A baby from birth to a year is the object of close attention of parents and relatives. Young parents tend to worry and worry even for no particular reason, let alone situations where the development of the baby does not fit, according to others, into the norm. Very often, the definition of such a norm is made not by pediatricians, but by neighbor grandmothers, familiar mothers, etc.
In this article we will talk about infant fontanelles. We will tell you what it is, what they are, what time the fontanel overgrows, what does the early closure of the fontanel mean, what to do if the fontanel overgrows poorly, etc.
What is a fontanel?
Fontanelles are called soft, non-ossified areas of the skull of a newborn, not covered by the cranial bones. They are formed due to the fact that the bones of the skull in the baby continue to develop, and at the time of birth they are not fastened together as tightly as in an adult. The mobility of the cranial bones makes it possible for the child to pass through the birth canal. In the first year of life, the child's skull continues to actively form, fontanelles gradually close (initially there are several of them). Parents often think that the slightest touch can damage the integrity of the fontanel. Actually it is not. The soft parts of the skull of the crumbs are covered not only with skin, but are also protected by an additional layer of liquid under it and a strong inner film. Of course, it is still worth observing safety precautions and elementary caution when in contact with the fontanel, but you should not be afraid to touch it. Often, because of their fear, parents want the fontanelles to close as quickly as possible and are worried that they persist, in their opinion, for too long. Meanwhile, one should be afraid, first of all, of the early closure of fontanelles, because if a fontanel quickly overgrows in a child, this indicates impaired development of the brain and central nervous system, especially when not only the fontanel closes, but also the head circumference decreases ..
The fontanelles on the sides of the head of the newborn are the first to close. This happens in the first month after birth.
The small fontanel located in the back of the head also decreases. Wherein large fontanelle, parietal, can increase in size - there is nothing wrong with that. But be careful - the simultaneous increase in all fontanelles and the divergence of the sutures of the cranial bones indicates an increase in the internal pressure of the skull.
If you notice the pulsation of the fontanel, do not worry. This suggests that the blood circulation of the crumbs is in order. But a sunken fontanel is already a reason for unrest - a sign of dehydration.
What time should the fontanel close?
As already mentioned, the lateral fontanelles are the first to close (in the first month of life in premature babies, and in children born at term, the lateral fontanelles very often close already at birth or in the first days of life, so that many parents do not even know about their existence). Non-closing lateral fontanelles in full-term babies may indicate the development of dropsy of the brain. Do not hesitate and consult a doctor for diagnosis and, if necessary, 
treatment prescription. After that, the small fontanelle (behind the head) gradually decreases in size and disappears - by the age of three months, it usually disappears completely. The closure of a large fontanel occurs later - usually up to a year. In some cases, its closure stretches up to 15 months and even a year and a half. Until this time, it gradually decreases in size until it closes completely.
Remember, if you have any doubts about the timing of overgrowth of fontanelles (it doesn’t matter if it seems to you that your baby is ahead of schedule or, on the contrary, behind them), contact your doctor right away.
A gentle pulsating area on the head of a newborn, called the fontanel, is not only an object of increased anxiety of parents, but also important indicator states child's body.
Most primiparous women are very intently look after the parent on the baby's head. And this is not surprising, because this delicate area on the child's head requires special attention.
So, fontanel condition can indicate a developmental pathology and even a life-threatening disease. What can the fontanel of a newborn say, when should it close and what kind to have - read in this article.
Where is the child's fontanel?
spring- soft space between the bones of the skull, filled with connective tissue, which in the process of growth and development of the child ossifies.
Not many people know that in fact the skull of a baby was originally has 6 fontanelles, not just one. By the time of birth, all 5 (or 4, not including the posterior one), except for the large one, may overgrow, or may remain of a small size. Rodnichki, like everything in human body, are not random at all - they play an important role.
During childbirth, thanks to fontanelles, the baby's skull shrinks and passes through the birth canal. After that, already in extrauterine life, fontanelles that were not overgrown, act as shock absorbers on impact without damaging the brain.
In addition, the fontanelles do not allow the bones of the skull squeeze the fast growing brain child, and elevated temperature play the role of thermostats, preventing the brain from overheating.
Newly made mothers, without extraneous clues, know where the notorious large fontanel is located. It’s hard not to notice it on the baby’s head, because it occupies an area 3 by 3 cm in the very center of the crown. A small posterior fontanel is located on the back of the head, but due to its small size, it often goes unnoticed.
