Youth and beauty 

The fontanel in a newborn: when it overgrows, what it should be, why it pulsates, does not close. When does the fontanel overgrow in newborns and how not to miss the signs of dangerous diseases? The fontanel does not grow for a long time

It turns out that normally a newborn has not one fontanel, but as many as 6! At first, during the first week of life, four of them close, then the fifth grows - at the age of about two months. And only the sixth - the largest - remains open for quite a long period of time. When does a fontanel overgrow in a child? Let's try to find the answer to this question.

Why do you need a fontanel?

First, let's figure out why nature provided for the presence of this mechanism. It turns out that the fontanel performs several important functions:

  • helps the baby to pass through the birth canal;
  • allows the brain to actively grow and develop in the first time after childbirth;
  • prevents an increase in the temperature of the meninges, since its increase above 38 ° C can lead to convulsions and swelling of the brain.

The overgrowth of the fontanel is a gradual process - the bones of the skull begin to grow together from four sides, which leads to the closure of the connective tissue in this place. Many moms are worried about how quickly this should happen. It turns out that it is impossible to unequivocally answer the question "what time does the fontanel grow in children". Normally, this can happen between the ages of 3 months and up to two years, so if your baby closes during this period, then you don’t have to worry. Sometimes the fontanel may not decrease, but increase - this is also associated with the active growth of the brain.

Early closure of the fontanel: should I be worried?

According to the observations of pediatricians, recently the closure of the “soft crown” in a child occurs quite early. It is assumed that the fontanel quickly overgrows in children whose mothers during pregnancy took vitamin and mineral complexes containing calcium. An excess of this microelement in the body of a child can contribute to the early closure of the “soft crown”.

The age of up to three months is the period when the fontanel overgrows prematurely in a child, but even in this case, pediatricians say that there is no need to sound the alarm. The baby should be monitored by a doctor who will monitor its development, and, in particular, such an indicator as the size of the head circumference, in order to exclude hydrocephalus.

But in most cases, even when a fontanel overgrows in a child under the age of 3 months, this does not indicate the presence of any developmental abnormalities. According to statistics, by the third month of life, it is already closed in 1-2% of children, up to a year this figure is 45%, and after two years, the “soft crown” remains open in 5% of babies. And this, too, may not affect

The shape and size of the fontanel

Another issue that parents usually worry about is the shape and size of the fontanel. In order to make sure that everything is normal, there is a certain indicator. It is calculated according to the following formula: the sum of the longitudinal and transverse dimensions of the fontanel is divided by 2. This value should be in the range of 0.6-3.6 cm. The shape of the pulsating "soft crown" resembles a convex or concave rhombus.

So, we can conclude that there are no clear terms when a fontanel overgrows in a child. Therefore, you should not worry and worry about this, just visit the pediatrician regularly and enjoy the joyful moments of communication with your baby.

Nature carefully “thought out” the process of the birth of a child. She provided for all the subtleties, thanks to which the baby is born healthy. In order for the baby to quickly pass through the birth canal of the mother, its head transforms and takes on an oblong shape, flattening slightly on the sides. Between the bones of the baby's skull there are gaps filled with plates of connective tissue. These areas are called fontanelles, and young parents have many different questions that concern them.

After birth, a baby has 6 fontanelles, most of which overgrow very quickly. Therefore, parents simply do not notice them. But the frontal, or large, fontanel, which remains open for a long period, is considered the main one. It is responsible for shock absorption, protecting the child from injuries and fractures during a fall.

When should the fontanel overgrow? You will find the answer to this question in our publication.

Where are located

The most prominent of the fontanelles is the large fontanelle (BR). It is located between the parietal and frontal bones and is quite large, because its size is about 3 cm. This area has a diamond shape and upon closer examination, you can see how it pulsates a little.

Many parents, wondering when the fontanel should overgrow in a child, are also interested in why it pulsates. This is because there is a thin connective tissue in this area, which allows you to see the vessels of the brain and fluctuations in the cerebrospinal fluid. This process is physiological and absolutely normal. It's not worth worrying. Also on the head of a newborn, you can find a small fontanel. It is located behind the large, where the parietal and occipital bones connect. It has the shape of a triangle, and its size is 5 mm. Very often, children are born with an already closed small fontanel. In other babies, it closes for 1 or 2 months.

