A large fontanelle in a child: size, timing of closure. The structure of the skull of a newborn

04.09.2019

Fontanelles- non-ossified areas connecting the skull bones of newborns. For some parents, they are a matter of concern, believing that if you accidentally push on them, you can damage the brain. However, such prejudices are absolutely meaningless, since, in addition to the skin, it is also covered with sealing bone tissue, which is simply impossible to damage by accidental pressing.

The fontanelle in newborns is not one, as almost all parents believe. Distinguish between anterior (large), posterior (small), wedge-shaped, mastoid. However, all the attention of pediatricians, neurologists is directed to the large anterior and small posterior, since the rest are very small and, as a rule, overgrow immediately after birth.

Fontanelle function

They make labor easier for both the mother and the baby. Allow to "squeeze" the vault of the skull, thereby facilitating the passage of the baby through the birth canal. That is why, after birth, the baby's head seems unnatural - a little elongated. However, after a few days, the head takes on a normal shape.
The fontanelles provide optimal spatial conditions for the growth of the brain at the required rate.
Participate in the regulation of heat exchange between the baby and the environment. If the body temperature rises above 38 degrees ˚С, natural cooling of the brain tissue will occur through this area.
They perform the function of a shock absorber in case of an accidental fall of the baby.

Where are located on the head

It is quite easy to determine where the large and small fontanel is located in a newborn. The large one has a diamond shape measuring 22-35 mm and is located right on the crown, and the small one has a triangular shape measuring 5 mm at the back of the head.

When overgrown

A large fontanelle in an infant completely closes by 12-24 months of life, a small one - two to three months after childbirth. According to statistics, this process is faster for boys than for girls. Also, the closing time depends on how much the child's body is provided with calcium. If a woman ate properly during pregnancy, followed the multivitamin regimen, then the overgrowth of these non-ossified areas occurs normally.

What affects closure

Heredity. The size of the fontanelle and the time of its closure in a baby primarily depends on genetic characteristics. If the parents had late or early overgrowth, then the baby will be the same. But in the absence of some diseases that affect the time of overgrowth of the crown.
The gestational age at which the baby was born. A premature baby up to 2-3 years old will lag behind in physical development from peers born on time. And accordingly, the timing of the closure of the fontanelle is longer.
Deficiency of calcium and vitamin D in the baby's body can cause prolonged overgrowth. And the excessive content in the body, on the contrary, causes the early closure of the fontanelle. Usually the reason for this is not diet, but metabolic disorders.
Some diseases.

When to worry

Knowing the size, the approximate time frame for the child's fontanelle overgrowing, one can notice any deviations, avoid and prevent the development of certain dangerous diseases:

Rickets(violation of the normal formation of bones during the period of their active growth). The disease is the most common cause of late overgrowth of the fontanelle. This usually occurs in premature babies who are deficient in vitamin D and calcium.
Down Syndrome(congenital developmental disorder of a child, manifested by mental retardation, impaired bone growth and other physical abnormalities). Too small anterior fontanelle in a newborn at birth, together with other signs, may indicate the presence of this disease.
Hypothyroidism(lack of production of thyroid hormones). A decrease in the amount of thyroid hormones can interfere with the closure of the large fontanelle.
Overgrowing ahead of time may indicate an excess of calcium in the body or indicate the presence of serious diseases - craniostenosis or microcephaly.
Sunken fontanelle may be a symptom of a dangerous condition - dehydration in a child. At elevated body temperature, repeated diarrhea, vomiting, the body begins to lose fluid. This condition affects the whole body - the skin becomes dry, cracks appear on the lips, the child's well-being is disturbed, the amount of urination decreases, the urine acquires an unpleasant odor and dark color.
Bulging observed against the background of diseases accompanied by an increase in intracranial pressure - encephalitis, meningitis, intracranial bleeding, tumors. Also, a bulging crown can be observed when an infant falls and is injured. With the addition of symptoms such as high, difficult to confuse, body temperature, vomiting, lethargy, drowsiness, loud crying, convulsions, loss of consciousness, strabismus, the baby must be urgently shown to the doctors.