Appearance of a large fontanel can tell you a lot:
- sunken fontanel in the first weeks of life, the baby speaks of its postmaturity, and subsequently - alarm signal dehydration
- protrusion with pulsation indicates increased intracranial pressure. If this happens during crying, then this type of fontanel should be, if at rest - see a neurologist
- too much slow closing may indicate the development of rickets or hydrocephalic syndrome
Be sure to tell us about your observations of the baby’s fontanel at the appointment of the district pediatrician, because the mother is with the child 24 hours a day and notices what escapes the eyes of the doctor.
Video: Fontanelle in a child
When should a fontanel grow in a child?
Terms of overgrowing of a large fontanel quite individual. There are no strict criteria for when exactly the fontanel should ossify, but most pediatricians tend to think that this should happen during the period 6 to 18 months. As statistics show, most often the closure of the fontanel occurs from half a year to a year, but there are cases when this happens earlier or later - at 3 months or up to two years.
Fontanelles most often close in the period from six months to a year, but can ossify much later Do not worry if the fontanel does not close during this most common period. Each child is individual, and if the fontanel of a neighbor's baby has already closed, but yours has not, then this only speaks of his individual development.
The size of the fontanel in a child by months
At each examination of the child, from the moment of his birth to the complete closure, the pediatrician will measure the fontanel. This is necessary in order to have an idea of brain growth and development and perfecting the baby's skull. There are certain norms that show what the size of the fontanel should be for months.
At birth, the size of the large fontanel is usually 3 by 3 cm, but it may be slightly less or more, which is not considered a deviation from the norm. During the month, the size of the fontanel can increase a little but don't be afraid of it. This is observed for the reason that during childbirth the child's skull was strongly compressed, and after a while, due to the elasticity of the tissues, returns to its original form.
Also fontanel enlargement in the first month of life, the crumbs contribute fast growth brain.
After the first month, the size of the fontanel should gradually decrease until complete ossification occurs and the fontanel closes completely.
Video: When should fontanelles close?
Fontanel in a child at 2 months
By the end second month of life the fontanel may decrease slightly. For parents, these changes can go completely unnoticed, but the doctor will definitely pay attention to how the fontanel has changed. Say exactly what it should be fontanel two month old baby difficult - because it is important to take into account what he was at birth.
On average, by two months, the fontanel can become the size 22-25 mm. Usually so early fontanel closure should not happen, and if this happens, then it is better to consult a pediatrician, because the baby is still very small, his brain is actively developing and growing, and earlier overgrowth of the fontanel may be extremely undesirable at this age.
Early overgrowth of the fontanel (up to 3 months) is considered pathological only if atypical sizes for this age are observed head circumference. If the head circumference corresponds to the norms and terms, then the child is considered healthy, and earlier closure of the fontanel is a feature individual development skeletal system.
Causes of early overgrowth of the fontanel:
- excess calcium that enters the body
- underdevelopment of the brain
- craniosynostosis is a specific disease that occurs against the background of endocrine diseases or rickets, which is characterized by earlier closure of the sutures of the skull and multiple concomitant symptoms(very rare)
- brain anomalies (extremely rare is the cause of overgrowth of the fontanel)
Talk about early overgrowth of the fontanel due to any disease, only a qualified neurologist can. And only after a specific diagnosis has been made, can any measures be taken to stop the ossification of the fontanel.
Fontanel in a child at 3 months
Only in 1% of children large fontanel overgrows at 3 months, and in average crumbs by this age it becomes the size 23-24 mm. If your baby belongs to this small percentage of children with by 3 months closed fontanel, then you should not raise the alarm and drag the child to hospitals.
If big the fontanel closed, but the child develops in time, you do not observe any pathologies and oddities in behavior, and the circumference of the head of the crumb corresponds to the age, then such a closure of the fontanel considered a physiological phenomenon.
Fontanel in a child at 4 months
From 3 to 4 months the fontanel of the child continues to overgrow and its size is about 2cm. Complete closure of the fontanel at this age is as rare as in the previous month, but individual cases still occur. On the whole complete ossification of the skull not typical for a 4 month old baby.
Parents should not worry - if the fontanel is overgrown not on time, then the pediatrician at the next appointment will definitely tell you about it. If necessary, the baby will appoint vitamin D or recommend increasing the amount of calcium in the diet of a nursing mother.