A close examination of the child's head reveals two paired fontanelles, which are located in the temporal regions. In another way they are called wedge-shaped. The second pair of fontanelles, called mastoid, is located behind the ear. All of them close rather quickly and have no diagnostic significance.

When does a fontanel grow in a child?

When trying to find the answer to this question, it is necessary to take into account the physical characteristics of the crumbs and many individual parameters. There are no strict criteria according to which the complete healing of the described area occurs. But most pediatricians are inclined to believe that overgrowth without deviation from the norm occurs between the ages of 6 and 18 months. In some cases, the fontanel closes at 6 months or when the baby is one year old. Much less often it occurs between the ages of 3 months and 2 years. It all depends on the individual characteristics of the baby.

Do not obsessively think about how much the child's fontanel should overgrow. After all, every baby is a unique creation, all children have their own characteristics and physiological properties of the body. And if the neighbor's boy has already healed, but your baby has not yet, there is no need to sound the alarm.

Factors affecting the speed of fontanel closure

Being interested in the question of when the fontanel should overgrow, it is necessary to understand that there are some factors that affect the healing rate. So the process depends on:

  • From hereditary predisposition. It is important to understand that the size of fontanelles during the birth of a baby and the rate of their overgrowth primarily depend on genetic characteristics.
  • From the gestational age at which the baby was born. If a child is born before the due date, he is slightly behind in physical development. Therefore, the timing of the closure of fontanelles is long.
  • From the concentration of calcium and vitamin D in the child's body. If the baby has a calcium deficiency, then his parents will definitely ask themselves the question of when the fontanel should overgrow, as they will notice deviations from the norm. If there is an excess of vitamin D in the body, then the depression will disappear ahead of time. However, the child's diet is in second place here. After all, the main cause of deviation from the norm is a metabolic disorder.
  • From whether the mother took any drugs during pregnancy. Doctors noted that there is a direct relationship between the size of the fontanel and the intake of multivitamins, as well as the diet of the pregnant woman.

It should be remembered that hereditary predisposition directly affects the size of the fontanel in a newborn.

What is the norm?

Immediately after the baby is born, the doctor examines the site and evaluates it. After that, he monitors the condition during monthly checkups. The pediatrician without fail pays attention to the size of the crown, the rate of its decrease, as well as the density of the bones that surround it.

If the child is healthy and full-term, the size of his fontanel is 2.5-3.0 cm. The doctor determines the diameter by palpation of the skull and making a measurement between opposite sides of the rhombus. He will also advise the mother and tell you when the fontanel in the baby should grow approximately.

If the baby is large and was born at 41-42 weeks, the fontanel may be smaller.

In the event that the baby is premature, the dimensions of his crown are 3.5 × 3.5 cm. In addition, it is worth knowing that a child who is already 1 month old may have a BR greater than at birth. After all, during this period there is an active growth of the brain and the bones diverge.

It is quite difficult to determine exactly what exactly the parietal area should be in crumbs at different ages. However, there are approximate parameters, and here they are:

  • At the age of three months, the size is 1.8-2.0 cm.
  • Upon reaching six months, the fontanel in the baby decreases to 1.8-1.6 cm.
  • At 9 months, this area has a size of 1.3-1.4 cm.
  • By the year, the size of the fontanel is reduced to 0.4-0.8 cm.

This guideline is approximate. And all because:

  • Each baby has its own fontanel size at birth.
  • The process of tightening the BR does not depend on its size.

It is very important to ensure that the described area is not too tense and that the fontanelles are at the level of the bones of the skull. A slight swelling or sinking, as well as pulsation, is allowed.

In addition, it is very important that the frontal and parietal bones located around the crown of the head are sufficiently dense, without areas of softening.

Deviation from the norm - should I be worried?

When should the fontanel overgrow and what is considered a deviation? Doctors consider the ossification of the fontanel under the age of 3 months to be too early. This situation can be observed as a result of the following pathologies:

  • Craniosynostosis. In this case, there is a rapid tightening of the fontanel and complete fusion of the cranial sutures, which prevents the normal development of the brain. Pathology is congenital or acquired. In most cases, it is accompanied by other disorders in the development of the child.
  • Microcephaly. With such a disease, we can talk about severe deviations in the development of the central nervous system. A pronounced sign is a reduced head size, a violation of proportions relative to other parts of the body.
  • Anomalies of brain development. Here we are talking about violations of its structure, a decrease in size and weight.

