Interesting Facts 

If the fontanel does not grow. The fontanel of newborns: the timing of overgrowth and deviation from the norm

At the very first appointment with the pediatrician, you will notice how, through simple manipulations, namely: palpation, the specialist will determine the condition and size of the fontanel. These indications are important, as there are established norms, deviations from which can signal certain diseases.

But you are unlikely to get an exact answer to the question of when the fontanel overgrows in newborns, since this time line is quite long and individual.

What is a fontanel?

The fontanel is soft areas on the baby's head, which are gaps between bone materials, which are tightened in the first months of a baby's life.

You may be surprised when you find out how many fontanelles a newborn has. You know for sure and have seen that the fontanel is located on the crown of the newborn. But there are other places open at birth:

  1. On the back of the head;
  2. Paired behind the ears;
  3. Paired in the temples.

These areas not covered by bone tissue are examined by a neonatologist in the first minutes of a child's life, and by the time of the next visit of specialists at 1 month, they, as a rule, are delayed.

As for the size, the fontanel located on the top of the head is just called large. Its diameter can reach 35 mm, while the other five have a maximum size of 5 mm, and then they are tightened literally immediately in the postpartum period.

The size and shape of the fontanel

The large fontanel is located at the junction of two bone tissues: frontal and parietal, so you can find another name for it: frontal. The size of the fontanel in newborns can vary from 6 to 35 mm, the ideal size is 20 mm.

  • The frontal fontanel is less than normal when all the other five fontanelles are closed at the time of the baby’s birth, it can signal violations in the development of the child, namely: a disproportionate structure, when the size of the head and brain is less than normal, and all other parts of the body are normal;

The reason for this may be intrauterine infections and, as a result, mental insufficiency.

  • More than 35 mm for a large fontanel is also a deviation. A large fontanel on the crown of a newborn may occur, as a result of premature birth, disturbances in calcium metabolism and problems with tissue ossification, disruption of the thyroid gland;

Regarding the shape, the soft part at the crown has the shape of a rhombus, and can be either sunken or convex.

  1. If you notice that the soft part of the head at the top of the newborn sunk, then your baby is experiencing dehydration. Such a condition, in the presence of a ventricular disorder (read the article on the topic: A newborn's tummy hurts >>>), profuse vomiting, elevated body temperature will be a cause for concern;
  2. A sunken fontanel without signs of dehydration and normal behavior of the baby may be in a post-term baby. In this case, everything is fine;
  3. The convex shape of the fontanel most often tells you about intracranial pressure. Signals of this disease can be frequent and profuse spitting up (Do you know that spitting up can also be one of the normal options? Read the current article about this: Why does a child spit up after feeding >>>), tremors and convulsions, irregular sleep, crying for no reason and excessive capriciousness. In this case, you need to do an ultrasound examination before the bones grow together and diagnose, or else refute the fact of intracranial pressure;
  4. A bulging fontanel is most often seen when a baby is crying. If there are no concomitant symptoms, and the fontanel returns to normal as soon as the baby calms down, then everything is fine and there is no need to wind yourself up;
  5. If the baby has fallen or hit his head hard, and you notice that the fontanel has changed its shape, you should immediately contact a specialist. The possibility of bruising or even concussion is not ruled out.

Regardless of the size and shape, there is no need to make hasty conclusions after gathering mothers on the site and conducting a comparative diagnosis of the fontanelles of babies. Each child has his own individual development plan (read more about this in the article Child Development by Months to a Year >>>), including tissue ossification.

Fontanelle closure time

As you know, a newborn has six fontanelles, and all except the frontal one close in the first weeks of a baby's life.

  • Fontanelles in the temple area in most cases are not palpable, since in a healthy full-term baby these tissues have already ossified in the mother's tummy, or they are compacted during the first week of extrauterine development;
  • Two fontanelles behind the ears of the baby are also tightened immediately after birth;
  • The occipital soft area should tighten and ossify two months after the baby is born (you will be interested to know what a child should be able to do at 2 months >>>). The normal size of this fontanel during childbirth is 5 mm.
  • The question of when the frontal fontanel closes in newborns is not so unambiguous. In 1% of infants, the ossification process takes no more than 3 months. In a little less than half of the babies, the fontanel is delayed by the first birthday, but in two years the process of ossification should be completed in all babies. Thus, the closure time of the fontanel varies from 3 to 24 months.

For information! Please note that in boys, the fontanel is tightened faster than in little princesses.

Causes of deviations from the norm

Both rapid and prolonged closure of the fontanel opening is a deviation from the norm. What it can be fraught with, now you will find out:

  1. Late closure is possible with rickets, and this is due to metabolic disorders and a lack of calcium, as a result (also read the article on the topic: Signs of rickets in infants >>>);
  2. If the baby’s fontanel does not close for a long time, while he behaves passively, sleeps a lot, eats poorly, swelling of the body is noted, the baby may have a disorder in the thyroid gland - hypothyroidism;
  3. A long non-tightening of the fontanel with a general disproportionate body of the baby can be an indicator of a serious disease of the skeletal system, achondrodysplasia, which leads to dwarfism;
  4. The fontanel does not drag on in "sunny" children with Down's syndrome;
  5. Rapid ossification may be an indicator of craniosynostosis - a violation of the skeletal system with concomitant intracranial pressure, impaired hearing, vision;
  6. A small fontanel in newborns and its early ossification may signal abnormalities in the development of the baby's brain, but such a course of events is very rare.

Myths and reality associated with the fontanel

Surely you have heard a lot of stories related to the fontanel. Which of them are true, and which are similar to Krylov's fables, it is worth figuring out:

  • Myth 1. Fear of harm;

Feeling the soft part of the baby's head, you definitely felt anxiety at the thought that you could damage the internal organs. Calm down! Despite the appearance of a weak spot, the tissues in the fontanel area are very dense and serve as a dense protective barrier. So calmly wash your newborn's head, wipe it thoroughly, comb the little one as much as you like.