Fontanel in a child at 5 months
From 5 months the size of a large fontanel becomes about 17 mm. Most likely, over the next two or three months it will remain unchanged, but quite often, by 6-7 months the fontanel is completely closed. The closure of the fontanel in the following months is not considered a pathology - this is quite normal.
According to the average indicators, the fontanel has such approximate sizes up to a year:
- 8-9 months - 1.4-1.5 cm
- 9-10 months - 1.2-1.4 cm
- 10-11 months - 0.9-1.2 cm
- 11 months - a year - 0.5-0.8 cm
Usually, by the age of one the fontanel of the crumbs closes, and in many cases this happens earlier.
Fontanel in a premature baby
At premature babies fontanelles are observed at birth large sizes and in addition to the front and rear there are also lateral fontanelles. Just like premature babies are born earlier deadlines, then their development differs in many respects from the development of their peers, and the overgrowth of fontanelles also occurs differently.
The closure of the fontanel in premature babies occurs somewhat later than is commonly considered the norm, but it's not a cause for concern. Even if the child is significantly behind his peers in development, his rate of development will come to normal by the age of three and will be equal to the same age.
As a rule, a large fontanel in premature babies closes in one and a half to two years. IN rare cases ossification occurs later at 2.5 years old.
Premature babies are under special control of pediatricians and at the slightest suspicion of any pathology, the doctor will prescribe an appropriate examination to exclude possible development pathology. Nevertheless, if any changes in the fontanel in a child bother you, then be sure to contact a specialist.
Why does the fontanel in a child grow poorly?
As already mentioned, the ossification of the skull and the tightening of the large fontanelle in each child occur in different ways. On how quickly the fontanel will drag on, such factors influence:
- term- if a child is born ahead of schedule, then he will lag behind his peers in development and the closure of the fontanelle will occur much later than in full-term children
- nutrition- in children who are on breastfeeding the fontanel ossifies earlier than that of artificial people. This is due to the fact that mother's milk contains a sufficient amount of calcium, which is necessary for the formation and strengthening of the skeleton. Important role in the closure of the fontanel, the intake of vitamin D also plays, which helps calcium to be absorbed
With a slow closing of the fontanel, the doctor may prescribe vitamin D - intensity of development- if the child grows slowly, then the fontanel will overgrow at that pace
- heredity
- the presence of endocrine, neurological, genetic diseases
What to do if the fontanel in a child closes early?
IN Lately increased incidence in pediatric practice early closure of the fontanel. Pediatricians attribute this primarily to the fact that during pregnancy, expectant mothers took crumbs complex vitamin preparations. As a result, an excess of calcium is observed in the child's body, which leads to the early closure of the fontanel.
If ossification occurs too early, many experts say about multiple negative consequences, after all, the rapidly growing brain slows down its development, squeezed by the cranium. In fact, no scientific research has been conducted on this subject and to say that it is indeed dangerous to close the fontanel earlier - it is forbidden.
Therefore, if your pediatrician, after measuring head circumference and other parameters, does not see any deviations from the norm in the child , then no action is required on your part to prevent the closure of the fontanel.
If the doctor considers that the rapid closure of the fontanel is due to violations metabolic processes , namely due to excess calcium, he will recommend reducing the intake of food containing calcium and vitamin D. Independently limit the child in such important substances not worth it.
spring plays a big role both during the birth of a child and after it is born. Behind this delicate part of the child's body, special control and reverent attitude are needed, because it can say a lot. about the child's condition and development. If you are concerned about the appearance of the fontanel or its closure, then you must definitely consult with a pediatrician.
Video: Fontanelle in a newborn. Komarovsky
Many people know that a baby has a soft spot on its head called a fontanelle. Fewer are those who are aware of the existence of lateral and posterior fontanelles. And certainly not everyone is sure why they are needed and what it really is.
In infants, the skull is not solid; it is made up of many individual bones. They are connected by a kind of membrane, when the child passes through the birth canal, this helps to flatten the head a little, otherwise natural childbirth would be impossible. In total, newborns have six fontanelles:
- front;
- rear;
- a pair of mastoid lateral;
- a pair of wedge-shaped lateral.
After the baby is born, the connective tissue gradually transforms into bone. In pediatrics, some norms have been established regarding the timing of the closure of fontanelles:
- The posterior fontanelle closes the fastest of all - in a maximum of 2 months, it can also close by the first month of a baby's life.
- Then the wedge-shaped ones close, it takes about six months.
- The next mastoid, their closure lasts from six months to one and a half years.
