Is it worth it to sound the alarm when a fontanel overgrows in a child earlier or later than the due date? If the fontanel does not overgrow Why does not the crown of the child overgrow

Many concerns of parents are associated with a pulsating area on the head of a newborn - a fontanelle. Anxiety causes care for the baby, there is a fear of harming him when exposed to an unprotected area. Parents are especially interested in when the fontanel in an infant overgrows, which is the norm, what deviations are possible.

Peculiarities

The fontanel is formed at the junction of the cranial bones of the child, connected by soft membranous tissue. It is dense enough to protect the brain from external influences: you can not be afraid to wash, comb and stroke the baby's head.

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

• Two pairs on the sides (in front of the auricles and behind them) are 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 (approximately 5 mm in diameter) - in most cases it closes during fetal development, more often observed in premature babies. Its overgrowing with bone tissue lasts from several days to two months;
• The large one, located on the crown of the head, is tightened last. Its dimensions vary between 22-35 mm.

A baby can be born with a pathologically large fontanel 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 complete closure of the remaining fontanelles is possible with a disproportion of a too small skull and brain compared to other parts of the body. Such cases require medical supervision, additional studies to determine the causes. The rate of overgrowth of the fontanel in babies with congenital pathologies may differ compared to children without deviations.

generally accepted norms

The parietal fontanel 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 (in 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

Dimensions are approximate, a deviation of a few mm up or down is acceptable. In the first three months, a slight increase in the fontanel 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 had early or late overgrowth without pathologies, a peculiarity may appear in the infant.

When should the fontanel drag on?

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

fast overgrowth

The fontanel can drag on for a baby up to 6 months. With normal growth and development, this is not a deviation. Ossification is considered too early soft tissue fontanel at the age of three months. Occurs as a result of pathologies:

• Craniosynostosis is a deviation in the formation of bone tissue, in which the fontanel is quickly tightened and the cranial sutures are completely fused, preventing the normal development of the brain. May be congenital or acquired, in most cases 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;
• Anomalies in the development of the brain - violations in its structure, a decrease in size, weight.

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

slow closing

This problem is more common, occurs if the baby:

• Congenital pathologies of the thyroid gland. Manifested by drowsiness, swelling, low activity of the baby, poor appetite, digestive problems, constipation;
• - Premature babies often suffer from them. It can occur with a lack or calcium in the body. Symptoms are sleep disturbance, appetite, increased nervous excitability, sweating with the appearance of a specific sour smell;
• Bone disease caused by genetic abnormalities - achondrodysplasia. Accompanied by growth retardation, shortened limbs, leads to dwarfism;
• Down's disease is a developmental delay.

Serious diseases are quite rare, a comprehensive examination is necessary to confirm the diagnosis. To make a diagnosis, you need to consult a neurologist, an endocrinologist.

Common myths

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The most common misconceptions associated with the overgrowth of the fontanel:

• Early closure limits brain growth. The bones of the skull are connected by sutures, which are completely fused after 20 years. They provide normal growth head and brain development. In case of early overgrowth of the fontanel, the condition of the seams is checked: if they are not closed, then there is no danger for the further development of the child.
• Rapid overgrowth is caused by taking 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 an acceleration of tissue ossification, it is an individual feature or occurs with violations in the development of the baby.
• If by the year the fontanel in a child does not overgrow, then he has rickets. The disease is manifested by 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 fontanel in a baby at birth should grow 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.

The exact time when it overgrows large fontanel in newborns, no . The process takes place individually, it is influenced by various factors. It is impossible to independently make diagnoses in case of deviations from the generally accepted terms for overgrowth of the fontanel. This cannot be the only symptom of serious diseases - they always have additional signs.

It is forbidden to self-prescribe medicines and use folk methods. For the health of the baby, 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 fontanel, you need to pay attention to its condition: excessively convex or sunken may be a sign of illness or a deterioration in the child's condition.

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 took vitamin and mineral complexes containing calcium during pregnancy. 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.

All children are born with a fontanel - a soft area on the crown, covered with thin skin. What size should the fontanel be when the bones of the skull grow together, which may mean a convex or sunken patch of skin on the crown of the head? We will answer these questions, as well as tell you everything that parents need to know about this feature of the baby.

Every newborn baby has a soft area on the crown of the head, which is called the fontanel.

Location of the fontanel

First, you should find out how many fontanelles a child should have, their size and location. It turns out that there are several areas on the baby's head that are not covered by bone tissue. However, almost all of them close by the time the baby is born.