  • Myth 2. Mental development;

You can hear the story that the rapid tightening of the fontanelle is fraught with mental potential, since the brain is limited in growth, and therefore does not develop. This is nonsense, since the brain and skull of a child grow and increase due to interosseous sutures, and certainly not a fontanel.

  • Myth 3. A large fontanel is a sign of rickets;

Such a development of events may not be excluded, but is not the rule. With rickets, the nature and shape of the fontanel is special: not just a soft area between hard bone tissues is observed, but there is a softening of the edges of the fontanel, deformation of the legs and pelvis, sweating.

  • Myth 3. The fontanel must be delayed by the age of 2;

In 5% of newborns, the process of tightening the fontanel takes more than 24 months. And this is not a deviation at all, just such an individual feature.

  • Myth 4. Indentation of the place where the fontanel is located in a newborn as a result of a fall.

The fontanel itself can be easily pressed with a finger, this place is flexible, and the fontanel definitely cannot fall after a fall. In addition, thanks to the fontanelles, the baby's head can be elastically deformed upon impact or take an elongated shape at the time of childbirth.

Know that you need to consider any case as a whole, do not make hasty conclusions and do not self-medicate.

After the child is brought into the house, soft areas remain on his head at the junction of the bones of the skull, which are called fontanelles. And many young parents will be interested to know when the fontanel closes in a child.

Fontanel properties

The fontanel in a baby performs several important properties:

  1. Since not all parts of the bones of the skull ossify, they are compressed at the birth of the baby, and this facilitates its passage through the birth canal. In this process, injuries are minimal, both for the baby and for his mother.
  2. The fontanel is important not only for the implementation of easy childbirth, it is also necessary after the baby is born. Since the bones of the skull remain conditionally mobile, and the growth and development of the brain occur at a very high rate, the bone plates can adapt to an increase in its volume for several more months.
  3. An important function of the fontanelles is the cooling of the brain, since the thermoregulation system in newborns is not yet sufficiently imperfect. Therefore, heat transfer occurs due to the movable spaces between the bones of the skull.
  4. In case of an accidental fall of the baby, these same formations play the role of shock absorbers, and reduce the likelihood of getting a concussion.

How are the bones of the skull and fontanelles formed?

When a baby is in the womb, bone formation goes through several stages. Initially, they are ordinary plates of fairly dense tissue. Then they turn into cartilaginous tissue, which subsequently undergoes a process of ossification.

The bones of the skull, located at the top and sides, slipped through the stage of cartilage formation. The membranous plates ossify in this case in the direction from the center to the periphery. When the birth process begins, the baby’s skull is already almost completely covered with bone tissue, which differs from that of adults, since it is more elastic. Along the edges, some plates are not ossified areas of membranous tissue, hidden under the skin.

These formations are called fontanelles. In total, there are normally 6 of them. Two single - frontal and posterior, and two paired - wedge-shaped and mastoid. When does a newborn's fontanel close? The occipital and lateral areas harden in the first six months of the baby's life. It is especially important to monitor the pace at which the frontal fontanel overgrows.

What happens normally

When will the fontanel close in a child completely? Complete closure of the frontal fontanel in a child normally occurs at 12 months. But each baby is an individual, and cases are described when complete ossification occurs at 1.5 years. Sometimes a large fontanel closes in a child aged 6 to 8 months. All these options can be considered the norm if the child has no other deviations.

The speed of fontanel closure depends on the following factors:

  1. Sufficient amount of calcium in the body of a child. This is achieved through a balanced diet in the mother, who, if necessary, should take multivitamin complexes.
  2. The required amount of vitamin D. This factor depends directly on the time of year when the baby is born. The doctor most often recommends taking drops containing vitamin D for the prevention of rickets, which are actively involved in the absorption of calcium by the body. This is especially important in those months of the year when there is a minimum number of sunny days.
  3. If you calculate when the fontanelles close in newborns, then it should be taken into account that in boys this happens faster.
  4. There are also features of heredity, and the doctor should know information about when the fontanelles of the mother and father of the newborn are completely overgrown.



Possible deviations

It is necessary to take into account not only the factor at what age the fontanel closes in a child, but also the presence of a convex fontanel, which occurs as a result of high intracranial pressure. It occurs in the following pathological conditions:

  • inflammation of the meningeal membranes;
  • encephalitis;
  • neoplasm in the form of a tumor;
  • brain tissue hematoma;
  • bleeding.

If the baby's fontanel becomes convex, and the skin above it rises and pulsates, you should immediately consult a doctor. Sometimes this phenomenon is observed during inflammatory viral diseases, accompanying a high temperature.

When symptoms characteristic of the pathology of the neurological system are observed simultaneously with the bulge, then you should immediately go to the pediatrician, the child may need treatment in a hospital. This is especially true for conditions with vomiting, convulsive syndrome, loss of consciousness.

Any delay in this case can cost the life of the child, so you should go with him to the doctor, as many times as necessary. Only he is well versed in how the fontanels of the skull of a newborn should look like and the timing of their closure, so he will be able to make the correct diagnosis quickly and help in each case.

If the fontanel sinks, then this may also indicate serious deviations in the state of health of the newborn. Most often, this phenomenon occurs when there is a lack of fluid in the body, caused by dehydration as a result of diarrhea, vomiting, or insufficient drinking. As soon as the child receives a normal volume of fluid, the balance is restored, the fontanel is leveled.

In rare cases, low rates of fontanel closure can be observed with rickets, thyroid disorders, hypothyroidism, Down syndrome.