The described abnormalities are rare, and manifestations in the form of a rapidly growing fontanelle are not enough for an accurate diagnosis. As a rule, the child also has other symptoms of the disease. Each mother will take an interest at what age the fontanel in the child should overgrow if she observes that it closes more slowly. This deviation from the norm is much more common than the first, and may indicate the following problems:

  • Congenital pathologies of the thyroid gland. In this case, the child has drowsiness, low activity, poor appetite, constipation, indigestion, swelling.
  • Rickets. Quite often, this disease occurs in premature babies. It also occurs when there is a lack of vitamin D and calcium in the baby's body. The child's sleep is disturbed, appetite decreases, and nervous excitability increases. He also begins to sweat profusely, and the sweat smells sour at the same time.
  • Chondrodysplasia. This pathology is a genetic disease of bone tissue. The child has a lag in growth, he also has shortened limbs. The disease leads to dwarfism.
  • Down's disease, in which

Of course, all parents think about when the child's fontanel should overgrow. Fortunately, serious pathologies are quite rare in babies, and in order to confirm the diagnosis, it is necessary to undergo a comprehensive examination.

The opinion of Dr. Komarovsky

How much should a child's fontanel overgrow, according to Dr. Komarovsky? This doctor says that the timing for each baby is purely individual. And there is nothing surprising in the fact that even in a healthy child, BR can grow only by the age of two, this is normal. It is also unlikely that a baby who develops without warning signs of the disease will have rickets or other ailments. You can not make a diagnosis just because the fontanel overgrows too slowly or quickly. The doctor also says that in this case, additional intake of vitamin D will not hurt. Don't worry about when the fontanel should heal. Komarovsky recommends not to panic for no reason.

What does the doctor pay attention to when examining the crown?

Are there parameters according to which the condition of the BD is assessed when examined by a doctor? Yes, the doctor evaluates the situation according to the following criteria:

  • Examines the fontanel and finds out how much its size corresponds to the age of the baby.
  • Establishes how many fontanelles a newborn had at the time of birth and compares their number with today's.
  • Looks at how much the fontanelles have changed, how fast they decrease and whether their shape has changed.
  • Feels the edges to prevent softening.
  • Sets whether the area is flaccid, sunken, bulging, or tense.

The doctor not only knows how many months the fontanel should overgrow, taking into account all factors, but will also be able to determine whether the child's condition is pathological.

A newborn has a protruding fontanel

Quite often, a too bulging fontanel is accompanied by encephalitis, cerebral hemorrhage or meningitis. With such diseases, high intracranial pressure is observed, which leads to the fact that the described area swells.

However, there is no need to jump to conclusions and panic. Brain disease is a serious pathology, and such a symptom as bulging fontanel cannot be the only one. If parents observe other threatening signs of deviations from the norm in a child, it is necessary to consult a doctor as soon as possible.

Here are the symptoms that you should definitely pay attention to if a child has a bulging fontanel:

  • A temperature that is almost impossible to bring down.
  • Attacks of nausea and vomiting.
  • Lethargy and drowsiness.
  • Presence of seizures.
  • Loud crying of the baby or irritability.
  • Loss of consciousness.
  • The appearance of strabismus.

You should also be wary if the site began to bulge after a child's injury resulting from a blow or fall.

sunken fontanel

If you are interested in the question of how much the fontanel should overgrow, and suddenly notice that it seemed to be drawn into the skull, this may indicate dehydration of the baby. BR changes shape, falling below the bones of the skull and indicates an acute lack of fluid. If there is a high temperature, repeated vomiting and indigestion, then this indicates a significant loss of fluid. This condition is pathological. The skin becomes dry, the child does not feel well, cracks appear on his lips.

It is very important to let your baby drink or breastfeed. After that, you should immediately consult a doctor in order to correctly replenish the lost fluid and receive an appointment for further treatment. It's best to call an ambulance.

Why does the fontanel in the baby pulsate?