- The anterior fontanel can be soft up to the age of two.
Most of all, moms have questions about the anterior fontanel. At birth, its size is from 2 to 3.5 centimeters. Many are afraid to even just touch this soft area on top of their heads, although a mother can kiss a child on the fontanel or comb her hair without any fear. There are many rumors associated with this area, so mothers start to worry when they think that the size of the fontanel is too large or it is not tightening fast enough. We would like to clarify all the incomprehensible points and thereby reassure young mothers.
Why is the fontanel big
In most cases, it just seems to the mother that the fontanel is larger than it should be, but normally it can reach a size of 3.5 centimeters. Sometimes a simple measurement dispels all doubts and confirms that the size does not exceed the norm. There are certain factors that affect the size of this area:
№
Causes of a large fontanel Cause Description
1
hereditary predisposition If one of the baby's grandmothers confirms that the parent was also born with a large fontanel, then this is absolutely not dangerous for the baby and is just a family feature.
2
Problems during gestation If the mother was deficient in vitamins, ate irregularly and did not take care of her diet, then this may be one of the reasons for the increased size. A pregnant woman should carefully take care of her menu, take special vitamin complexes and walk more
3
baby menu A child who is breastfed usually does not have such problems, but artificial ones sometimes have a large fontanel
To understand what kind of fontanel tightening dynamics is normal, check out the table:
Age Dynamics
1 month During this period, no visible changes in size are observed.
2 months Sometimes at this age, the fontanel increases slightly. This is the normal version
4 months Approximately at this time, the first changes in the direction of decrease begin.
6 months The pulsation of the fontanel remains noticeable, so it is difficult to accurately measure changes
8 months The area acquires a rounded shape, the pulsation decreases
1 year Some fontanelles are delayed by this time, others may remain partially open until the age of 2 years
Note that no relationship was found between the size of the fontanel at birth and its subsequent changes. Some pediatricians note that in boys this process is faster than in girls.
If at 8 months the fontanel is still too big and hasn't changed much since the baby was born, tell your pediatrician about it for advice.
What can a large fontanel say
In rare cases big size The fontanel can still signal serious problems:
№
Causes of a large fontanel Description
1
Rickets This is a disease that is characterized by the fact that the child does not receive enough calcium, because of this, the formation of bones occurs with disturbances. It often happens in those babies who do not receive enough vitamin D, they rarely go out into the sun, sometimes this is the result of prematurity. In addition to an unretractable fontanel, one of the symptoms is a thickening of the bones on the sides of the sternum. In this case, you need to show the child to the doctor, most likely, he will be prescribed vitamin D.
2
Down syndrome It is clear that this syndrome is diagnosed immediately after the baby is born according to the characteristic appearance and the only transverse fold on the palm, an additional study of the number of chromosomes is assigned. This disease causes deviations in physical development and also mentally. This child needs help. medical workers throughout life
3
Hypothyroidism In this disease, a person has reduced basic functions thyroid gland. Additional symptoms: lethargy, lethargy, drowsiness, frequent constipation, food refusal. Since the thyroid gland affects the formation of the skeleton, it also indirectly affects the tightening of the fontanel. To accurately determine the diagnosis, you need to donate blood to determine the concentration of hormones. If the disease is confirmed, the doctor prescribes hormone replacement therapy
4
Chondrodysplasia The disease is extremely rare, its other name is dwarfism. In babies with this disease, the arms and legs are slightly shorter than in other children, the head is wide, and the forehead protrudes significantly. In modern medicine, the disease is recognized as incurable.
5
Hydrocephalus In this disease, an excess amount of cerebrospinal fluid accumulates in the brain. The disease has several stages, depending on the complexity, doctors make predictions. To date, there is an operation that can help the child, and if the disease is detected immediately after childbirth and the operation was performed on time, then the consequences for the child will be minimal
6
Apert syndrome This is a pathology of cranial development, the most bright symptom: anomalies of the hands, for example, fusion of the fingers. It is a rare disease that occurs in one in 180,000 babies. Treated with surgery
7
Clavicular-cranial dysplasia It is inherited. With this syndrome, developmental disorders of the cranial bones are noted, the clavicles are either underdeveloped or completely absent. Occurs in 1 in a million children born. Doesn't affect at all mental development child
8
"Glass/Crystal Man" Syndrome With this pathology, human bones lack collagen, they become too brittle and break from minor impacts. There are 4 types of the disease, differing in severity of manifestations
As you may have noticed, most of these diseases are rare, if not exotic. The most common cause of a large fontanel is the prematurity of the baby.
preterm birth
A baby is considered premature if it is born at less than 37 weeks of gestation. In Russia on this moment Babies are considered viable from 22 weeks. However, cases of rescue of 20-week-old babies have been recorded.