If a fontanel closes early in a child, it can be assumed that this is just an individual feature of his body. But it should be shown to the doctor. Very rapid overgrowing occurs with an excess of calcium in the child's body, or craniostenosis, which is accompanied by intrauterine overgrowth of the skull bone and leads to problems during childbirth, and the development of deformation of the baby's head. In some cases, a small fontanel may indicate that the child has microcephaly, that is, the mass and volume of the brain is less than normal.

All parents noticed on the head of their newborn crumbs an unossified pulsating area - a fontanelle. Many even try not to touch this place, fearing to harm the child. But the doctor must feel the fontanel during a routine examination. After all, it serves as one of the indicators of the state of health and development of the child.

With age, the fontanel becomes ossified. When the fontanel overgrows in newborns, it depends on many factors - these are the individual characteristics of the baby, and violations of the development and health of the crumbs. Therefore, the state of the fontanel requires special attention.

The fontanel is a soft, non-ossified area of ​​​​the skull, consisting of a dense membrane, connecting certain bones of the infant's cranium. These areas allow the skull to transform to facilitate the birth process. In addition, thanks to the fontanelles, the cranial vault adjusts to the intensively growing brain of the newborn.

After childbirth, the baby has six fontanelles:

    • Fontanelle connecting the two parietal bones and the occipital bone of the skull

It is called posterior or occipital. It is quite small, only 0.6 mm;

    • Anterior, which connects 2 frontal and 2 parietal bones

At birth, its size is about 30 mm;

  • Lateral fontanelles of two types: wedge-shaped and mastoid

Wedge-shaped are located closer to the temples, mastoid - to the back of the head;

The main one is the largest fontanel - the anterior one. It stays open the longest. Another fontanel that can be felt is the back, although it is much smaller than the large one. However, it overgrows 1-2 months after birth. The rest of the fontanelles have very small gaps, are almost invisible and overgrow and ossify within a few months, forming cranial sutures.

Since the head of the child is quite large by the time of birth, its passage through the birth canal can be difficult. Thanks to the fontanelles, the baby's head is deformed, which not only facilitates patency, but also protects the contents of the skull.


In addition, fontanelles have other functions:

    1. The fontanel plays a significant role in the thermoregulation of the baby.

Newborns maintain the required body temperature quite poorly due to the immaturity of thermoregulation mechanisms. The fontanel helps heat transfer during overheating, protecting the brain of the child and the body as a whole.

    1. The elasticity of the fontanel tissue helps protect the child from injury during falls.

It is a kind of shock absorber between the bones of the skull. It is in infancy and early age that the child controls his body worst of all, therefore nature protected the head of a small person from frequent falls and blows in this way.

    1. According to the state of the fontanel, some diseases in the child are determined

So if the fontanel swells, this may be a sign of intracranial pressure.

  1. An ultrasound examination of the brain can be done through an open fontanelle(neurosonography)

After overgrowth of the soft area, this will become impossible, because the cranium serves as an acoustic barrier.

Where is

There is a large fontanel in the upper part of the head, almost on the top of the head. It connects two frontal and two parietal parts of the skull. The plot has a diamond shape. The size of the fontanel may vary. As the head grows, it decreases. So from the initial size of about 3 * 3 cm, it gradually decreases to 5 mm and overgrows.

When overgrown

A large fontanel should overgrow closer to 12-18 months. However, it depends on how much calcium is in the baby's body. If it is enough, then the fontanel can drag on for up to a year. Small deviations in the timing of overgrowth from the norm are not critical. In the absence of other signs of pathologies, they cannot indicate violations in the body.

The following factors can influence the timing of overgrowth of the fontanel:

    • Prematurity baby

Such children usually lag behind their peers in development. Therefore, the fontanel may grow more slowly. Usually by 3 years the backlog disappears.

    • If the child grows quickly with good nutrition, then the fontanel can close faster

With an abundance in the diet of carbohydrates or proteins, growth may slow down.

  • Baby feeding method

In breastfeeding children, the fontanel overgrows faster, since breast milk is most fully absorbed by the body.

However deviation from the norm can also be caused by hereditary diseases or a lack of calcium and vitamin D3.

Norms and deviations. When to worry

How many months the fontanel overgrows depends on the individual characteristics of the organism and related factors.

If it overgrows before 3 months, then this is not normal. If the child is older, then it is necessary to regularly show the baby to the pediatrician, who will monitor his condition. In a newborn, the fontanel seems to pulsate. In some countries it is called a fountain. If this pulsation does not go away with age, then you should consult a doctor.


Often a deviation from the normal state of the fontanel can be evidence of disease. In this case, it is necessary to pay attention to other accompanying symptoms.

    • A bulging fontanel indicates a possible increase in intracranial pressure

What can be a sign of such diseases as hydrocephalus (dropsy of the brain), meningitis, encephalitis. If swelling of the fontanel is accompanied by convulsions and high fever, then the child needs urgent medical attention;

    • A sunken fontanelle can be a sign of malnutrition and dehydration.

If the sunken fontanel is accompanied by fever, diarrhea, vomiting, which indicates the presence of infection and dehydration of the body, then it is urgent to call an ambulance and hospitalize the child;

    • The size of the fontanel, which exceeds the norm, may be one of the signs of Down syndrome;
    • A long-term non-overgrowing fontanel may indicate rickets

Rickets occurs due to a lack of calcium and vitamin D in the body. However, to diagnose this disease, it is imperative to look not only at the fontanel, but at other characteristic symptoms;

  • A slowly overgrowing fontanel may be a sign of an endocrine disorder;
  • If the fontanel, on the contrary, is overgrown too quickly, it may indicate the development of the disease microcephaly or craniosynostosis (craniostenosis).

Therefore, in case of any deviations from the norm, it is better to consult a doctor. It will help determine if there are other signs of the disease or if this condition is normal for this child.