So where are they located:

• On both sides of the head of the crumbs, 4 small fontanelles of a small size are determined - two on each temple. They are tightened by bone tissue while the baby is in the womb. In premature babies, this process may not be completed, then the fontanelles close within a month after birth.
• There is another small area - on the back of the baby's head, 0.5 cm in diameter, which also closes in utero. In rare cases, this fontanel in newborns may be open within 1 month and heal a little later. It is believed that such a feature is not a pathology if all other parameters are within the normal range.
• The largest fontanel in newborns is called the “soft crown” and is located at the junction of the parietal and frontal bones, sometimes they say “at the crown”. You can see this area in more detail in the photo below. Its closure occurs during the first 2 years of a child's life, and the shape resembles an elongated rhombus with 2x3 cm diagonals. Its condition, frequency and strength of pulsation, as well as its size, can tell a pediatrician a lot. It is about the anterior fontanel of the skull that we will talk further.

Functions of the soft crown

The soft crown, like everything that the human body has, has its own purpose. Why is he needed? We list the main functions of the temechka:

• This area on the baby's head facilitates the birth process. Due to the fact that the bones of the skull are not fully fused, they can “run into” each other, changing the shape of the head. At the time of passage through the birth canal, the head slightly lengthens, its diameter becomes smaller. A week or two after birth, the head of the crumbs is slightly rounded, and the bones of the skull fall into place.

When passing through the birth canal, the baby's skull becomes slightly elongated, but over time, the shape of the head changes

• The first year or two of a baby's life, his brain develops and increases significantly in volume. The inner space of the cranium slowly adjusts to the growing brain, and the fontanel also takes part in this process.
• According to research, the soft crown serves as one of the regulators of heat transfer in the baby's body. Through this hole in the skull, the brain is cooled in time, if necessary.
• Despite all precautions, the baby may fall while the mother turns away for a second. If the blow falls on the head, the fontanel will soften its strength.
• Pediatricians and neonatologists, during the examination of the child, evaluate the size and condition of the fontanel, drawing conclusions about whether the baby is developing correctly. Sometimes the parameters do not correspond to the standard values, in which case the pediatrician may prescribe additional examinations to detect the disease at an early stage.
• Specialists can also examine the child with neurosonography and identify abnormalities in the development of his brain at an early stage. This procedure is possible due to the anterior fontanelle and is indicated for all newborns.

The timing of the closure of the fontanel

Pediatricians for a long time of observation have noticed that the anterior fontanel is completely closed on average by the end of the first year of a child's life. However, there is no reason to assert that those whose fontanel is overgrown in the period up to 4 months or after 12 have health problems. For example, Dr. Komarovsky claims that the timing of the overgrowth of the soft top of the head in each child may be different. The main thing is to visit the pediatrician on time and by all means undergo examinations that the doctor will prescribe.

There is also statistics that says that only in 40% of babies the fontanel overgrows by the year, in 1% it can grow up to 3 months of age. For other children, the closure time may be delayed, but usually this happens within the first 2 years of life.

Our material presents the average parameters of the parietal zone. It is enough to compare your measurements of the length and width of a large fontanel with tabular data.

Table 1:

Recall that the figures given are averages, so in no case should you panic if the child does not fit into this picture. Parents should only measure the length and width of the fontanel, and make sure that its parameters correspond to the table values. If everything is in order, it is enough to undergo a scheduled examination by a pediatrician, otherwise, consult an unscheduled one.

What will the measurements tell?

Every month, during a routine examination, the doctor will certainly probe and measure the fontanel in an infant. He writes these data into the child's card in order to observe the dynamics.

Parents can independently measure the parameters of a large fontanel, comparing them with tabular values. If they do not correspond to normal sizes, you should definitely consult a doctor.

What can the length and width of the soft crown say? What can premature closure of the parietal fontanel mean, or is its parameters too large compared to the norm? These issues need to be looked into more thoroughly.

Soft crown more than normal

The fontanel in newborns and children up to a year, which differs from the standard value by 2-3 mm, is not considered a serious cause for concern. If its parameters are much larger, this situation can say a lot, for example:

• indicate a metabolic disorder and insufficient absorption of calcium, which can lead to rickets;
• prematurity;
• trauma received at birth;
• malformations;
• poor outflow of fluid from certain parts of the brain;
• infectious and endocrine diseases.

In premature babies, the fontanel may have a larger area than normal.

It is important not to miss the main symptoms that may indicate pathology. Along with the significant size of the crown, there are other signs that you should pay close attention to. We have collected in the table those diseases, one of the symptoms of which may be a large fontanel.