There are many factors that affect the timing of the birth of a child. There are reasons that the mother cannot influence:
- previously, the mother had operations on the uterus or abdominal organs;
- multiple pregnancy;
- placenta previa;
- the sex of the baby is male (boys are more often born prematurely);
- severe illnesses.
However, some of the risk factors are the responsibility of the mother:
№
Factors Description
1
Stress Frequent stressful conditions, high fatigue at work, especially in the later stages, lead to early delivery. Here we include the ride in public transport during rush hour for a significant period and refusal to part with heels
2
Nutrition Irregular eating, skipping meals can affect the health of the mother. Some pregnant ladies believe that they have gained a lot of weight and drastically limit their diet in pursuit of beauty. This negatively affects the condition of both mother and child!
3
Mother's age Prematurity is faced by minors and women elegant age(closer to 40 years), especially if their first pregnancy
4
Bad habits If during pregnancy the mother smokes, drinks or uses drugs, then this is a direct path to premature birth.
Try to watch your diet, not worry about troubles at work, protect yourself from worries. And of course, do not poison your child with poisons. Some mothers refer to their acquaintances who drank/smoked, and "everything is fine with the child." Each child is individual, in addition, it is impossible to predict the impact of these substances on the health of the baby in the future.
A large fontanel in the vast majority of cases is not a pathology, rather, a feature of development.
If you're still worried, then just handle it with care:
- No need to put pressure on this tender area. If it is sunk or, conversely, slightly swollen, then contact your pediatrician for advice. You don't need to explore it yourself.
- Do not comb your baby's hair too often so as not to disturb the fontanel area. An ungrown fontanel is easy to injure with the teeth of a brush or comb.
- Make sure that there are no scratches, abrasions and wounds in this place.
- Do not let the baby sleep on one side or only on the back, turn it over. It also contributes to the formation correct form skulls.
- If you see crusts or peeling in this place, lubricate them with cosmetic baby oil or cream, then carefully comb them out.
- Try to reduce the impact on the fontanel: carry the baby in your arms, put on a hat.
- Save your baby from stress and excessive crying, if you continue to breastfeed, then eat more cottage cheese and dairy products.
Most importantly, do not panic, especially under the age of six months. At this age, it is still impossible to track the dynamics of overgrowth of the fontanel, the doctor should recommend that you add vitamin D to the child's diet (2 drops per day) and continue to monitor general condition baby.
Summing up
Dangerous and incurable conditions, which are accompanied by an increased size of this area, are extremely rare. Moreover, they are usually diagnosed immediately after birth. If this did not happen in your case, then the ecology and the modern rhythm of life, which is exhausting, are most likely to blame. future mother and affects her general condition.
Video - fontanel. Doctor Komarovsky
A newborn baby is a small, gentle creature that you want to protect in every possible way from dangers. The baby is still fragile and parents are afraid to even take him in their arms. Parents are especially careful about the soft crown on the baby's head, which is also called the fontanel. Everything seems to be worth carelessly touching this place and you can harm the child's brain. And among the people, a large or vice versa small width of the fontanel becomes a cause for concern about normal development baby. Is it correct? And when does the fontanel grow in newborns? Let's see what the doctors have to say about this.
The fontanel in a newborn child is usually considered an unossified space between the frontal and parietal bones of the skull. This is the remnant of a cartilaginous membranous formation that first surrounds the fetal brain in the womb. Subsequently, this space is filled with bone tissue. Further, small bone points are formed, like islands covering the future skull of the child. And in the end, gradually connecting, these points form bone plates, which already represent the basis of the bones of the skull. When a child is born and the bones of the skull are almost formed, there are elastic spaces between them that can pulsate like water in a spring. By analogy, the name of these areas appeared. Wide gaps are called fontanelles, and narrow gaps are called sutures.
Young parents are frightened by the pulsation of the fontanel and it often happens that they try not to touch this place on the baby's head. These fears are in vain, because the fontanel is covered with a strong elastic fabric, protecting the baby's head from touch and serious injury.
Six fontanels of newborns?