Fontanelle care

Often parents are afraid to even touch the place of the fontanel. But you shouldn't worry. The connective tissue is strong enough to withstand touch and various hygiene procedures. Of course, some care must be taken, but the child can fearlessly wash his hair, comb his hair, and perform other care procedures.

There is no special care for the fontanel. No need to constantly feel or measure it. If there are violations, they will immediately become noticeable.

In addition, the doctor, during regular examinations, always feels the fontanel and notices deviations.

Myths about fontanelles

Often, out of ignorance, parents worry too much about fontanelles. There are such myths:

  1. If the fontanel is quite large and poorly overgrown, then the child has rickets.

However, this is not required. Rickets, in addition to the speed of overgrowth of the fontanel, has other signs: sleep disturbance, severe sweating, tearfulness, muscle flabbiness and others. Therefore, the diagnosis must be made by a doctor. The duration of overgrowth of the fontanel depends on other factors.

  1. You can’t touch the fontanel, you can damage the brain

This is wrong. The brain is protected by a strong connective tissue membrane. It is able to withstand both touch and baby care activities.

  1. If the fontanel overgrows quickly, then you can not take calcium and vitamin D3 even with rickets

Parents should know that rickets is a very serious disease. You cannot self-medicate. If the doctor prescribed the drug, then it is necessary to take it. For all other questions, it is better to consult additionally;

  1. In all children - peers, the size of the fontanel should be the same

This is wrong. There are certain norms, but each child has his own characteristics of growth and development. Therefore, the size of the fontanel and the rate of overgrowth may differ in children of the same age.

  1. When the fontanel closes ahead of time, the brain will stop growing and the child will be mentally handicapped

This is wrong. The development of the brain is not associated with the timing of the closure of the fontanelles. The skull is not a monolithic structure. The bones of the skull are connected by elastic sutures that lengthen as you grow. The cranium grows up to 20 years.

Thus, deviations from the norm in the size of the fontanel can be both an individual feature and a symptom of the disease. Therefore, you should pay close attention to this area.

If the child is healthy and vigorous, nothing bothers him, then, most likely, deviations from the norm are his individual feature. If in doubt, be sure to consult your doctor so as not to miss the time.

Any newborn baby has small marks on the head - fontanelles. Immediately after birth, the baby develops six marks, four of which close in the first weeks of life. The fifth mark, located on the back of the head, disappears by two or three months. The sixth remains on the baby's head the longest. Knowing what a fontanel is and what function it performs will help parents to more clearly imagine the process of growth and formation of their child.

What is a fontanel

The fontanel in a child is an empty space between the parts of the skull, closed by a dense membrane. The baby also has sutures resulting from the connection of two bones of the skull. Fontanelles appear in the junction of several bones. Some time after birth, these parts of the skull become ossified, and the corresponding marks disappear. The first five out of six membranes close in all children at about the same time, but the formation of the sixth fontanel in a newborn child is a purely individual process. Among its main functions are the following:

  1. The main function is to help in the easy passage of the head through the birth canal. During childbirth, the shape of the baby's head is slightly deformed. Tapering, it passes forward more easily through the birth canal. Often, in a baby, immediately after birth, you can find bones that have found each other. Such defects quickly pass, and the shape of the skull is restored.
  2. Another no less important purpose of this physiological phenomenon is to help in the active growth and development of the brain. In the first year of life, the baby's brain grows rapidly and intensively. The membranes provide the necessary space for this process, expanding the cranium and allowing the brain to grow to the desired size and volume.
  3. The free space between the parts of the skull provides thermoregulation of the brain. In newborns, heat transfer in the body is at the stage of formation and development. Because of this, babies overheat easily. When the child's body temperature reaches approximately 38 degrees Celsius and above, the fontanelles turn on the ventilation function, thereby preventing the brain from overheating.
  4. The fourth function is depreciation. Physiological marks that occur in children immediately after birth provide protection for the baby from possible shocks and injuries. This is not a reason to leave a small child unattended, because a small membrane will not be able to protect the fragile bone structure of an infant from serious blows or concussions.
  5. The last role of the fontanel in a small child is to help in the medical study of the brain. The membranes greatly simplify the conduct of neurosonography, ultrasound and other examinations in order to identify potential pathologies and diseases at an early stage. These membranes help medical professionals control the development and formation of the brain, and if problems are detected, apply timely treatment.

Large and small fontanel in a child

The dimensions of the membranes are calculated by the formula in which the longitudinal and transverse diameters are added, after which the sum is divided by two. The result obtained is indicated as the size of the membrane. Immediately after birth, the parameters of this mark on the back of the head average 0.5-0.7 mm. This is a small fontanel, which closes by the second month of a child's life.

A large fontanel is usually well palpable and stands out. Almost all parents are concerned about the question of whether the size of the large fontanel of their small child is normal, how soon it should disappear and what to do if it does not overgrow for a long time. Doctors say that there is no strict time frame for closing the membrane. Each child develops this process differently.

A large fontanel in a newborn child usually has the shape of a diamond, each side of which is approximately 25 mm. In most cases, the mark disappears at 12-18 months. According to statistics, in the case of boys, this process proceeds faster. There is no relationship between the size of the membrane and the time of its closure. The first three months of life, the mark will increase intensively, since during this period the process of active brain growth usually occurs.

How many months does it take


The fontanel can close at any time. This usually happens between three months and two years. In some babies, it overgrows earlier, in others - later. For comparison, we present the results of statistical studies, according to which in 1% of crumbs the mark on the head closes up to three months, in 40% - from a year to a year and a half, and in 95% of newborns - by two years. In the remaining five percent, the fontanel overgrows only after two years.