Table 2:

Disease	signs	Treatment
Rickets (we recommend reading:)	The bone tissue along the edges of the fontanel is thinned - it is flexible and supple. The back of the head is flat, on the sides chest bony thickenings are observed.	After confirming the diagnosis, a therapeutic dose of vitamin D is prescribed, additional exposure to the sun.
Down syndrome	Congenital pathology, it is diagnosed immediately after the birth of the crumbs. Down syndrome is characterized by specific facial features, a shortened neck, and a crease in the palm of the hand.	Special care is required, regular consultation with a pediatrician.
Hypothyroidism	Lack of specific hormones produced by the thyroid gland, which leads to lethargy, drowsiness, decreased appetite and a tendency to edema.	It is necessary to pass tests to determine the amount of a specific hormone. After that, the endocrinologist may prescribe hormone replacement therapy.
Achondrodysplasia	This disease is characterized by various manifestations of bone tissue development disorders - the shape of the head becomes wider, the forehead is large and convex.	After a series of studies and confirmation of the diagnosis, the doctor prescribes the treatment.

Less than normal

Sometimes the soft crown heals early in the baby - already by 3-4 months, or its length and width are much less than the standard. The area on the crown becomes hard, but at the same time it is slightly lower than the level of the surrounding tissues. This situation also requires the intervention of a specialist.

If the fontanel closes too early, the doctor may prescribe a series of examinations.

Early closure of the fontanel, as well as its small parameters, may indicate the presence of such a serious disease as craniosynotosis, or indicate anomalies in the development of the brain. What other signs of these pathologies may be, we will consider in more detail.

Table 3:

Disease	signs	Treatment
craniosynotosis	Incorrect growth of bones, which is reflected in the cranium. The sutures of the skull overgrow ahead of time, the fontanel quickly closes, which leads to head deformity. Hearing and visual impairments are possible.	Craniosynotosis can be cured, it is important to consult a doctor in time. Surgery is indicated.
Anomalies of brain development	Developmental delay of the patient and other signs that a neuropediatrician can see.	The doctor prescribes treatment.

However, these diagnoses are very rare, most often the baby inherits a small fontanel or its early closure from one of the parents. Such a sign can also be explained by the individual characteristics of the development of the child's skeletal system.

There is an opinion that vitamin D can do a disservice by causing premature ossification of the uncovered part of the skull. However, you can not stop taking the medicine yourself if it is prescribed by a doctor. Early closure of the large fontanel may not be related to the use of this drug.

If the intake of vitamin D was prescribed by a doctor, then you do not need to cancel it yourself.

Not always a large or small size of the crown indicates pathology. The pediatrician, along with examining this area, will ask parents questions about how their offspring sleeps, whether he spits up too often, and whether he is behind his peers in development. Also, a specialist can prescribe a series of studies to exclude the presence of serious diseases of the crumbs. If everything is in order, then the non-standard parameters of the crown are an individual feature of the child.

Signs by which the condition of the fontanel is assessed

In addition to the obvious signs - the parameters of the fontanel, the doctor evaluates his condition according to other criteria. Normally, it looks a little sunken or is flush with the surrounding tissues. In addition, in newborns and in children up to six months, the parietal zone can pulsate.

We list what you should pay special attention to when consulting a doctor is necessary:

• Drooping of the skin around the crown of the head may indicate dehydration. This symptom becomes even more alarming if it is accompanied by a small amount of urination of the crumbs, drying out of the mucous membranes, as well as a lethargic, tearful state. In this case, you should immediately contact a specialist.

Retraction of the fontanel is an alarming signal and requires urgent consultation with a specialist

• Protrusion of the fontanel above the surface of the skin. When the baby cries, is naughty, the parietal region of the head may become convex, while starting to pulsate. In moments of calm, sleep, this zone returns to its normal state. It happens that it protrudes above the surface of the surrounding tissues even when the baby is calm - the reason may lie in increased intracranial pressure. This symptom itself rarely occurs, often it is a concomitant sign of another disease, the consequences of which can be quite serious.
• Why does the fontanel sometimes pulsate (more in the article:)? The pulsation of the soft top of the head in a newborn and infant up to 6 months is the norm, but rather its complete absence speaks of the pathology. The beats of the membrane transmit the pulsation of the vessels through the cerebrospinal fluid, the fluid that surrounds the brain. It can pulsate quickly when the baby screams, is naughty. The rest of the time, her beats weaken, and after 6 months they become less noticeable. In other cases, consultation with a pediatrician is required.

The fontanel of the crumbs requires special attention. This place on his crown should be protected from a draft, an accidental blow, so it’s better to wear a cap that will create an additional barrier near the crown (for more details, see the article:). It is also not recommended to lower the baby under water, simulating diving. This can cause fluctuations in intracranial pressure.

However, there are procedures that are necessary for the proper development of the child, as well as for stimulating brain activity:

• Some mothers are afraid to touch the fontanel so as not to harm the baby. However, the skin on his head needs to be regularly looked after - washed, lubricated with baby oil and in time to get rid of the crusts that often form on the baby's head.