The size and timing of fontanelle closure helps to suspect changes in the child's health. However, the diagnosis is made not only by its size and timing, but also in the presence of concomitant symptoms characteristic of one or another disease. In addition, the closure of the fontanelles depends on the individual characteristics of the baby. Some newborns are born with an already small crown, which quickly grows over. A large crown will close only by 2 years. If the baby is feeling well and is developing normally, then there is no need to worry.

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The fontanelle in newborns is a constant concern for parents. There are a lot of questions and misconceptions about this, especially when the pediatrician at the reception feels this area and prescribes an ultrasound scan. This is a standard activity and will do absolutely no harm.

Parents should know what the fontanelle is, so as not to worry unreasonably, but to understand in time when physiological changes visually are not typical, in order to prevent possible unpleasant consequences.

Features, sizes, role and quantity

A child's skull bones grow in direct proportion to the rate of increase in brain size. For the first two years of life, children are characterized by the most intensive development of the brain, therefore, the bones of the skull are also constantly undergoing changes. It is a misconception that if the fontanelle is completely overgrown, this stops the growth of the newborn's skull.

The fontanelle in children plays an important role in increasing the size of the cranium, but the sutures of the skull are no less important - they remain open until the age of 18-20. The main function of the fontanelle is the ability to adjust the skull during childbirth to the size of the woman's pelvis. The ideal shape of the baby's head is selected instantly during labor contractions. That is why after the birth of a baby, his head seems a little elongated, not natural. However, thanks to the extraordinary elasticity of the fontanelles, after a few days, the child's head takes on its usual normal shape.

Experienced parents know that in the case of a child falling in the first couple of years of their life, minor head injuries are not dangerous, and all because the skull retains the ability to deform. When it is completely overgrown, children practically do not have falls with head injuries, since they already move confidently and have good coordination of movements.

The fontanelle in newborns is not one, as many parents believe - there are only six of them, but only a large anterior, a small posterior one is subject to careful examination by pediatricians and neonatologists, since the other four, unlike them, are negligible, as a rule, their overgrowth occurs after a few days after birth.

What should be the fontanelle of a newborn?

The size of the fontanelle of a child is calculated very simply when the diameters obtained during measurements (transverse and longitudinal) are summed up, then divided by 2. The resulting average is indicated as the actual size of the fontanelle. Immediately after the birth of the child, the dimensions of the posterior fontanelle are 0.5-0.7 mm. Usually, there are no problems with it. This fontanelle in newborns closes after a couple of months.

All attention is paid to the large fontanelle, since it is outwardly noticeable and well palpable. All parents want to know: is everything going right, the fontanelle is normal or not, is it not closing too slowly, or maybe, on the contrary, early overgrowth occurs.

You should know that each child has its own developmental characteristics - some newborns may have a large fontanel, others small. The parameters do not have to be exactly the same. And no one can say for sure when the fontanelle in children is completely overgrown, so you should not worry for no reason. In different children, the fontanelle heals at different times, and the approximate timing is very conditional. In any case, an ultrasound scan will help clarify everything.

As a rule, the anterior fontanelle has a rhomboid shape measuring 25 by 25 mm. It usually closes at 12-18 months of a child's life. According to medical statistics, this process is faster in boys than in girls. There is no direct relationship between the time and size of the fontanelle. In any case, it closes gradually. There is an opinion among the people that the fontanel should only decrease over time, and its increase is direct evidence of the child's improper development or illness. But due to the active growth of the brain, for the first 3 months, an increase in the fontanelle is sometimes observed, which causes panic in the parents, and this is just a feature of the child's development.

Fontane changes - what to look for?

If a parent sees that the child's fontanel is throbbing, it bulges out or slightly sunken, then this indicates the child's full health. In addition, there is an earlier closure of the fontanelle, which is stated only in the case when the baby is not yet 3 months old. However, this fact is also possible with the normal development of the child, if the size of the head is assessed by the pediatrician as normal.

