When does baby soft spot on head close
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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Long, MD
all you need to know about fontanelles in newborns and children 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 fontanel 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 fontanelle 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. In a calm state, it should neither bulge and pulsate, nor sink.
Is it normal to have crusts on the child's head in the fontanel area?
Parents should understand that the fontanel does not require special care. The head of the baby is washed and the hair is combed as usual. But if there are traces of flaky skin on the fontanel, then before bathing they can be lubricated with olive or corn oil, and after bathing, carefully comb out the head. But only if there is a need for it. Sometimes such "shells" on the child's head may indicate manifestations of diathesis, so they need to be monitored.
If they appear again and again, contact your pediatrician.
Yulia Melnichuk
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 infants, 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. Role of the fontanel: The size of the anterior (large) fontanelle varies greatly. On average, the normal size of the fontanel at birth is 3.0 * 2.5 cm, it has a diamond shape. As the baby actively grows and develops, 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 Hypotryeresis - Rachit 9000,0002 Rachelite 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. The change in the appearance of the fontanel also indicates a number of certain problems: - the temperature increase to febrile numbers - multiple vomiting - diarrhea - meningitis - encephalitis - intracranial bleeding - increased intracranial pressure Many factors are affected on the pace of ossification: - a balanced diet - sufficient intake of calcium in the body - polyvitamin complexes - prescribing Vitamin D Large fontanel in newborns. Examination IPM Clinic for Children Krasnoyarsk
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.
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.
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Dispensary examination of a child under one year old allows the pediatrician to examine the baby every month.