The process of formation of the bone tissue of the cranium in each case proceeds individually. In children from the same parents, characteristic marks disappear at different ages. If the mother consumed too much calcium during pregnancy, there is a possibility that the free space between the parts of the skull will tighten faster. Young parents should not worry about this. It is important that this process takes place within the time limits. If the baby is not worried about well-being, he develops normally, there is no need for worries.

Retraction and protrusion of the fontanel


The fontanel in an infant sticks out a little when there is increased intracranial pressure or other neurological disorders. A bulging fontanel is not the only symptom that indicates the appearance of health problems. If you find that the membrane on your head is slightly swollen, do not panic, but it is better to immediately consult a doctor.

A sunken fontanel is usually a typical sign of dehydration in a baby. This happens with vomiting and prolonged diarrhea in a small child. In this situation, the newborn needs to provide plenty of fluids. It is necessary to contact the pediatrician to find out the reasons that led to dehydration and, as a result, the sinking of the fontanel.

If the fontanel pulsates, is it worth worrying


Many parents, noticing that the child has a pulsating membrane on the head, panic. You shouldn't worry. This is a completely natural and normal phenomenon. Pulsation corresponds to the heart rhythm. The reason for its appearance is the flow of blood flowing to the brain with each heartbeat. In all children, the pulsation is expressed in different ways: in some it is stronger, in others it is weaker. But if there is no pulsation at all, this indicates the appearance of problems with pressure. In this situation, it is better to consult a doctor.

When should a child's fontanel close?

As noted above, in all children, the space between the parts of the skull overgrows at different times. The large fontanel usually closes between the ages of three months and two years. Often there are cases when characteristic marks disappear earlier or later than the due date. This is a purely individual process that will definitely happen in. If the mark drags on too quickly or, conversely, does not overgrow for a long time, it is better to consult a doctor who will help determine the cause of the anomaly and give appropriate recommendations.

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Parents always have a lot of questions, for example, what sizes of a large fontanel are considered the norm, why is it large or small, the measurement of a large fontanel, and so on. Through research, it was found that many parents do not touch its location on the child's head, as they are afraid of harming the baby's brain. This is a misconception, since the fontanel is a dense shell, the function of which is protection. It is located on the crown of the child, shaped like a rhombus. Why is a large (also called anterior) fontanel needed? In order to make it easier for the baby to be born, passing through narrow birth passages. This is a kind of shock absorber that helps the cranial plates move and move apart. If you look closely at it, you can see a slight pulsation, especially noticeable when the baby cries. You can touch it, and some doctors even advise gently massaging it while combing.

How does a large fontanel close in a child?

The size of a large fontanel of a newborn is approximately 2x2 cm in area, but an excess of 1-3 cm in size is considered a variant of the norm. In the first month, a significant increase in size is possible. And by 3-4 months it decreases to 1x1cm. In the period from 12 to 18 months, a large fontanel should normally close completely. But these terms are averaged, and for each child, closing occurs at its own time (as well as the terms of teething or the first steps).

What conditions of a large fontanel should alert parents? Prevention

Parents must visit the children's doctor without fail, doing this regularly for up to a year. And the pediatrician, for his part, will make sure that the baby does not lag behind his peers in development and takes the necessary measures in time.

One of the external indicators of the normal development of a child for pediatricians, neurologists and other pediatric specialists is the fontanel in newborns. It is a small soft pulsating area on the baby's head, under which the brain tissue is located close enough. The surface of the fontanel is covered with a dense film with a small fluff.

Fontanelle of a newborn baby

  • The fontanel of a newborn greatly facilitates the process of childbirth, both for the baby and for the mother. Passing the birth canal, the bones of the skull are compressed, and therefore the head of the newborn for the first time after childbirth looks elongated. Then the shape of the head is restored;
  • The presence of a fontanel provides optimal spatial conditions for normal brain growth at the pace that is laid down by nature;
  • The fontanel is involved in the regulation of heat transfer of the baby and the environment. If the child's body temperature exceeds 38 degrees, then the brain tissue naturally cools through the fontanel;
  • Due to the ability to shrink, the fontanel can act as a shock absorber in case of an accidental fall of the child.

Large and small fontanelles

Where is

Determining where the fontanel is located in a newborn baby is quite simple.

A large diamond-shaped fontanel measuring 2 by 2 centimeters is located right in the middle of the crown, or, as they usually say, on the top of the head.

A small fontanel is located on the back of the head. Its size is about half a centimeter.

When overgrown

A large fontanel overgrows by about one year of age of the child, sometimes there are slight deviations from this parameter up to about one and a half years. But if the child meets the age norms in other respects, then there is no reason for concern.

A small fontanel in children born at term is already closed. However, it happens that it was discovered after childbirth. Then its closure should be expected in two to three months.

The speed and time of closing the fontanelles mainly depends on how much the baby's body is provided with calcium. If there were no deviations in the mother's diet, the optimal regimen for taking multivitamins was observed, then the overgrowth of fontanelles usually occurs normally.

Deviations in development

Knowing the timing when the fontanel overgrows, as well as the size, you can see any deviations, avoid and prevent the development of many dangerous diseases in newborns. Among them are a few:

  1. Rickets. This disease is almost the most common cause of late closure of the fontanel. As a rule, this happens in premature babies who are rarely exposed to the sun, who have a lack of calcium and vitamin D. Read the article >>>;
  2. Hypothyroidism. A decrease in the amount of thyroid hormones can also be the reason for slowing down the process of overgrowth of the fontanel;
  3. Down Syndrome. Too large sizes of the fontanel indicate the presence of this disease along with other characteristic signs;
  4. Overgrowth of the fontanel ahead of time may indicate an excess of calcium , as well as testify to diseases such as craniostenosis, microcephaly;
  5. A depressed fontanel is also a serious symptom. This phenomenon indicates acute dehydration of the body.