In healthy children, only slight bulging or sinking of the fontanel is possible. It is considered normal if it pulsates. However, external changes, and especially sharp ones, may well indicate the development of the disease in newborn children. What should parents do if the fontanelle causes them fears of the following nature:

A sunken anterior fontanelle often indicates dehydration, especially when symptoms such as diarrhea and vomiting are present. A newborn child should be given warm boiled water, call a doctor at home to find out the real causes of dehydration.
A bulging fontanelle in the presence of seizures requires an urgent call to an ambulance home. Such symptoms can indicate a serious illness.
If there are no other symptoms, and outwardly the newborn seems to be completely healthy, and the fontanel is bulging for a long period, you should also consult a doctor as soon as possible.

In addition, a sunken fontanelle, which pulsates, is observed when the temperature rises, when the child loses fluid and dehydration also occurs. Often, the fontanelle in children pulsates when it naturally tightens, so it is important to be able to distinguish dangerous from typical manifestations. If desired, it will be possible to undergo an ultrasound scan to clarify all the issues.

How to care for the fontanelle

A small fontanel in a newborn is as strong as a large one. Careful palpation during a routine examination by a doctor does not harm the baby in the least. Therefore, there are no special measures to protect it from external influences. The area of the newborn's head, where the anterior fontanelle is located, can be washed and gently patted with a towel.

Standard baby care manipulations are not capable of disrupting the elastic membrane of the skull. Experts recommend doing regular scalp care for your newborn. And it doesn't matter whether the fontanelle is large or small, and how quickly it overgrows, one should not forget that the crusts must be removed systematically. The perceived fear of damaging the soft fontanelle of the newborn stops some parents from scratching off the yellowish-white layer from the scalp of their babies.

To properly remove this crust from the scalp of a newborn, while not causing any harm to the baby's health, you will need to take baby oil, slightly warmed up, and apply about 1-1.5 hours before evening bathing on the head. It is recommended to wear a light cap on top. Before bathing, you need to gently massage your head with a special brush made of natural soft bristles. At the same time, the little baby does not feel absolutely any discomfort. Then it is necessary, and the particles of the crust will move away very easily during the process of combing with a comb.

Many of the concerns of parents are associated with a pulsating area on the head of the newborn - the fontanelle. Anxiety is caused by caring for the baby, there is a fear of harming him when exposed to an unprotected area. Parents are especially interested in when the fontanelle in a baby is overgrown, what is the norm, what deviations are possible.

Peculiarities

The fontanelle forms at the junction of the baby's cranial bones, connected by a soft webbed tissue. It is dense enough to protect the brain from external influences: you can not be afraid to wash, comb and iron your baby's head.

In the process of intrauterine development, 6 fontanelles are formed:

Two paired on the sides (in front of the auricles and behind them) - rather narrow, more like seams. They are delayed by the time of birth or immediately after it and are invisible to parents:
Small in the occipital region (about 5 mm in diameter) - in most cases it closes during intrauterine development, more often observed in premature babies. Its overgrowth with bone tissue lasts from several days to two months;
The large one, located on the crown, is tightened last. Its dimensions vary between 22-35 mm.

A baby can be born with a pathologically large fontanelle as a result of prematurity, hydrocephalus (accumulation of excess fluid in the ventricles of the brain), or disorders in the development of the skeletal system. The reduced size of the parietal and the complete closure of the remaining fontanelles is possible with a disproportion of the too small skull and brain compared to other parts of the body. Such cases require medical supervision, additional research to find out the reasons. The rate of overgrowth of the fontanelle in babies with congenital pathologies may differ in comparison with children without deviations.

Generally accepted norms

The parietal fontanelle is characterized by a rhomboid shape, the width and length of which are in the range of 5 - 35 mm. To calculate the size, you need to determine the maximum dimensions of the soft area along and across, add the resulting numbers and divide by two. The average parameters of the parietal fontanel, depending on age, are shown in the table:

Age (months)	Formula size (cm)
up to 1	2,6-2,8
1-3	2,2-2,5
3-4	2-2,1
4-7	1,6-1,8
7-9	1,4-1,6
9-10	1,2-1,4
10-11	0,9-1,2
11-12	0,5-0,8

The dimensions are approximate, a deviation of a few mm up or down is permissible. In the first three months, a slight increase in the fontanelle is possible due to the intensive growth of the brain.