In the process of vital activity of the body, there is an active supply of blood to the brain. The vessels of this organ are located close to the heart muscle, and when the blood moves, shocks and an increase in pressure are observed. In this case, the pulsation extends to the membrane of the brain and the plate, which covers the frontal fontanel. If there is a slight pulsation, then this can be considered the norm. However, if the pulsation is too strong, you should consult a doctor to find out the cause of the violation.

Conclusion

The article considered the question of how long the fontanel in a child should overgrow. Despite the fact that there are norms for the overgrowth of BR and usually this process is completed by one and a half years, in some cases there are minor deviations in healthy babies. Therefore, speaking about when the fontanel should overgrow in an infant, it is important to understand that there are no clear boundaries. However, parents should be wary if a child has a rapidly growing BR and is not yet three months old. In this case, as in others, it is better to seek the advice of a doctor.

There is also a faster closure of the fontanel when the baby eats fully and gains weight well, but this is not a pathology. So, in babies who are breastfed, there is a faster overgrowth of the described area than in artificial babies.

It is categorically impossible to self-medicate and independently prescribe medicines to a child or use folk remedies. It is very important to follow the rule: contact a pediatrician in case of suspicion. The specialist will prescribe additional examinations, and this will preserve the health of the child. You should not only pay attention to the size of the fontanel, but also monitor its condition.

Article last updated: May 03, 2018

The baby has just been born. He looks so small and defenseless. On the head of the crumbs there are special formations - fontanelles. Newly minted parents are often afraid to even touch the head, not to mention combing and washing their hair. In addition, there are rumors that it is possible to injure the brain of the crumbs with inaccurate pressure on the fontanel in newborns. There is a lot of talk and prejudice around this area on the baby's head. But is it so easy to hurt the fontanel in newborns? Is it true that its size and timing of closure play a huge role in diagnosing serious diseases in a child?

Pediatrician, neonatologist

The skull of a newborn is made up of bones that are joined together by sutures. The bone tissue on the baby's head is thin, supple, rich in blood vessels. Some areas on the head do not ossify, they are membranous tissue. They are located at the junction of several bones and are called fontanelles.

How many fontanelles does a newborn have? For many, it will be a surprise to learn that a child is born with six fontanelles.

Where are the fontanelles in a newborn?

A large fontanel in a newborn is the most noticeable of the fontanels, located on the top of the head between the frontal and parietal bones. It got its name for a reason. Its size is quite large and averages 3 cm.

Why does the fontanel pulsate? The thin connective tissue that forms the fontanel allows you to see the pulsation of the cerebral vessels and fluctuations in the cerebrospinal fluid. This is an absolutely normal physiological process, you should not worry about the pulsation of the fontanel.

A small fontanel in a newborn is located posterior to the large fontanel at the junction of the parietal and occipital bones. This fontanel looks like a triangle about 5 mm in size. Often children are born with an already closed small fontanelle, in the rest it closes within one to two months.

Two paired fontanelles can be found in the temporal regions. These are wedge-shaped fontanelles. Another pair of fontanelles, mastoid, is found behind the ear. All of them close shortly after the birth of the child and have no diagnostic significance.

Why is a child born with fontanelles?

Everything in the human body is not without reason, and the child is no exception. The baby's body is a complex system, each organ has its own unique function.

What is the function of the fontanel in newborns?

  1. The fontanel plays an important role during childbirth. Thanks to this formation, the baby's head is compressed and easier to pass through the birth canal. The shape of the head of a naturally born baby is elongated, dolichocephalic. Over time, the configuration of the head changes, becomes normal, rounded.
  2. The child is growing rapidly, and with it the brain of the baby. The bones of the skull become denser, increase in size, and the fontanel overgrows. The presence of the fontanelle and the sutures of the skull creates favorable conditions for the growth and development of the brain.
  3. The fontanel helps the baby maintain normal body temperature, is involved in thermoregulation. With severe (more than 38 degrees Celsius), the fontanel helps to cool the brain and meninges.
  4. cushioning function. Although the fontanel seems very fragile and fragile, it helps protect the brain if the baby falls.

When does the fontanel heal in a newborn?

We will understand the norms and timing of the closure of fontanelles.