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A careful examination of the child by specialists, parents of the baby's condition will be the key to early detection of abnormalities and will contribute to the correct appointment of preventive treatment.

Reasons for the early closure of the fontanel

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Fontanelle too small or fontanel closing too fast

Protruding fontanel?

Most often, a bulging fontanel is observed against the background of diseases that are accompanied by an increase in intracranial pressure: meningitis, encephalitis, tumors, intracranial bleeding, increased intracranial pressure for another reason.

If a bulging fontanel is combined with one or more of the following symptoms, you should call a doctor as soon as possible:

  • Strong temperature;
  • The bulging of the fontanel arose after a head injury, a child's fall;
  • Vomit;
  • Drowsiness or excessive irritability of the child;
  • Strabismus;
  • Convulsions or epileptic seizures;
  • Loss of consciousness;
  • Bulging fontanel for a long time without other symptoms.

Fallen fontanel?

Most often, the retraction of the fontanel is observed due to dehydration of the child against the background of temperature, diarrhea, and repeated vomiting. If a sunken fontanel is found, the child should be given plenty of fluids and a doctor should be contacted to treat the disease that caused dehydration.

Fear of harm

Many are very much afraid of somehow damaging the fontanel. Remember! - it's practically impossible. Despite the apparent softness of the fontanel, it is very durable, and it cannot be damaged by ordinary manipulations (washing, bathing, combing, etc.).

Video:

Newborn baby. It is a soft area on the parietal part of the head between the parts of the skull. This area does not have bone tissue, but is closed by a strong membrane. The fontanel in infants makes it possible to shrink during childbirth during the passage of the baby through the birth canal.

What are fontanelles in newborns?

Newborn babies have six fontanelles. The largest is the front, the second largest is the back. There are two more mastoid and two wedge-shaped. Two main fontanelles usually remain open after childbirth: frontal (large) and occipital (small).

Sizes of children's fontanelles

The large fontanel resembles the shape of a rhombus. It is considered normal if its size is in the range of 1-3 centimeters. Most often, such a fontanel in children is 1.7-2.5 centimeters. And at the age of three months, it decreases to 1-1.5 centimeters.

To correctly determine the size of the frontal fontanelle, add its longitudinal and transverse diameters and divide the resulting sum by 2. The small fontanel resembles the shape of a triangle. Its dimensions usually do not exceed 0.7 centimeters. Although most often a child is born already with a closed small fontanel. But do not worry if the size and shape of the fontanel in a child differs from the standard ones. Each child is individual. A pediatrician should be consulted to determine if this is a concern.

Timing of fontanel closure

Four lateral fontanels in full-term babies close at birth, in premature babies - in the first few days after birth. The occipital fontanel in infants is completely closed at 2-3 months. But there are no exact deadlines for closing the largest fontanel. It's a very individual process. It can overgrow by 12 months, or maybe at 1.5 and 2 years. In recent years, thanks to the acceleration of children, the frontal fontanel disappears by 10 months.

What is the reason for the early closure of the frontal fontanel?

Closing of the fontanel before the third month of the baby's life is considered early. Usually this is due to the expectant mother's enthusiasm for taking multivitamins and the result of which are small and fairly dense fontanelles in the child. Therefore, you should follow the norm in taking vitamins according to the duration of pregnancy.

Why is it dangerous?

Early closure of the fontanel has a significant effect on the full development of the brain, impeding its normal growth. The danger lies in the fact that early overgrown

the fontanel can be the cause of serious illness in infants. Very rarely (but there is still a chance) a baby can have one of two diseases: an anomaly in the development of the brain and craniosynostosis. These diseases are accompanied by a number of other symptoms. If the child's fontanel closes early, but the circumference of his head is normal, this means that the child is healthy.

What is the reason for the late closure of the fontanel?

Late closure of the frontal fontanel is associated with a low content in the baby's body and limits the intake of vitamin D3. And this leads to a change in bone tissue.

Why is it dangerous?

In itself, the late closure of the fontanel does not indicate danger. It is important to study the accompanying symptoms, as this can also be a dangerous signal.

The most common cause of late closure is rickets. It can also be a signal of Down syndrome, achondrodysplasia and other serious diseases. Even if the fontanel that does not close for a long time in infants does not cause concern, you should consult a specialist.

What else can the fontanel “tell” about?

There are a few more "signals" that should not be ignored:

    the fontanel in infants sinks - there is not enough fluid in the body;

    for a long time it is “convex” -;

    enlarged sizes - violation of ossification or prematurity.

The whole body of the baby is the embodiment of fragility and insecurity, but there is the most vulnerable, small, pulsating area on his head - the crown or fontanel. This phenomenon in a newborn is one of the most exciting topics for young mothers, and for pediatricians and pediatric neurologists, it is the most important indicator of the correct development of the child. Let's try to figure out: what it is and what functions the fontanel performs in children.

Fontanelle of a newborn

The soft area on the head of a newborn is the distance or the so-called “window” between the bones of the skull. It is covered with dense, elastic connective tissue - a membrane, which, contrary to prejudices, is quite difficult to damage, and which ossifies and hardens by a certain age. Immediately after birth, the baby, normally, has 6 such "windows".

The largest fontanel in a newborn is located on the top of the head, between the two frontal bones. It is called parietal or anterior unpaired, has a diamond shape and reaches a size of up to 4 cm.

The second unpaired fontanel is located on the back of the head between the occipital and parietal bones.

The rest of the "windows" are called paired, because. are located on the sides of the head - in the temporal regions and behind the baby's ears.


As a rule, all fontanelles, except for the anterior one, are no more than 5 mm in size, and the process of ossification of the connective tissue covering them occurs much faster than the anterior one - during the first two months of a child's life, and sometimes even in the womb. Therefore, most often the parents of a newborn do not know about their existence at all.

What are the functions of the fontanel?