There is a dependence on the sex of the child (in boys, the soft area is tightened faster) and heredity: if one of the parents experienced early or late overgrowth without pathologies, it is possible for the baby to manifest a feature.

When should the fontanelle heal?

Dr. Komarovsky notes that normally tissue ossification occurs between the ages of 3 to 24 months. The exact time is individual, depending on the characteristics of the child's development. Closure is rare in three-month-old babies - about 1%, in about 40%, an overgrown fontanelle is observed at the age of one, and by the age of two, the process is completed in 95% of babies. Perhaps later overgrowth, in the absence of developmental abnormalities, it is considered normal.

Rapid overgrowth

The fontanelle can be tightened in a baby up to 6 months. With normal growth and development, this is not a deviation. Ossification of the soft tissue of the fontanelle before the age of three months is considered too early. It occurs as a result of pathologies:

Craniosynostosis is a deviation in the formation of bone tissue, in which the fontanelle is quickly tightened and the cranial sutures are completely healed, preventing the normal development of the brain. It can be congenital or acquired, in most cases it is observed in combination with other developmental disorders;
Microcephaly - expressed in a decrease in the size of the head, refers to severe deviations in the development of the central nervous system. The main symptom is a reduced head circumference, a violation of proportions relative to other parts of the body;
Abnormalities in the development of the brain - disturbances in its structure, a decrease in size, weight.

Such deviations are rare, not limited to manifestation in the form of a rapidly overgrowing fontanelle.

Slow closing

This problem is more common, arises if the baby has:

Congenital pathologies of the thyroid gland. It manifests itself as drowsiness, swelling, low activity of the baby, poor appetite, digestive problems, constipation;
- premature babies often suffer from them. It can occur with a lack of or calcium in the body. Symptoms are sleep disturbance, appetite disturbance, increased nervous excitability, sweating with the appearance of a specific sour odor;
Disease of bone tissue caused by genetic abnormalities - achondrodysplasia. Accompanied by stunting, shortened limbs, leads to dwarfism;
Down's disease - manifested by developmental delay.

Serious illnesses are rare, and a comprehensive examination is required to confirm the diagnosis. For the diagnosis, consultation of a neurologist, endocrinologist is required.

Common myths

The most common misconceptions associated with overgrowth of the fontanelle:

Early closure limits the growth of the brain. The bones of the skull are connected with sutures, which heal completely after 20 years. They support normal head growth and brain development. In the case of early overgrowth of the fontanelle, the condition of the seams is checked: if they have not closed, then there is no danger for the further development of the child.
Rapid overgrowth is caused by the intake of vitamin D and calcium supplements. They are prescribed taking into account the development of the baby for the prevention of rickets; only a lack of substances can affect the growth of bone tissue, which slows down the process and increases the period of overgrowth. The very intake of minerals, vitamins does not cause the acceleration of tissue ossification, it is an individual feature or arises from disorders in the development of the baby.
If the child's fontanel does not overgrow by the year, then he has rickets. The disease manifests itself in a number of signs and cannot be determined only by the rate of ossification of the membranous tissue on the baby's head.
A small fontanelle in a baby at birth should overgrow faster and vice versa. The timing of tightening does not depend on the initial size of the membrane, but on the characteristics of the organism.

There is no exact time when the large fontanelle overgrows in newborns ... The process takes place individually, it is influenced by various factors. You cannot make diagnoses on your own in case of deviations from the generally accepted timing of the overgrowth of the fontanelle. This cannot be the only symptom of serious diseases - they always have additional symptoms.

It is forbidden to independently prescribe medicines and use folk methods. For the baby's health, it is important to follow the rule: discuss any concerns with the pediatrician, who, if necessary, will prescribe additional studies. In addition to the size of the fontanelle, you need to pay attention to its condition: excessively convex or sunken can be a sign of illness or deterioration of the child's condition.

When the pediatrician feels the child's head with his fingers and prescribes an ultrasound scan, the parents begin to worry. It is not for nothing that grandmothers say that the fontanelle in newborns is a weak point and must be carefully protected. Is it true? What is a fontanelle and why watch when it is overgrown? Can an untimely overgrowth cause problems with the development and well-being of an infant? Is it worth fearing the consequences, and does it need special care?