Timing of fontanel closure

A large fontanel in infants overgrows in the period from six months to one and a half years.

Due to a change in the configuration of the head after childbirth, a change in the shape and size of a large fontanel is possible. After the head becomes rounded, the size of the crown will decrease.

Half of newborns are born with an overgrown small fontanel. In other children, the fontanel is delayed for one to two months.

The remaining paired fontanelles are rarely seen in a full-term newborn. If the baby was born with lateral fontanelles, they overgrow soon after birth.

What affects the closure of fontanelles?

Why are some children born with a dotted fontanel, which soon overgrows completely, while in others the depression can be felt up to 2 years?

  1. hereditary predisposition. The size of the fontanelles with which the baby was born, as well as the time of their overgrowth, primarily depends on genetic characteristics. After talking with the grandmothers and asking them about the fontanelles of the parents, you can predict how the baby's crown will close.
  2. The gestational age at which the child was born. Children born prematurely are slightly behind in physical development from full-term peers. Approximately to 2 — 3 years this difference is leveled. But premature babies have their own characteristics in development. In particular, longer periods of closure of fontanelles.
  3. The concentration of calcium and vitamin D in the body of the baby. With calcium deficiency, the overgrowth of fontanelles can be delayed, and with an excess of the element, the depression disappears ahead of time. But the baby's diet plays a secondary role here, more often the cause is a disturbed metabolism.
  4. Taking medications during pregnancy.

There is also a relationship between the size of the fontanel of the newborn and the intake of calcium and multivitamin preparations by the mother, and the woman's nutrition.

But hereditary predisposition plays a primary role in the size of the fontanel at birth.

The fontanel does not grow in time, is it worth worrying?

Dr. Komarovsky answers this question.

The closure of the fontanelles occurs in different ways. Some babies are born with very small fontanelles. In others, a large fontanel may only be overgrown by the age of two. With normal health and development of the child, both situations are considered normal. It does not matter when the fontanel closes in newborns.

The size of the fontanel may indicate the development of the disease. But there is no pathology that would be manifested only by a change in the size of the fontanel. The pediatrician assesses the state of health of the child and the size of the fontanel at each preventive examination.

When should you worry?

With certain diseases in newborns, a late closure of the fontanel is possible.

  1. Rickets. In addition to the slow closing of the fontanel, rickets is manifested by a lag in physical development, changes in the musculoskeletal and cardiovascular systems, and a decrease in immunity.The disease is more common in children born prematurely who did not receive vitamin D as a prophylaxis. In a full-term baby with regular walks and proper nutrition, the risk of developing rickets is minimal.
  2. . This is a congenital disease in which the thyroid gland does not perform its function properly. In addition to changing the timing of the closure of the fontanel, with hypothyroidism, lethargy, drowsiness, constant, deviations in the mental and physical development of the child are observed.
  3. Achondroplasia. It is manifested by gross violations of the development of bone tissue, dwarfism, slow closing of the fontanelles.
  4. . A disease associated with chromosomal abnormalities. With Down syndrome, children have a characteristic appearance, developmental abnormalities.

What can early closure of the fontanel mean?

In most cases, it does not matter when the fontanel in an infant overgrows. It does not affect the development of the brain and intelligence in any way. But there are situations associated with a violation of calcium metabolism, metabolism, in which the fontanel closes too quickly.

Other diseases, such as craniosynostosis, brain developmental anomalies, are very rare, have a severe course and characteristic signs. If the child feels well, develops according to the calendar, the rate of fontanel closure does not matter.

Fontanel changes

With some serious diseases, the state of the fontanel changes. A bulging or, conversely, sunken fontanel becomes an "indicator" of the pathology, indicating the severity of the disease. Thus, the assessment of the state of the fontanel is an important diagnostic feature.

Bulging fontanel in a newborn

Most often, a bulging fontanel accompanies meningitis, encephalitis, and intracranial hemorrhage. All these diseases are high, for this reason the fontanel bulges.

Do not make hasty conclusions and panic ahead of time. Brain diseases cannot be characterized only by a bulging fontanel. But with accompanying threatening symptoms, you need to urgently consult a specialist.