We are used to the fact that the fontanel is called a soft area on the head, located approximately above the baby's forehead. This is not entirely true. In fact, this fontanel is the sixth of those that are on the head of the child:
- The first and second are two small wedge-shaped fontanelles located in front between the parietal, frontal, squamous and sphenoid bones. They overgrow in the womb or at the beginning of the baby's life.
- The third and fourth are also two small fontanelles. They are called mastoid and are located behind, behind the ears, where the parietal bone, occipital scales and mastoid process of the temporal bone connect. They also close shortly after birth.
- The fifth is a single occipital fontanel. It is triangular, also small in size - somewhere around 5 millimeters. It is located where the two parietal and occipital bones converge. This fontanel overgrows in the first two months of a child's life.
- The sixth is a single frontal or parietal fontanel. It is diamond-shaped and is located in front of the crown, at the point of convergence of the parietal and frontal bones. At birth, its dimensions are approximately 2.5-3.5 cm. It overgrows by two years. Just this spring is widely known among the people. It is also called the soft crown. About him and will be discussed further.
The parietal fontanel is given special attention. If it exceeds the expected norm in size (length 1.8-2.6 cm, width 2-3 cm), then this is considered a symptom indicating the accumulation of fluid in the ventricles of the brain. The reason for this may be the birth of a child prematurely or a violation of ossification inside the womb. And vice versa: if this fontanel is smaller, then this indicates a decrease in the size of the skull and brain of the baby. The reason for this is considered to be infection of the fetus in the womb. 
As you can see, it is not in vain that people are so attentive to the size of the soft top of the head - this is a serious material for diagnosing diseases of the newborn.
Functions of the soft crown
- Protection of the skull and brain. The largest part of the body of a newborn is the head and therefore it is loaded the most. During the passage of the birth canal, the child's skull is compressed and deformed. But due to the elasticity of the fontanelles, this process does not injure the organs inside the skull due to the mobility of the bones of the skull.
- Participation in thermoregulation of the body. Heat transfer in the baby's body is still imperfect: the body of a child overheats more often than the body of an adult. In these cases, the soft crown promotes heat transfer and thus affects the temperature of the brain and the whole body.
- Disease indication. The pulsation of the fontanel can indicate increased intracranial pressure, and hence possible diseases.
- Injury protection. The fontanel softens the blow if the child falls and thus protects the baby's head.
When does the fontanel grow in newborns?
In the first months of a child's life, the brain is actively developing and sometimes the size of the soft top of the head exceeds the norm. But when should the child's fontanel completely overgrow? The timing of the overgrowth of the fontanel depends on the individual characteristics of development, so for all children this happens in their own way. Therefore, the time when the fontanel overgrows is described conditionally. At about 3 months, the parietal fontanelle overgrows in 1% of children, in 40% it closes at 1 year and at 2 years in 95% of children.
It is known that in girls this process is slower. But there is no one term for the overgrowth of the fontanel, suitable for everyone. And you don’t need to be scared when a child’s fontanel overgrows earlier. This will not affect the development of the brain.
When the fontanel is larger than necessary, they often talk about signs of rickets. But this is not true. To more accurately determine whether a child has rickets, examining the edges of the fontanelles will help: if they are softened, then the likelihood of the baby having this disease is high. Late ossification of the fontanel also indicates rickets, as well as the accumulation of fluid in the ventricles of the brain or insufficient thyroid function. To determine what kind of disease a child has, neurosonography is prescribed.
It should be noted that if the baby's fontanel closed earlier, this does not yet indicate that there is no rickets, it is not a reason to cancel the diet for children with low calcium and does not exempt them from vitamin D prophylaxis.
Myths associated with the overgrowth of the fontanel
There are some misconceptions associated with the overgrowth of the fontanel in infants. Let's consider the main ones.
- Closing the fontanel ahead of time will limit the development of the brain. In fact, its growth and enlargement is due to the sutures between the bones of the skull. And these seams overgrow only by the age of 18-20. If the sutures did not close when the fontanel closed, there is no cause for concern.
- Taking vitamin D and calcium preparations accelerates the ossification of the fontanel. This is not true. Just if these substances are not enough, then this can affect the rate of overgrowing of the soft crown: slowing down the ossification of the fontanelle, the lack of calcium and vitamin D, respectively, prolongs the time for its closure. The speed of overgrowth of the fontanel does not depend on the intake of minerals and vitamins. The acceleration of ossification of the soft crown is an individual feature of the development of an individual child, which occurs if there are violations in the development of the baby.