Parents do not need to avoid touching the fontanelle, but it requires careful handling

• If the daughter boasts a lush head of hair, the mother needs to comb her hair regularly. Do not worry that the teeth of the comb will damage the parietal zone. The skin there is quite strong, it is enough to try to comb the baby carefully, then there will be no problems.
• Also for children infancy you can and should do a scalp massage. Such a procedure is quite within the power of the mother, and the benefits of it are obvious. Massage will calm the baby, make him sleep better, and also serve as a good stimulant of mental activity. It is not necessary to do a massage for a long time - 3-5 minutes is enough.

Finally, I would like to note that non-standard parameters and the condition of the fontanel cannot be the only symptom of a serious illness. The criteria that a good pediatrician is guided by to determine the condition of the child and the level of his development are very diverse. The task of parents is to notice possible deviations in the size and condition of the fontanel in time. If the pediatrician prescribes vitamin D intake, or recommends another therapy, it is important to follow his advice strictly.

They have tiny antennae but no kneecaps yet. And newborns have more bones than an adult: 300 versus 206. The thing is that some bones merge together during growth. For example, the bones of the skull - it actually consists of several parts. This is necessary so that the baby's head can pass through the woman's birth canal. The bones of the skull are completely fused into one box when the fontanel overgrows.

Photo by GettyImages

Although we see one fontanel on the head of a newborn - the frontal one, in fact there are six of them. There is also a small occipital and four temporal, which usually close by the time of birth or during the first month of life.

The role of the large frontal fontanel is to protect the baby's head from damage during passage through the birth canal and allow the brain to fully develop, not limiting it to the hard bones of the skull, at least at the first stage of a person's life. In addition, the large fontanel is involved in the thermoregulation of the brain. Over time, the process of natural regulation improves and the frontal fontanel closes by 12–18 months of age.

But all terms are strictly individual. Late or early closure is normal for a particular baby. The district doctor monitors the condition and size of the fontanel.

How to care for a fontanel

The fontanel does not require special care. The main thing you need to know is that in no case should you put pressure on this area. But while the child's skull is being formed, there are still some things to watch out for.

If the baby sleeps all the time, turning his head in the same direction, the skull on this side may become flat. Ideal if the baby sleeps on his back, or turns his head in different sides. This is what parents can influence: put the baby’s favorite toy on the side where you need it to turn. Such an “exercise” will also help strengthen the muscles of the neck. And even if a “flatness” appears, it will smooth out when the baby gets older, can sit, lie on his stomach.

But if the shape of the head seems strange to you, then it is better to discuss this with your doctor. He will conduct an examination and be able to understand if the problem is with the development of the bones of the skull. Usually you can fix everything with regular physiotherapy. If the problem is serious, your pediatrician will refer you to a specialist.

Photo by GettyImages

What to do if the fontanel overgrows poorly

However, if the issue of slow tightening of the fontanel worries, you can contact a neurologist. He will examine the baby, if necessary, conduct an ultrasound of the brain and dispel your doubts.

The birth of a child is not only a miracle in the philosophical sense. It's also technically a miracle. Nature has thought through this process to such an extent that in order to pass through the birth canal of the mother, the child's head is able to decrease in size, acquire an oblong shape and flatten from the sides.

This is facilitated by the presence of gaps between the bones of the skull, filled with plates of connective tissue. These are fontanelles, the condition, overgrowth and bulging of which so often worries parents.

Despite the fact that there are six of them at birth, five of them grow so quickly that many parents do not even have time to know about their existence. All worries go around the most noticeable fontanel - the frontal or large fontanel (BR).

If the purpose of small fontanelles ended after birth, then the large one in children continues to perform the functions of shock absorption, preventing fractures and injuries of the skull during falls and bumps.

When does a child's fontanel close?

If your child is already a year old, and his fontanel has not overgrown, then there is no reason for concern. Normally, this physiological process ends in 1-1.5 years. If the timing of its closure in your baby does not fit into the norm, then see a doctor. He will determine what is the cause: a disease or a developmental feature of the child.

What should be the fontanel in the norm?

After the birth of a child, as well as monthly when visiting a doctor, the pediatrician evaluates his condition, size, rate of decrease, and density of the surrounding bones.

Normally, the size of the fontanel in a healthy full-term baby is 2.5 - 3 cm, which is estimated by palpation and measuring the distance between opposite sides of the rhombus. Premature babies have a larger BR, about 3.5 by 3.5 cm. And large babies born at 41-42 weeks may have a smaller BR. All of this is normal. By the way, the fontanel of a month-old baby may be slightly larger than at birth. This is due to the intensive growth of the brain.

What should be the size of the BR at a certain age, it is impossible to say for sure. Some sources give the following numbers:

• 1.8-2 cm at three months;
• 1.8-1.6 cm in six months;
• 1.3-1.4 cm at 9 months;
• 0.4-0.8 cm per year.