Alarming symptoms that, in combination with a bulging fontanel, threaten the life of a child:

  • , which is hard knocked down and soon rises again;
  • nausea and vomiting in a child;
  • loud cry, irritability or, conversely, lethargy, drowsiness of the baby;
  • , loss of consciousness;
  • if the fontanel began to bulge after the fall of the crumbs, injury;
  • appearance of eye symptoms.

sunken fontanel

If the soft crown has become sunken, this is a symptom of dehydration of the baby. The fontanel changes, falls below the bones of the skull and indicates an acute lack of fluid for the baby. With repeated vomiting, high temperature, a significant loss of fluid occurs. Dehydration affects the entire body. The skin becomes dry, the formation of cracks on the lips is possible, a violation of the child's well-being.

It is necessary to drink the child, organize the feeding of the baby, if possible. And immediately consult a doctor for proper treatment and replenishment of lost fluid.

What should parents know about the fontanel? FAQ

  1. The child's fontanel is very large. Is it rickets? The size of the fontanel with rickets may not change at all. It is possible to change the shape of the head, increase the frontal and parietal tubercles, soften the edges of the fontanel. With rickets, the edges of the fontanel become flexible, pliable, but the size remains the same.
  2. With a small size of the fontanel, it is impossible to prescribe vitamin D, even if rickets is diagnosed? In addition to external signs of rickets, laboratory confirmation must be available to make a diagnosis. With rickets, the level of alkaline phosphatase, the level of calcium in the blood and in the urine are changed. visible on x-ray of the wrists and tubular bones.With confirmed rickets, vitamin D and calcium are prescribed, and the size of the fontanelles does not matter. Medicines selected in the right dosages do not accelerate the closure of the fontanelles.
  3. Prolonged overgrowth of the fontanel may indicate hydrocephalus in a child? Hydrocephalus (hydrocephalic syndrome) occurs when there is an increase in the amount of fluid (liquor) in the brain. This leads to an increase in intracranial pressure and a change in the well-being of the child. He becomes restless, capricious, sleep is disturbed.When examining a baby, doctors pay attention to the development of the child, muscle tone, increase in head circumference, and the condition of the fontanel. An increase in the circumference of the head, combined with an increase in the size of the fontanel and a change in the condition of the child, may indicate the development of the disease.
  4. If the fontanelle closes too quickly, will the baby's brain stop growing? The growth of the head occurs not only due to fontanelles, but also sutures, enlargement and compaction of the bones of the skull. Even if the fontanelles are completely closed, the head continues to grow.
  5. Is it possible to damage the baby's brain by touching the fontanel? You can safely touch, kiss, comb the head of the child, this will not bring unpleasant consequences. The brain is securely hidden under the membranes and surrounding tissues.
  6. How to care for a fontanel? This area does not require any special care. Like the rest of the baby's skin, the scalp needs to be taken care of. After washing with a special baby shampoo, blot the water with a towel. Do not rub the head, blotting is enough.
  7. Is it necessary to take vitamin D with a fast or slow overgrowth of the fontanel? The question of the advisability of prescribing vitamin D is decided individually in each case. Many factors affect this, including the region where the child lives, the seasons, and the duration of walks.

When prescribing vitamin D, the doctor takes into account the feeding of the baby, the content of vitamin D in the infant formula, the nutrition of the nursing mother and the woman's intake of multivitamins. An important role is played by the state of health of the crumbs. The need for vitamin D in premature babies is higher than in healthy full-term toddlers.

The main task of parents is to take care of the proper nutrition of the baby, regular walks and proper care. Leave the assessment of the condition of the fontanel to a specialist. At each preventive examination, the doctor needs only a few seconds to run over the head and evaluate the fontanel.

Parameters by which the condition of the fontanel is assessed when examined by a doctor

  • the fontanelles of the child are open or closed, whether this corresponds to the age of the crumbs;
  • how many fontanelles were at the time of birth and their number at the moment;
  • how the fontanelles have changed, how quickly they decrease, whether the shape of the fontanelles has changed;
  • what are the edges of the fontanel to the touch. Normally, the edges should be elastic, and softening is a sign of a lack of calcium and vitamin D;
  • how does the fontanel relate to the surrounding tissues? A sluggish, sunken or tense, bulging spring is always a sign of pathology.