- If the fontanel has not closed by the year, the child has rickets. Not necessary. A disease such as rickets has a lot of symptoms and it cannot be determined only by the speed of overgrowth of the fontanel.
- The large size of the soft crown of the baby guarantees its long overgrowth and vice versa. In fact, the speed of ossification of the fontanel is determined not by its size, but individual feature separate organism.
In what cases should you consult a doctor?
If the child was born on time, without deviations, then the fontanel on his head can be determined by a slight bulge in front. It is also easy to feel with your finger, because it is really soft. Therefore, it is called the soft crown.
It is not scary if the fontanel protrudes when the child cries or screams. It's quite normal. But if it remains convex when the baby is calm, this may indicate increased intracranial pressure, which in turn indicates a disease. If, in addition to this symptom, your child vomits, feels sleepy, has a fever and has convulsions, you should immediately consult a doctor.
A sunken fontanel may indicate dehydration. This can be caused by vomiting, diarrhea, heat. The rate of dehydration of the child's body is quite high and it is dangerous for his life.
If, in addition to the sinking of the fontanel, the baby has a decrease in the amount of urine and drying of the mucous membranes, an urgent need to call a doctor.
In premature babies, at first, the fontanel may seem slightly sunken. But if at the same time the baby sleeps and eats well, everything is in order with the stool, and he is gaining weight well, then there is nothing to worry about, over time everything will come back to normal.
In conclusion, we note that each disease has many symptoms, among which there may be an increase or decrease in the soft top of the head and early or late dates its overgrowth. However, relying only on the size of the fontanelle or on when the fontanel overgrows in newborns, it is still impossible to make an accurate diagnosis. Don't worry if your baby's soft crown is different in size from other babies. All people are unique from birth and differ from each other. But still, you should be careful and if there are any doubts about the size, overgrowth or condition of the child's soft crown, consult your pediatrician.
How many months does the fontanel in a newborn child overgrow. Komarovsky's advice: video
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The birth of a child is not only a miracle in the philosophical sense. It's also technically a miracle. Nature has thought through this process to such an extent that in order to pass through the birth canal of the mother, the child's head is able to decrease in size, acquire an oblong shape and flatten from the sides.
This is facilitated by the presence of gaps between the bones of the skull, filled with plates of connective tissue. These are fontanelles, the condition, overgrowth and bulging of which so often worries parents.
Despite the fact that there are six of them at birth, five of them grow so quickly that many parents do not even have time to know about their existence. All worries go around the most noticeable fontanel - the frontal or large fontanel (BR).
If the purpose of small fontanelles ended after birth, then the large one in children continues to perform the functions of shock absorption, preventing fractures and injuries of the skull during falls and bumps.
When does a child's fontanel close?
If your child is already a year old, and his fontanel has not overgrown, then there is no reason for concern. Normally this physiological process ends in 1-1.5 years. If the timing of its closure in your baby does not fit into the norm, then see a doctor. He will determine what is the cause: a disease or a developmental feature of the child.
What should be the fontanel in the norm?
After the birth of a child, as well as monthly when visiting a doctor, the pediatrician evaluates his condition, size, rate of decrease, and density of the surrounding bones.
Normally, the size of the fontanel in a healthy full-term baby is 2.5 - 3 cm, which is estimated by palpation and measuring the distance between opposite sides of the rhombus. have a larger BR, approximately 3.5 by 3.5 cm. And large children born at 41-42 weeks may have a smaller BR. All of this is normal. By the way, the fontanel of a month-old baby may be slightly larger than at birth. This is due to the intensive growth of the brain.
What should be the size of the BR at a certain age, it is impossible to say for sure. Some sources give the following numbers:
- 1.8-2 cm at three months;
- 1.8-1.6 cm in six months;
- 1.3-1.4 cm at 9 months;
- 0.4-0.8 cm per year.
However, they can be guided only approximately, because:
- All children initially different sizes(within the normal range).
- The size of the fontanel does not affect the growth rate. A large one can drag on for a year, and a small one for 1.5 years.
However, all fontanelles during examination should not be tense, not bulge, be at the level of the cranial bones. It is permissible for the spring to sink or bulge slightly, and also to pulsate. The frontal and parietal bones, surrounding it should be dense, without areas of softening.
What to do if the fontanel does not close?