Despite the fact that the fragility of the baby is the cause of fears and concerns for his parents, nevertheless, even it is thought out by nature to the smallest detail. This also applies to the topic of this article. The fontanelles on the baby's head perform a number of important functions:

When does the fontanel grow in newborns?

So, we have already mentioned above that the occipital and lateral "windows" overgrow almost immediately after the birth of the child. But when should the largest anterior fontanel heal?

Experts do not name any specific dates for the ossification of the connective tissues on the head of newborns, because, like any process in the body, it proceeds depending on the individual characteristics of the child's body. There is an opinion that the time of their healing can be genetically determined, and also depends on the sex of the newborn.

If we talk about approximate terms, then, as a rule, the fontanel in newborns heals at the age of 6 months to 1.5 years, sometimes this process can continue up to 2 years of the child. Minor deviations should not be a cause for concern for parents, because. they are considered the norm.


Indicators of the norm of the fontanel and their deviations

As we have already found out, normally, the crown of a newborn closes by about two years, has the shape of a rhombus and is 2 to 4 cm in size, depending on the degree of maturity of the baby. Also, the norm will be a slight increase in the first month of a child's life, due to the rapidly increasing brain size. A slight protrusion or retraction of the membrane relative to the level of the skull bones may also be normal.

However, there are exceptions to everything. Sometimes deviations in the timing of overgrowing or the size of the crown may indicate some pathologies.

For example, a long non-healing, large fontanel in a child may indicate a number of diseases such as, for example:

  • down syndrome
  • hydrocephalus
  • hypothyroidism
  • rickets

Also, a too small fontanel in a newborn may indicate any health problem, i.e. when early ossification of the connective tissue occurs. In this case, we can talk about such deviations:

  • microcephaly
  • craniostenosis
  • developmental anomalies of the brain
  • meningitis
  • excess calcium in the body of a newborn

A cause for concern should be a fontanel that is obviously convex or sunken in shape. This may be an indicator of pathologies such as:

  • meningitis
  • encephalitis
  • tumor formations
  • intracranial pressure

But it should be remembered that any disease has a complex of symptoms, so it is impossible to draw conclusions based only on the "behavior" of the fontanel of a newborn. If there is nothing more alarming in the behavior of the baby, most likely, its development proceeds in the normal mode. Only a specialist can determine compliance with the norm or deviation from it, visits to which should not be neglected.

Why does the fontanel in the baby pulsate?


A completely physiological feature for a healthy newborn is a slight pulsation of the membrane. The fact is that the cerebrospinal fluid, the fluid that fills the ventricles of the brain, constantly circulates in the cerebrospinal fluid pathways. This leads to the pulsation of the brain tissue, which we observe in newborns under the connective tissue that covers the distance between the frontal and parietal bones.

The pulsation of the fontanel of the newborn is also provoked by the beating of the heart - each contraction of it leads to a rush of blood to the brain, this leads to the rhythmic movement of the crown of the child.

There are some deviations from the norm, which should alert the parents of the newborn and serve as a reason to see a doctor:

  • the fontanel pulsates too intensely
  • does not pulsate at all
  • the pulsation of the crown is accompanied by a strong anxiety of the child: constant crying; bad sleep; regurgitation; refusal to eat, etc.

In the process of growing up and healing the fontanel, the nature of the pulsation will change somewhat.
If the first two months of a newborn's life, the pulsation of the membrane is almost constant and visible to the naked eye, then by about three months of age it will be noticeable only during crying or when the child is very stressed.

How to care for the baby's fontanel?

Young parents consider the fontanel on the head of their crumbs the most vulnerable, easily injured place and simply prefer not to touch it. This is not quite the right approach, because. this area in a child is covered with the same skin as his entire body, therefore, it requires care and hygiene. There are no special rules for caring for a child's crown, it is enough to take into account some of its nuances:


  • it cannot be pressed;
  • comb your hair very carefully without touching the fontanel;
  • protect the newborn from hitting the head during games, swaddling, bathing;
  • if it is necessary to remove the birth crusts from the scalp of a newborn, it must be carefully lubricated with oil half an hour before bathing

Experts also advise regularly changing the position of the baby's body, turning him from side to side, picking him up, laying him on his stomach. When the baby is in one position for a long time, there is uneven pressure on the fontanel area, which can lead to a shift in the bones of the child's skull and, subsequently, to its deformation.

The skull of a newborn is designed so that during childbirth the head can easily pass through the birth canal of the mother. Therefore, soft cavities exist on the head of a newborn, which form at the junction of the junction of the bones of the skull. Over time, they overgrow, only a large one remains on the crown. When this fontanel overgrows in a child, the skull becomes the same as in an adult, differing in size.

Already inside the mother's womb, the child is preparing for birth. On the cranium, he has up to 6 cavities, or fontanelles, that are not closed by bones. On top they have plates of connective tissue. During passage through the birth canal, the head of the fetus is flattened from the sides due to the presence of fontanelles behind the auricles. Immediately after birth, they close, but a large fontanel remains on the crown of the head, which has a diamond shape and sizes ranging from 22 to 35 millimeters. Every mother knows about this webbed window. It overgrows later than others, gradually decreasing in size.

Convex

Bulging of the fontanel occurs in the first months of a newborn's life due to the fact that the brain increases in size. It presses on the elastic plate of the crown, and the surface becomes convex. But excessive bulging of the parietal region is a symptom of high intracranial pressure in a baby.

If the child's body temperature rises, vomiting appears, then it is necessary to check it with a specialist.

The bulge of the crown surface can also be associated with a head injury if the child falls and hits. In any case, you need to see a pediatrician.

Sunken

Sometimes there is, on the contrary, sinking in the area of ​​the soft top of the head. With a slight indentation, you can not be afraid for the health of the newborn. Usually this happens when the baby overheats in the sun or wraps him up tightly. In this case, the body begins to dehydrate, so it is necessary to give the child more drink.

