelles allow you to “compress” the cranial vault during childbirth for a better passage of the baby through the birth canal. Four of them close in the first days of a child's life, the fifth in the second month of life, and the sixth, the largest (anterior), closes from 3 to 24 or more months. Very often, fontanelles and the pace of their closure cause great concern to parents.
Role of the fontanel:
- The growth of the skull bones depends on the growth of the brain. The fontanelles provide elasticity to the skull during the most rapid growth. This period is from birth to two years of a child's life.
- Fontanelles also protect the baby's skull from injury: upon impact, the possibility of elastic deformation of the skull remains, which extinguishes all the kinetic energy of the blow and protects the child.
- The brain of a newborn baby is very sensitive to overheating, and a kind of natural “window” brings excess heat out and naturally cools the meninges, thereby playing an important role in the processes of heat transfer and thermoregulation of the body.
The size of the anterior (large) fontanel varies greatly. On average, the normal size of the fontanel at birth is 3.0 * 2.5 cm, it has a diamond shape.
With active growth and constant development of the baby, the free space between the bones gradually hardens and decreases in size, the pulsation becomes almost imperceptible.
Timing of fontanel closure may vary. On average, complete closure occurs by the year (normally also up to two years).
When the fontanel closes too slowly, the parents start to worry. But premature closure also does not speak well.
Causes of the “big” fontanel:
- Achondroplasia (hereditary disease)
- Down Syndrome
- Hydrocephalus
- Premature birth
- Neonatal Hyphyeriosis
- RACHIT 9000,0006 RACHITS is one of the most common causes slow closure of the fontanel. Most often, rickets develops in premature babies and in children who do not receive preventive treatment with vitamin D. In a child with rickets, the edges of a large fontanel are flexible, the back of the head flattens, and characteristic bone thickenings form on both sides of the sternum.
The change in the appearance of the fontanel also indicates a number of certain problems:
- Furious fontignant occurs against the background of
- an increase in temperature to febrile numbers
- multiple vomiting
- diarrhea
- Burring of the native nourish
- meningitis
- encephalitis
- intracranial bleeding
- increased intracranial pressure
Many factors are affected by the Rodnichka:
- for mom:
- a balanced diet
- sufficient intake of calcium in the body
- polyvitamin complexes
- for the child:
- prescription of vitamin D 9000
— sunbathing
Dispensary examination of a child under one year old allows the pediatrician to examine the baby every month. During the examination, a complete examination of the child is carried out, weighing, measuring height, head and chest circumference. The size of the large fontanel is also measured.
Be healthy!
Phone number for making an appointment with a pediatrician (391) 200-50-03
everything you need to know about fontanelles in newborns and children - Children - tsn.ua
they are a little worried: how to do everything correctly and accurately, without injuring the fragile bones of the baby? They are especially afraid of washing the head of the baby and combing the hair because of the fontanel. Maya Smolyar, head of the department of post-intensive nursing of premature newborns of the Zhytomyr Regional Perinatal Center, spoke about whether special care is needed for the fontanel and what changes in it should alert.
What is the fontanelle and what is it for
The fontanel is that part of the child's head where there is temporarily no complete ossification. The largest fontanel is on the crown, where the bones do not converge together, leaving a diamond-shaped area. Physiologically, the child is designed so that during childbirth, these bones of the skull are slightly deformed, allowing the fetal head to pass through the birth canal. In addition, the fontanel is a kind of reserve, due to which the brain of a newborn child will then grow.
Normally, a child has 6 fontanelles. The largest is located on the crown, the second largest is the occipital, it is typical for premature babies. The smallest are located on the sides of the cranium.
When do fontanelles overgrow?
At the time of birth, a full-term baby has only one large fontanel on the crown of the head. All others must be closed. In extreme cases, traces of the occipital fontanel may remain, which should close during the first month. And the lateral fontanelles must be overgrown by the time of birth.
When does the parietal fontanel close?
Normally, a large fontanel closes in the period from one to 1. 5 years. If the closure occurs earlier, for example, at 6-8 months, then this may be a normal variant or a family predisposition, but this should be paid attention to and consulted with a pediatrician. Premature closure of the fontanel may indicate the manifestation of certain problems.
What should I do if the fontanel actively pulsates or sinks?
If the child's parietal fontanel pulsates when crying, you should not pay attention to it, but if the pulsation is noticeable in the child's calm state or during sleep, then you need to contact a pediatrician, who will refer you to a pediatric neurologist. Most likely, the child has increased intracranial pressure, or the so-called hydrocephalic syndrome.
Sometimes, the fontanel, on the contrary, sinks inward. This can only happen in children of the first month of life. And if it sinks after the first month, then this indicates that the child has lost fluid with diarrhea or is not eating enough. Parents should know that a normal fontanel should be at the level of the skull bones.