What is the fontanelle of newborn children for?

The fontanelle is not only a newborn child. Monkeys, puppies, kittens have it. These are special voids between the cranial bones, tightly closed by the membrane.

Nature has awarded living creatures with a fontanel that performs several vital functions:

Passing through the birth canal, the skull is freely compressed and takes on an optimal shape. Bones overlap each other to facilitate childbirth. Therefore, in infants, the shape of the head is irregular, acquiring a rounded appearance after a few days.
The brain of newborn babies is actively increasing in the first days. The elastic fontanelle allows it to gain height and provides the necessary space for development.
Normalization and stabilization of the temperature of the membranes of the brain. When, for various reasons, a child's temperature rises, the fontanel helps them cool, thus avoiding cerebral edema and seizures.
It is a natural shock absorber that protects the baby's head from impacts against hard objects and surfaces.
Modern medicine, taking advantage of these functions of nature, with the help of neurosonography can, without the slightest obstacles and inconveniences, reveal injuries, bleeding, tumors, diseases of the brain structures at the earliest stages, which contributes to the possibility of complete or partial cure with the least losses and consequences.

How many fontanels do children have

The baby's head does not consist of one, as many believe, but of 6 fontanelles:

posterior (small) - connects the parietal bones with the occipital. You can feel it on the back of your head. The size is about 5mm;
large fontanelle (anterior) - connects the parietal bones of the newborn with the frontal ones and is considered the largest. Determining where it is located is simple. It has a diamond shape 2 by 2 cm and is located right in the middle of the crown - on the crown;
lateral - located on the sides of the head, two of which are wedge-shaped, and two are mastoid.

rice. projection of the large (left) and small (right) fontanelles

When should be overgrown

Many parents ask doctors how long it takes for a large fontanelle to heal.

The posterior, wedge-shaped and mastoid fontanelle closes 1.5-2.5 months after delivery.
The anterior one, through which the ultrasound is done and which protects the newborn's brain from injury in a fall, should completely close by two years, but if there are any abnormalities, the fontanelle may not close at all. It is the small and large fontanelle that neonatologists and pediatricians pay attention to.

It happens that, contrary to expectations, the fontanelle of a three-month-old baby does not heal, but increases. The whole family starts to panic. Indeed, the people say that its increase is proof of the child's backwardness and improper development. Do not worry about this. At first, active development of the brain can provoke an increase in the fontanelle. This is a physiological feature that will smooth out over time.

Interesting: According to statistics, in boys, the closing of the fontanel is a little more dynamic than in girls.

The size of the fontanelles of newborns is determined by the formula: the doctor, when measuring the sum of the longitudinal value and the transverse in diameter, divides it in two.

It is believed that all children have the same diameter of the large fontanel, but in practice the allowable sizes vary from 0.6 to 3.6 cm.

Tightening depends entirely on metabolic processes, absorption of calcium, phosphorus, mother's nutrition, intake of calcium-containing multivitamins during gestation.

If there was a lot of calcium, then the fontanelle in the baby will be small, dense and it will quickly close.

What diseases can the fontanelle prevent?

There are no definite norms and parameters for tightening the fontanel, and the approximate time is conditional. But there are features that parents need to pay attention to:

1. The fontanelle overgrows too quickly. This means that the brain will not have enough time to develop and correctly position itself in the skull.

Overgrowth can be accelerated by:

Hypervitaminosis is an excess of vitamin D and calcium in the body. The deficiency, as well as an overdose of these substances, are dangerous to the health of the newborn. Mom needs to monitor nutrition, control the intake of vitamins;
Craniostenosis is a congenital pathology when the cranial sutures close early. It is characterized by a small irregular head size, high intracranial pressure, retarded development, strabismus, exophthalmos, deformation of parts of the face, anxiety, convulsive seizures. Sometimes it occurs due to rickets or a malfunction of the thyroid gland. Diagnosed in special clinics and treated with surgery;
Brain pathology. Diagnosed by neuropediatricians and treated depending on the nature of the disease.