If by the age of 18 months the baby's fontanel is still closed, then you need to see a doctor. This may be normal for your child, or it may be a symptom of a pathological condition.
| Pathology | Impact on BR | Additional research | Your actions |
| Rickets | As a result, the bones soften, including the bones of the skull. The BR is open for a long time, the edges of the bones are soft to the touch. Lethargy, sweating during sleep, nape baldness appear. Bone growths form on the ribs and wrists. The shins are bent (see) |
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Therapy with therapeutic doses of vitamin D |
| Achondrodysplasia | A disease of the bone tissue that leads to impaired growth. The skeleton becomes disproportionate, the limbs are short, and the head is massive and wide. BR does not drag on for a long time. |
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Prescribed growth hormone somatotopin |
| Congenital | The lack of thyroid hormones, which, among other things, regulate bone growth, leads to a long-term non-overgrowth of the fontanel. In addition, the child has constipation, a nasal voice, sometimes combined with umbilical hernias. Children are lethargic, drowsy, often large. |
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Replacement treatment with thyroid hormones |
| The increased pressure of the liquor does not allow the cranial bones to "converge". Together with the BR, which rises above the bones, the circumference of the head also increases. Additionally, the child may have convulsions, developmental delay, hearing and vision problems. |
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Treatment with anticonvulsants, diuretics, nootropics. Sometimes a shunt is performed. |
The fontanel in the baby quickly overgrows, what should I do?
If the child has a small fontanel, then a pediatrician, endocrinologist and neurologist will need to be consulted. By the way, in 1% of cases, the spring can overgrow in 3 months. This is unusual, but if all other indicators of development are normal, then everything is fine. But sometimes small sizes accompany pathology.
| Pathology | Impact on BR | Additional research | Treatment |
| Craniosynostosis | The sutures of the skull and fontanels fuse quickly and early. There may be a deformation of the skull, jaw, secondary hydrocephalus. |
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Surgical incision of sutures |
| Microcephaly | An anomaly in the development of the brain, in which the bones of the brain part of the skull stop growing, and the facial part continues to grow. The brain remains small and underdeveloped. developmental delay. . |
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Symptomatic therapy |
| Increased function of the parathyroid glands | Violation of the exchange of calcium and phosphorus leads to an increase in calcium in the blood. Early closure of the fontanel is combined with bone pain, arrhythmia, damage to the kidneys, and the gastrointestinal tract. |
|
Surgical treatment |
If the fontanel is too large
A large BR is considered to be larger than 3.5 cm. This may be normal in premature or immature babies. For the rest, a consultation with a pediatric neurologist and an ultrasound scan of the brain, an electroencephalogram to exclude hydrocephalus and are obligatory.
If the fontanel pulsates
The brain is very well supplied with blood, and its vessels are located close to the heart, so the blood flows in them under great pressure and with strong points. This pulsation is transmitted to the cerebrospinal fluid, to the membranes of the brain, to the plate that closes the large fontanel in children. Therefore, a slight pulsation is normal.
However, if the fontanel pulsates strongly, then this may be a signal of the disease. Other symptoms are usually present: dehydration, diarrhea, intoxication, high fever, vomiting (see). In this case, diagnosis and urgent treatment is necessary.
If the child has a sunken fontanel
The retraction of the fontanel (sunken) indicates dehydration of the child or malnutrition. The lack of fluid may occur against the background of:
- heat;
- overheating with strong wrapping;
- high temperature and intoxication;
- with severe vomiting, diarrhea.
Lost fluid must be replenished. In case of overheating and temperature of the baby, it is necessary to cool and drink. At intestinal infection when one drink is not enough, the child will undergo invasive therapy in a hospital.
What does a protruding fontanel mean?
The BR may bulge (raise above the level of the surrounding bones of the skull) against the background of intracranial pressure, which may be due to diseases such as meningitis, encephalitis, intracranial bleeding, tumors, or for another reason. If, in addition to bulging, there are the following symptoms, you should urgently call a doctor or an ambulance:
- Heat
- Vomit,
- Bulging after a fall or other head injury
- Convulsions (see)
- Strabismus
- If swelling without other symptoms, but long time you should also consult a doctor.
How to take care of him?
No special action is required. Despite the fact that the plate of connective tissue covering it is thin, it is equally strong. Therefore, when combing or examining the fontanel by a doctor, nothing terrible will happen. However, you should not be zealous with scallop movements either. For a child, this may be simply unpleasant. You can also not be afraid to wash your hair or cut your child's hair.