However, they can be guided only approximately, because:

• All children initially different sizes(within the normal range).
• The size of the fontanel does not affect the growth rate. A large one can drag on for a year, and a small one for 1.5 years.

However, all fontanelles during examination should not be tense, not bulge, be at the level of the cranial bones. It is permissible for the spring to sink or bulge slightly, and also to pulsate. The frontal and parietal bones, surrounding it should be dense, without areas of softening.

What to do if the fontanel does not close?

If by the age of 18 months the baby's fontanel is still closed, then you need to see a doctor. This may be normal for your child, or it may be a symptom of a pathological condition.

Pathology	Impact on BR	Additional research	Your actions
Rickets	As a result of calcium deficiency, the bones soften, including the bones of the skull. The BR is open for a long time, the edges of the bones are soft to the touch. Lethargy, sweating during sleep, nape baldness appear. Bone growths form on the ribs and wrists. The shins are bent (see rickets in infants)	Pediatrician examination Blood test for calcium, phosphorus and alkaline phosphatase Urine test according to Sulkovich	Therapy with therapeutic doses of vitamin D
Achondrodysplasia	A disease of the bone tissue that leads to impaired growth. The skeleton becomes disproportionate, the limbs are short, and the head is massive and wide. BR does not drag on for a long time.	genetics consultation Skull x-ray PCR for gene mutation.	Prescribed growth hormone somatotopin
congenital hypothyroidism	The lack of thyroid hormones, which, among other things, regulate bone growth, leads to a long-term non-overgrowth of the fontanel. In addition, the child has constipation, a nasal voice, sometimes combined with umbilical hernias. Children are lethargic, drowsy, often large.	Consultation of a pediatrician, pediatric endocrinologist. Blood test for TSH, T3 and T4. Thyroid ultrasound	Replacement treatment with thyroid hormones
Hydrocephalus	The increased pressure of the liquor does not allow the cranial bones to "converge". Together with the BR, which rises above the bones, the circumference of the head also increases. Additionally, the child may have convulsions, developmental delay, hearing and vision problems.	Observation of a pediatric neurologist brain ultrasound	Treatment with anticonvulsants, diuretics, nootropics. Sometimes a shunt is performed.

If the child has a small fontanel, then a pediatrician, endocrinologist and neurologist will need to be consulted. By the way, in 1% of cases, the spring can overgrow in 3 months. This is unusual, but if all other indicators of development are normal, then everything is fine. But sometimes small sizes accompany pathology.

Pathology	Impact on BR	Additional research	Treatment
Craniosynostosis	The sutures of the skull and fontanels fuse quickly and early. There may be a deformation of the skull, jaw, secondary hydrocephalus.	Skull x-ray MRI, head CT	Surgical incision of sutures
Microcephaly	An anomaly in the development of the brain, in which the bones of the brain part of the skull stop growing, and the facial part continues to grow. The brain remains small and underdeveloped. developmental delay. More.	Observation of a neurologist brain ultrasound Electroencephalography genetics consultation	Symptomatic therapy
Increased function of the parathyroid glands	Violation of the exchange of calcium and phosphorus leads to an increase in calcium in the blood. Early closure of the fontanel is combined with bone pain, arrhythmia, damage to the kidneys, and the gastrointestinal tract.	Blood test for calcium and phosphorus The level of parahormone in the blood Ultrasound of the thyroid and parathyroid glands X-ray of the bones of the skull	Surgical treatment

If the fontanel is too large

A large BR is considered to be larger than 3.5 cm. This may be normal in premature or immature babies. For the rest, it is obligatory to consult a pediatric neurologist and perform an ultrasound of the brain, an electroencephalogram to exclude hydrocephalus and increased intracranial pressure.

The brain is very well supplied with blood, and its vessels are located close to the heart, so the blood flows in them under great pressure and with strong points. This pulsation is transmitted to the cerebrospinal fluid, to the membranes of the brain, to the plate that closes the large fontanel in children. Therefore, a slight pulsation is normal.

However, if the fontanel pulsates strongly, then this may be a signal of the disease. Other symptoms are usually present: dehydration, diarrhea, intoxication, high fever, vomiting (see frequent regurgitation or vomiting in infants). In this case, diagnosis and urgent treatment is necessary.

If the child has a sunken fontanel

The retraction of the fontanel (sunken) indicates dehydration of the child or malnutrition. The lack of fluid may occur against the background of:

• heat;
• overheating with strong wrapping;
• high temperature and intoxication;
• with severe vomiting, diarrhea.

Lost fluid must be replenished. In case of overheating and temperature of the baby, it is necessary to cool and drink. With an intestinal infection, when one drink is not enough, the child will undergo invasive therapy in a hospital.