Early closure is diagnosed when the newborn is under 3 months of age. But this fact does not indicate the presence of the listed diseases. If the baby develops correctly, it does not have dangerous symptoms, the size of its head is normal (assessed by a pediatrician) - there is no need to worry. Closing the fontanelle does not signal the cessation of brain development. The skull continues to grow and develop by increasing the size of the central zone of bones.

The sutures formed in the middle of the forehead heal completely, and the rest are closed by the age of 18-20. This means that the skull and brain are gradually growing all this time. Fears of the older generation about the early tightening of the fontanelle and about the possibility of increased intracranial pressure due to the stopped growth of the skull are groundless.

2. The fontanelle grows very late. When doctors diagnose late fontanelle closure in a two-year-old child, it is necessary to identify the root causes:

Lack of vitamins and calcium. It is required to enrich the baby's diet with dairy products, walk a lot, perhaps take him to the sea. Calcium is absorbed faster by the body, combining with vitamin D.
Rickets becomes a common cause of the late tightening of the fontanelle. This mainly applies to premature babies suffering from calcium deficiency.
Hypothyroidism - observed when the thyroid gland of a newborn is disrupted. A smaller amount of hormones enters the bloodstream, which leads to a hormonal imbalance that causes many ailments: late overgrowth of the fontanelle, severe sweating, diabetes mellitus, etc. Symptoms of congenital hypothyroidism, in addition to late overgrowth, are lethargy, obesity, constipation in infants, diarrhea, drowsiness, lack of appetite, swelling. If hypothyroidism is suspected, the doctor sends for a blood test and, when the diagnosis is confirmed, prescribes hormone therapy.
Down syndrome - a very large, poorly overgrowing fontanelle, may indicate this disease in combination with other symptoms and signs - mental and physical retardation, a certain facial expression, slanted eyes, a transverse fold on the palm, a short neck, a flat nape. Physicians can establish an accurate diagnosis using karyotyping.
Diaphyseal aplasia. An ancient congenital pathology of bone tissue, in which the skeleton is damaged. The growth and development of the newborn is impaired, limbs are shortened, leading to dwarfism. Such children are identified not only by a slowly tightening fontanelle, but also by disproportionate short arms and legs, a wide head, a flattened nose, wide-set eyes, and a protruding forehead. Modern medicine is powerless against such a disease.

Possible developmental deviations

Some parents do not understand why it is necessary to observe the fontanel of a newborn. The fontanelle in a healthy newborn should protrude slightly or be slightly sunken, standing out against the background of the skull. But any discrepancy with the norm should alert and cause a visit to the doctor.

Sunken fontanelle

A sunken fontanelle speaks of dehydration due to diarrhea, vomiting, and fever. Mom needs to give the baby a lot of fluids and see a doctor.

Bulging fontanelle

Speaks of abnormal intracranial pressure associated with meningitis, encephalitis, meningoencephalitis, internal bleeding and neoplasms.

If, at the same time, the crumbs have convulsions, he has a pulsating and protruding fontanel - you need to call an ambulance.

Even when there are no visible symptoms, the baby is feeling well, and the fontanelle bulges noticeably, you should visit a doctor.

Mommy should not worry if the fontanelle on the newborn's head throbs. This is a natural phenomenon. This is how the baby's heartbeat is outwardly manifested. The human brain is surrounded by a special fluid called cerebrospinal fluid. When the vessels, contracting, pulsate, they transmit impulses that cause pulsation of the cerebrospinal fluid and fontanelle.

Do I need to take care of the fontanelle

A small fontanel in a newborn is as strong as a large one. The pediatrician, carefully probing it during the examination, cannot harm the baby in any way. Special measures for the care and protection of the fontanelle are not required. When washing your hair, the crown should be gently blotted with the edge of a towel, and not rubbed with pressure. Experts advise to carry out standard procedures for the care of the delicate skin on the baby's head, which are not capable of damaging the elastic cranial membrane. When crusts appear, they are recommended to be removed, despite the imaginary fears of grandmothers that it is impossible to touch soft places and it is dangerous to comb the yellowish layer from the child's head.