Summing up

Fontanelles - anatomical formations of membranous tissue located on the head of the baby. Due to the presence of fontanelles, the head can freely pass through the birth canal, changing its shape (configuration).

The size and timing of overgrowth of fontanelles help pediatricians to suspect changes in the health of the crumbs. But even an experienced specialist cannot make a diagnosis only by the size of the fontanel, because each disease has a number of other important symptoms.

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.

but 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 not true. 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 not true. 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 not true. 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.

INR analysis is the most reliable method for determining blood clotting. Deviations of its values ​​from the norm can indicate serious problems in the body.

What is MNO?

Human blood contains a complex protein, prothrombin, which ensures that it remains liquid during circulation through the circulatory system and clotting in case of injury. Determination of the amount of prothrombin helps to establish a tendency to bleeding or the formation of blood clots.

Analysis for INR is an indicator of clotting

Blood clotting is determined in the framework of three studies:

  • PTT - prothrombized time, which shows how long after the addition of the reagent a fibrin clot is formed in the plasma. Normally, its values ​​\u200b\u200bshould be 11-15 seconds.
  • PTI - prothrombin index. This is the ratio between the plasma clotting time in a healthy person and the patient's plasma clotting time. Normal values ​​are 93–107%.
  • INR is the international normalized ratio. Represents the ratio between the PTT of the patient and the PTT of the capillary blood of a healthy person. It also takes into account the MIC coefficient (international sensitivity index), which differs for different reagents.

The INR indicator is necessarily determined in pregnant women before surgery or blood plasma transfusion. It is the basis for selecting the optimal dosage of anticoagulants and other drugs.

If a person takes anticoagulants and is in a hospital, it is recommended to check the level of INR daily. And after discharge from the hospital, it is necessary to take appropriate tests every two to three weeks.

Deciphering the results

The INR norm in women and men is different. Moreover, its values ​​also depend on several factors. Consider the average normal INR:

  • the INR norm in healthy women and men is in the range of 0.7–1.3;
  • surgery is allowed if the patient's INR is 0.85–1.25;
  • for pregnant women, values ​​​​of 0.8–1.25 are considered normal;
  • after heart surgery, the INR can rise to 2.5–3.5, which is the norm;
  • when the patient is taking direct anticoagulants, the INR may be 0.8–1.2;
  • when taking indirect anticoagulants, the values ​​\u200b\u200bmay rise to 2.0–3.0;
  • INR indicators also differ by age: in people over 50 years old, the norm decreases slightly.

If the indicators are different from the norm, this may indicate some health problems. Therefore, the results of the study should be deciphered by a specialist in order to detect deviations in time.


Venous blood is taken to determine INR values.

What do the low values ​​mean?

If the clotting index is low, the risk of blood clots increases. Because of them, the blood supply to vital organs is disrupted, which can lead to functional failures.

First of all, it is necessary to establish the exact reason why the INR values ​​\u200b\u200bare below normal. This happens in the following cases:

  • deficiency of vitamin K in the body;
  • a side effect from taking hormonal, anticonvulsant, diuretic drugs;
  • physical injuries accompanied by blood loss;
  • thromboembolism during pregnancy or after childbirth.

The result of the study may be erroneous if technological errors were made during blood sampling or the material taken was stored for too long. You also need to carry out proper preparation before the procedure. For two days before it, it is forbidden to consume alcoholic beverages, fried and smoked foods.

Therefore, if deviations are found, a re-analysis is mandatory. After establishing the cause, the appropriate treatment is selected. Anticoagulants may also be prescribed.

Reasons for increasing INR

A high level of INR indicates hypocoagulation. In this case, there is a high risk of bleeding even with minor injuries.

Elevated INR values ​​can be observed for the following reasons:

  • heart disease, including pre-infarction conditions and heart attack;
  • diseases of the liver and gallbladder;
  • the presence of malignant neoplasms in the body;
  • increased level of erythrocytes in the blood;
  • diseases of the gastrointestinal tract;
  • taking antibiotics and hormones, a side effect of which can be a high level of INR.

After 50 years, it is necessary to constantly monitor blood clotting. Checking the INR level is recommended annually. If the patient has an INR above 6.0, he should be urgently hospitalized. In this case, the likelihood of death is high.