What does a protruding fontanel mean?

The BR may bulge (raise above the level of the surrounding bones of the skull) against the background of intracranial pressure, which may be due to diseases such as meningitis, encephalitis, intracranial bleeding, tumors, or for another reason. If, in addition to swelling, the following symptoms are observed, you should immediately call a doctor or ambulance:

How to take care of him?

No special action is required. Despite the fact that the plate of connective tissue covering it is thin, it is equally strong. Therefore, when combing or examining the fontanel by a doctor, nothing terrible will happen. However, you should not be zealous with scallop movements either. For a child, this may be simply unpleasant. You can also not be afraid to wash your hair or cut your child's hair.

zdravotvet.ru

Why does the fontanel in a child not overgrow? What to look out for

The development of an infant in the first year of life greatly worries young parents. Moms worry if the teeth are “late”, or the neighbor’s baby is already walking, and his child is still afraid to let go of the support. One of these burning topics is the issue of overgrowing the fontanel. Mothers often worry about why the fontanel in a child does not overgrow. Will try to answer.

The role of the fontanel

Most mothers know that the fontanel is necessary for the child to successfully pass through the birth canal. The head of the baby, due to the presence of the fontanel, is somewhat deformed and compressed, so the process of childbirth is easier.

It is for this reason that the shape of the head of a newborn child can surprise an ignorant person. But after a few days, due to the elasticity of the tissues of the fontanel, the head takes on a normal shape.

Few people know, but the baby at birth has not one, but as many as six fontanelles (anterior, wedge-shaped (left. right), mastoid (left, right), posterior). It's just that the first five grow very quickly, literally in the first days and weeks of life. The largest fontanel, located at the crown, remains open longer.

This is necessary to ensure the normal growth of the bones of the skull. The fastest growth and change in the bones of the skull is carried out in the first 2 years, and the fontanel also contributes to this to some extent. By the way, if it happened that the fontanel closed a little ahead of schedule, then there is nothing to worry about, the growth of the bones of the skull will not stop from this.

In addition, the fontanel also performs protective functions. For example, it protects the baby from head injuries. It's no secret that even the most attentive parents of children periodically fall and at the same time can hit their heads. Upon impact, the fontanel plays the role of a kind of shock absorber, so ordinary falls do not bring harm to health. The time of complete overgrowth of the fontanel coincides with the age when the baby already knows how to walk well and the likelihood of falls is somewhat reduced.

Another important function of the fontanelle is participation in the functions of thermoregulation of the body. So, part of the heat is removed through the fontanel if the child is sick and has a temperature. It is thanks to the fontanel that the baby's brain suffers less from high temperature, which reduces the likelihood of developing phenomena such as convulsions, etc.

The fontanel helps not only the baby, but also the doctors. Through this place, an important examination of the brain can be performed, which is necessary if the child has neurological problems.

Norms

The front fontanel, located on the top of the baby, has the shape of a rhombus, and its dimensions can vary from 5 to 30 mm. If the mother wants to take the size of the fontanel on her own, then she needs to determine the distance between the two most distant points and divide the resulting measurement in half.

As a rule, two measurements are taken - longitudinal and transverse, these measurements are recorded on the map approximately in this form - 1.5 x 0.5 cm.

The initial size of the fontanel does not affect the rate of its overgrowth, but according to the observations of pediatricians, overgrowth in boys occurs a little faster.

On average, the age of overgrowth of the fontanel is 16-24 months, however, deviations in both directions are quite acceptable. The norm is the overgrowth of the fontanel after a year. However, the process of tightening the fontanel, as well as all other processes in the body, proceed individually.

Normally, the fontanel on the baby's head is almost invisible visually, but if you run your hand over the head, you can easily feel it. It is not considered a deviation if the fontanel protrudes slightly above the surface of the head or sinks quite a bit.

Mothers are often frightened if they notice that the skin in the area where the fontanel is located is pulsating. If this happens infrequently (as a rule, during the period when the child is excited), then there is nothing to worry about.

Monthly rates

To make it easier for parents to understand, we present the average size of the fontanel in infants by month. But keep in mind that the given norms are approximate, so if you find small deviations, you should not panic. Although, of course, you need to ask questions to the pediatrician.

So, the size of the fontanel, depending on the age of the baby:

• 0-1 months - 20-30 mm;
• 1-3 months - 18-20 mm;
• 4-6 months - 16-17 mm;
• 8-9 months - 12-14 mm;
• 11-12 months - 4-8 mm.

What affects the speed of tightening?

The following factors can influence the growth rate:

• Prematurity. This is one of the most common causes the fact that the fontanel does not grow in the child for a long time. These babies are usually physical development they lag a little behind, but by the age of 2-3 they successfully catch up with their peers who were born at term.