You can touch your fingers, stroke and kiss the baby in the fontanelle. The main thing is to monitor its development, condition and appearance. Every kid is different. It is impossible to compare the overgrowth of his fontanel with other children against the background of the absence of critical symptoms. It is necessary to regularly visit a doctor who can identify the problem in time.

An anatomical formation called the fontanelle is a small area of skull bone cleft on the head of a newborn. Until a certain age, this site has a low density and increased vulnerability. Very often, parents of newborn children are concerned about fears associated with the possibility of harm to the baby by exposure to the unprotected area of the head. Such parents have a question regarding the timing of the infestation of the fontanelle, its normal size, as well as probable deviations.

Anatomical features

The place of localization of the fontanelle is the area of contact of the bones of the child's skull. Until the formation of dense interosseous sutures, this area is connected by means of a soft membranous membrane. This shell provides temporary protection of the baby's brain tissue from external factors. During the intrauterine development of the baby, 6 fontanels are formed, represented by the occipital (small), two paired lateral and one large fontanel located in the parietal region.

Paired lateral fontanelles are the first from this list, and the last place in this queue is occupied by the large parietal fontanelle. Some children are born with an enlarged large fontanelle, which may indicate a disease such as hydrocephalus, impaired development of bone tissue, or premature birth of a baby. The rate of overgrowth of the large fontanelle is influenced by the time the baby is born, as well as the presence or absence of congenital pathologies.

Age norms

The parietal fontanelle is diamond-shaped. In order to determine the size of this anatomical formation, it is necessary to calculate the maximum size of the area with reduced density along and across. The resulting data is added and divided by two. A variant of the physiological norm are the following age parameters of the large fontanel:

From the moment of birth to 1 month 2.6-2.8;
From 1 to 3 months 2.2-2.5;
From 3 to 4 months 2-2.1;
From 4 to 7 months 1.6-1.8;
From 7 to 9 months 1.4-1.6;
From 9 to 10 months 1.2-1.4;
From 10 to 11 months 0.9-1.2;
From 11 months to a year 0.5-0.8.

The indicated age parameters are given in centimeters, and each of them is individual. A deviation of a few millimeters in the direction of decreasing or increasing is not a pathology option. For children in the first 3 months from the moment of birth, a sudden insignificant increase in the size of the large fontanel is characteristic, which is associated with the accelerated growth of the brain.

The parameters of the parietal fontanelle depend on the gender of the newborn baby. In newborn boys, in comparison with girls, there is an accelerated infection of this area. The fact of heredity cannot be ignored either. If one of the child's parents had an accelerated or delayed infection of this formation, then the baby may inherit this feature.

Splicing dates

In the absence of congenital diseases, infection of the large parietal fontanel occurs at the age of 3 months to 2 years. The exact period is different for each child. The formation of dense bone sutures on the skull in three-month-old children is very rare (no more than 1%). At the age of one year, this process is observed in 40% of children, and by the time they reach the age of two, the fusion of the large parietal fontanel occurs in 95% of babies.

Slow overgrowth

There are situations in which the formation of dense interosseous sutures in newborns is delayed for a long period of time. Such factors can provoke this deviation:

Disorders of calcium and vitamin D3 metabolism in the body (rickets). This serious disease is more common in children born prematurely. The disease can be recognized by such characteristic symptoms as increased emotional excitability in a baby, sleep disorders, complete or partial lack of appetite, excessive sweating. At the same time, a characteristic sour smell is felt from the baby.
Congenital diseases of the thyroid gland. If the baby has pathologies of this organ, then he is worried about symptoms such as indigestion, decreased physical activity, drowsiness, edema, decreased appetite and constipation.
Down Syndrome. This congenital disease is manifested by persistent developmental delay. In children with Down syndrome, late infection of the large parietal fontanelle is very often observed.
Genetically determined pathologies of bone tissue. Later, ossification of the fontanelle occurs in children with chondrodysplasia. In addition to the mentioned symptom, children with this disease show a slowdown in skeletal growth and shortening of the limbs.