But with a deep sinking of the plate, you need to consult a pediatrician. If the baby starts vomiting, diarrhea, then this is due to intestinal infections. And you can't do without hospital treatment.

Throbbing

A weak pulsation of the fontanel on the crown of the head can be observed constantly. It occurs due to the fact that the vessels are located in the newborn close to the heart. The blood pulsates in them, and this action is transmitted to the cerebrospinal fluid, to the membranes of the brain. Accordingly, the parietal plate begins to pulsate. Often observed pulsation of the cavity in children under 3 months.

But with a constantly high pulsation in a large fontanel, they pay attention to the behavior and condition of the baby. When fever, intoxication are added to this symptom, they urgently consult a doctor.

The size and location of the fontanel in an infant

When a baby is born, most of the soft parts of the skull overgrow, and a large fontanel remains. Each child has a different size. For babies that appeared on time, the membranous window has the shape of a rhombus with sides on average 20-35 millimeters. It can be determined on the head in the region of the crown by palpation.

The boundaries of the soft part of the crown change. If at first they increase due to the growth of the brain, then the replacement of connective tissue with bone begins from the edges. By the year, the fontanel becomes small, and by the age of 1.5 it is completely overgrown.

Functions of the fontanel

Young parents are wondering why a child needs a fontanel, what role it plays in its development.

Due to the membranous connection of the bones of the skull:

  • the child easily passes the birth canal;
  • the baby's brain is protected by this shock absorber from concussions and bruises;
  • you can determine the increase in intracranial pressure in a baby;
  • there is a normal development of the brain, filling it with the necessary space inside the cranium;
  • the child's brain cools when the body temperature rises.

According to the state of the elastic plate, diseases of the newborn are determined. After an ultrasound examination of the parietal region, the presence of tumors and other pathological changes in the body is determined.

Factors affecting the rate of overgrowth

Like the size of the fontanel, the rate of its overgrowth is different for each child. The time of disappearance of the membranous window depends on:

  • the sex of the child, since in boys the process is faster;
  • heredity;
  • pathologies that arose in fetal development or in the first months of a baby's life.

It is also necessary to take into account when the baby appeared, on time or earlier. Indeed, in premature babies, development occurs with a delay.

What is the norm

The rate of overgrowth of the parietal window does not depend on its size. Starting from 1 month of life, the replacement of the lamellar membrane with bone tissue will begin. No matter how many months the process starts, the edges of the window grow first. The whole procedure takes up to a year. There remains a small dent of 5-8 millimeters, which is also quickly tightened. But it is also considered the norm that in a newborn only in 1.5 years the crown grows.

The speed depends on the state in which the newborn was after birth, whether he had developmental disabilities, whether he was susceptible to infections. In any case, by 18 months, the child should close a large fontanel. This will be the norm.

Deviation from the norm - is it worth worrying

A deviation in the development of the child is considered when the soft crown closes quickly. It is impossible that time stretched to 2 or more years. It is believed that the process of overgrowing is influenced by pathological changes in the body of a newborn.

Before the time

Do not rejoice that the baby's temechko became hard early. The fontanel quickly closes if the child has:

  1. Craniosynostosis, when the sutures on the cranium quickly heal. The disease is associated with deformity of the skull, secondary hydrocephalus.
  2. Impaired function of the parathyroid glands. Hence, due to metabolic disorders, an increase in calcium in the blood occurs. Together with the early overgrowth of the fontanel, arrhythmia and problems in the functioning of the organs of the gastrointestinal tract are detected.
  3. Microcephaly, which will lead to underdevelopment of the brain, developmental delay.

It is worth sounding the alarm, visiting specialists at the early closure of the fontanel.

Later than normal

When the overgrowth of the crown of the head is delayed, it is worth paying attention to whether the child has:

  • rickets;
  • lack of thyroid hormones;
  • hydrocephalus;
  • bone growth disorders.

In any case, with a delay in closing the soft top of the head, you should contact a specialist. Perhaps there were some failures in the development of the baby.

Signs by which the condition of the fontanel is assessed

Parents themselves can assess the condition of the fontanel, determine deviations. The further development of the baby depends on their behavior. Therefore, from the first month it is necessary to examine the temechko. Do this carefully, without pressing on soft tissues.

Visually determine the dimensions of the unovergrown crown. It should be within 20-30 millimeters. If the dimensions are too reduced or enlarged, then it is necessary to pay attention to whether the fontanel protrudes or is depressed. In the first case, it is possible that the pressure inside the baby's skull is increased. The symptom is associated with such serious diseases as meningitis, hydrocephalus.

The depression of the crown indicates that the child is hot, he wants to drink. But there may be problems with the digestive tract. With a strong pulsation of the plate, it is imperative to seek advice in order to eliminate the risk of pathologies.

Does the crown need special care?

The fontanel does not require special care. While bathing, they try to keep the child carefully so as not to injure the soft tissues of the head. During a walk, a hat is put on the baby's head. In the summer, you need a light Panama hat so that the child does not bake his head. In cold weather, the cap will protect the soft tissues of the skull from colds.

For proper development, the baby needs massage, exercise. It is necessary to turn the baby over more often to improve blood circulation in the brain.

Who to contact if you have problems

Any problems in the development of the baby can be resolved by the doctor. If there is a deviation in the condition and size of the parietal cavity, they turn to the pediatrician. He can send for tests, brain research. Under the power of treatment of diseases associated with the development of the brain, a neurologist. Deviations in the work of the thyroid gland will see the endocrinologist.

Any changes in the timing of overgrowth of the fontanel, its size and shape should be known to specialists. Only they will prescribe and carry out the correct treatment.