• Growth rate. Some children grow ahead of the dates indicated in the tables; in such children, the fontanel overgrows somewhat faster.

• Nutrition. It has been observed that in children receiving breast milk, overgrowth of the fontanel occurs faster than those who feed on mixtures. After all, it is mother's milk that is ideally balanced for full development.

• Hereditary and congenital syndromes. Late overgrowth of the fontanel is possible with congenital hypothyroidism, Down's syndrome and other diseases.

• Nutrient deficiency. The speed of tightening the fontanelle depends on the presence of vitamin D3 in the body.

What does the doctor pay attention to?

Children under one year of age are examined by a pediatrician monthly. Each time, the doctor should pay attention to the condition of the fontanel and measure the circumference of the head. These two parameters are very important for assessing the condition of the baby and the characteristics of its development.

The following points may alert the doctor:

• the fontanel is clearly visible on the head, it represents an owl cavity or, on the contrary, protrudes above the bones of the skull;

• the fontanel grows too slowly or too quickly.

If the fontanel looks like a hollow, then you can suspect that the child's body is dehydrated. This can happen due to an illness that is accompanied by diarrhea, vomiting, fever. If dehydration is insignificant, then the child is prescribed special solutions that need to be drunk. But if such simple measures do not help, or dehydration is severe from the very beginning, you need to call the ambulance so that the child can be helped in a hospital setting.

If, on the contrary, the fontanel protrudes noticeably above the bones of the skull, then this symptom can indicate such serious diseases as hydrocephalus, intracranial pressure, meningitis, etc. In this case, neurosonography can be prescribed - a special examination conducted through the fontanel.

This examination is absolutely safe for the baby, it will not cause him pain and discomfort. In its principle, neurosonography is similar to ultrasound. Thanks to this examination, it will be possible to identify any, even minor disorders in the brain.

If the baby is prescribed such an examination, the mother does not need to be scared. As already mentioned, it does not hurt, and you can do the procedure as many times as required. The procedure itself takes no more than 15 minutes, no special preparation is required for it.

Pathologies are considered if a large fontanel overgrows in the first three months of a child's life. In other cases, earlier tightening is considered a variant of the norm. The rapid overgrowth of the fontanel can be caused by an excess of vitamin D3. This happens if a mother takes some kind of supplements containing this vitamin in large quantities and at the same time breastfeeds her baby.

Too fast tightening of the fontanel is not so common. Much more often, mothers are worried that the fontanel in the child is poorly overgrown. In fact, this phenomenon is common, often complete ossification of the bones of the skull is observed only by the age of three.

To find out the causes of this phenomenon, the pediatrician may recommend donating blood to find out the level of calcium and phosphorus, as well as undergo other tests to rule out rickets.

However, according to Dr. Komarovsky, there is no direct connection between the speed of tightening the fontanel and rickets. Although this symptom should not be ignored.

In fact, rickets is a condition characterized by a lack of calcium in the body. If it is detected in the early stages, then the disease is quite easily treated and does not leave any consequences. But in the absence of treatment, serious consequences are observed up to the deformation of the bones of the skeleton. Therefore, at a low rate of overgrowth of the fontanel, children may be prescribed calcium and vitamin D supplements.

4allwomen.ru

The fontanel does not grow

In order to make it easier for a child to pass through the birth canal, the bones of his skull converge, on his head there is a so-called fontanel - an elastic gap between the bones of the skull. Over time, it should completely overgrow. However, this does not always happen, and parents may notice that the fontanel in the child does not overgrow.

When is the fontanel completely overgrown?

There are fontanelles on the head of the child:

As a rule, a small fontanel overgrows by the time of birth or by the end of the first week of a newborn's life.

A large fontanel, on average, closes by the baby's first birthday, but can close at 16 months, which is also the norm of development.

Why does the fontanel not overgrow for a long time?

However, it happens that a large fontanel may not overgrow for a long time. This is due to the following reasons:

• rickets;
• hydrocephalus;
• metabolic disease;
• hypoxia in childbirth.

It is possible that during pregnancy a woman spent little time outdoors, did not consume enough dairy products and vitamin-mineral complexes. As a result, the child in the future has difficulties with the overgrowth of the fontanel.

What to do to overgrown the fontanel?

If the child's fontanel does not close for a long period of time, then it is necessary to drink a course of vitamin D3. In order to strengthen the bones of the baby, you need to adjust his diet and introduce foods that contain a large number of calcium, cottage cheese, egg yolk.

If parents are concerned about the size of the fontanel in their child, you can show it to a neurologist, who will additionally prescribe neurosonography. It is possible that blood and urine tests may be required to determine the level of phosphorus and calcium.