Important! The listed diseases in newborn children are rare, therefore, in order to identify the cause of the slow growth of the parietal fontanelle, it is important for parents to examine the baby in a complex. Such a child will need advice from an endocrinologist, pediatrician and pediatric neurologist.

Rapid overgrowth

In a healthy baby who does not suffer from congenital pathologies and is born on time, an infection of this area can be observed at the age of up to six months. This is the norm. It is possible to talk about pathology if the ossification of the soft shell occurs in a child under 3 months old. The following conditions can serve as factors of early ossification:

Anomalies of the development of the brain. Early fusion occurs when the mass and size of the brain substance decreases. In addition, this condition occurs when some structures of the brain are underdeveloped or absent;
Craniosynostosis. This pathological phenomenon is characterized by the accelerated formation of bone tissue and interosseous sutures. Craniosynostosis is dangerous because the child's normal development of the brain and an increase in its size are disrupted. Craniosynostosis can be acquired or congenital. Most often, this disease occurs in combination with other pathologies;
Microcephaly (visual reduction in the size of the head due to underdevelopment of the brain). Microcephaly is referred to as severe congenital diseases of the central nervous system. In babies with a similar diagnosis, there is a body imbalance due to a decrease in head circumference.

Each of the conditions mentioned is a reason for lifelong monitoring of the child's condition.

Myths and misconceptions

There is a whole list of common misconceptions about the process of fusion of the large fontanelle, which cause unnecessary worries in the parents of newborn children. The most common myths include:

Accelerated fusion of the parietal fontanelle is provoked by taking medications containing calcium and. This group of drugs is prescribed for infants to prevent rickets and stimulate bone growth. The use of such medicines does not lead to accelerated ossification of the large fontanelle. If this problem occurs, the baby should be shown to a medical specialist in order to undergo a comprehensive examination and identify the cause of accelerated overgrowth.

Early fusion of the bones of the skull leads to restriction of the growth of the brain. Complete fusion of the cranial bones is observed in people over 20 years old. Up to this point, the bones of the skull enable the brain matter to form in full. If the child has an early infection of the parietal fontanelle, then medical specialists check the condition of the interosseous sutures. If by this moment they have not been closed, then the baby develops in accordance with the physiological norm.

If a one-year-old baby does not grow together the parietal fontanel, then he can safely assume rickets. This sign indicates the formation of rickets indirectly. This disease is characterized by other symptoms that reliably signal the development of the disease.

The small fontanelle should overgrow immediately after the baby is born. The timing of ossification of this anatomical formation is also individual for each baby. It is impossible to make serious diagnoses to a newborn child, relying only on data on the timing of the infection of the large fontanelle. In addition to this criterion, the listed congenital and acquired diseases are accompanied by a whole list of additional symptoms.

If a child has a slow or accelerated infection of the parietal fontanel, then parents are strictly forbidden to resort to self-medication at home. Any independent prescription of drugs and their dosages will cause irreparable harm to the body of a newborn baby.

Other deviations

In addition to late and early fusion of the cranial sutures, there are criteria for assessing the health of the infant. These criteria include:

... Moderate pulsation in the region of the parietal fontanelle is a variant of the physiological norm. If this process is not accompanied by intense bulging or sinking, then the parents of a newborn child have no cause for concern. In terms of its relief, this anatomical formation may not correspond to the smoothness of the cranial bones.
Convex fontanelle. The reason for seeking medical help is the excessive protrusion of the large fontanelle in the newborn. This sign speaks of the danger to the health and life of the baby if he was preceded by a head injury. Anxiety is caused by a combination of symptoms such as a protruding fontanelle, seizures, high body temperature, loss of consciousness, strabismus, vomiting, epileptic seizures, and emotional instability.
Retraction of the fontanelle. When seeking medical help, some parents complain that a dent is found in the region of the parietal fontanelle. This symptom indicates significant fluid loss (dehydration). This symptom develops in children against the background of diarrhea, profuse vomiting, high fever and other manifestations of general intoxication of the body. Often, the fontanelle sinking occurs in the summer, when the air temperature reaches high levels.

If the above conditions occur, you cannot postpone the visit to the doctor.