Parents should remember that each child is individual, as well as the pace of his development and the characteristics of his health. Therefore, the timing of overgrowth of the fontanel may be different. However, you should not worry too much and panic if the fontanel does not overgrow, but the child feels comfortable, sleeps well, eats and has good mood during the day. A simple dynamic observation by a neurologist will allow you to control the process of overgrowth of the fontanel, and properly selected nutrition with a high content of calcium will accelerate its closure. And parents only need to observe the behavior of their child and his health.

Related articles:

Cerebral hypertension in infants One of the neurological pathologies found in children is increased intracranial pressure - cerebral hypertension. In our article, we will talk in more detail about the causes and treatment of this phenomenon.	Syndrome of movement disorders in newborns The syndrome of motor disorders in newborns is a complex of disorders of the motor sphere. However, you should not immediately draw terrible diagnoses in your head. Most of them are quite correctable.
Pylorospasm in newborns Pylorospasm is a phenomenon that the baby's parents may encounter in the first months of his life, which is expressed in regurgitation with a fountain and frequent vomiting. We will tell you how serious this disease is and how to treat it.	Why does a newborn sneeze? Sometimes parents of a newly born baby notice that he sneezes too often. What is the cause of this phenomenon and should I be worried? Let's figure it out in our article.

womanadvice.ru

When should the fontanel in babies overgrow? Should parents worry about overgrowing too fast or too slow?

Many concerns of parents are associated with a pulsating area on the head of a newborn - a fontanelle. Anxiety causes care for the baby, there is a fear of harming him when exposed to an unprotected area. Parents are especially interested in when the fontanel in an infant overgrows, which is the norm, what deviations are possible.

Peculiarities

The fontanel is formed at the junction of the cranial bones of the child, connected by soft membranous tissue. It is dense enough to protect the brain from external influences: you can not be afraid to wash, comb and stroke the baby's head.

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

• Two pairs on the sides (in front of the auricles and behind them) are 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 (approximately 5 mm in diameter) - in most cases it closes during fetal development, more often observed in premature babies. Its overgrowing with bone tissue lasts from several days to two months;
• The large one, located on the crown of the head, is tightened last. Its dimensions vary between 22-35 mm.

A baby can be born with a pathologically large fontanel 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 complete closure of the remaining fontanelles is possible with a disproportion of a too small skull and brain compared to other parts of the body. Such cases require medical supervision, additional studies to determine the causes. The rate of overgrowth of the fontanel in babies with congenital pathologies may differ compared to children without deviations.

Important!

generally accepted norms

The parietal fontanel 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:

Dimensions are approximate, a deviation of a few mm up or down is acceptable. In the first three months, a slight increase in the fontanel 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 had early or late overgrowth without pathologies, a peculiarity may appear in the infant.

When should the fontanel drag on?

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

fast overgrowth

The fontanel can drag on for a baby up to 6 months. With normal growth and development, this is not a deviation. The ossification of the soft tissue of the fontanel at the age of up to three months is considered too early. Occurs as a result of pathologies:

• Craniosynostosis is a deviation in the formation of bone tissue, in which the fontanel is quickly tightened and the cranial sutures are completely fused, preventing the normal development of the brain. May be congenital or acquired, in most cases 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;
• Anomalies in the development of the brain - violations in its structure, a decrease in size, weight.

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

slow closing

This problem is more common, occurs if the baby:

• Congenital pathologies of the thyroid gland. Manifested by drowsiness, swelling, low activity of the baby, poor appetite, digestive problems, constipation;
• Rickets - they often affect premature babies. May occur with a lack of vitamin D or calcium in the body. Symptoms are sleep disturbance, appetite, increased nervous excitability, sweating with the appearance of a specific sour smell;
• Bone disease caused by genetic abnormalities - achondrodysplasia. Accompanied by growth retardation, shortened limbs, leads to dwarfism;
• Down's disease is a developmental delay.

Serious diseases are quite rare, a comprehensive examination is necessary to confirm the diagnosis. To make a diagnosis, you need to consult a neurologist, an endocrinologist.

Common myths

The most common misconceptions associated with the overgrowth of the fontanel:

• Early closure limits brain growth. The bones of the skull are connected by sutures, which are completely fused after 20 years. They provide normal head growth and brain development. In case of early overgrowth of the fontanel, the condition of the seams is checked: if they are not closed, then there is no danger for the further development of the child.
• Rapid overgrowth is caused by taking 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 an acceleration of tissue ossification, it is an individual feature or occurs with violations in the development of the baby.
• If by the year the fontanel in a child does not overgrow, then he has rickets. The disease is manifested by 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 fontanel in a baby at birth should grow 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 a large fontanel in newborns overgrows. The process takes place individually, it is influenced by various factors. It is impossible to independently make diagnoses in case of deviations from the generally accepted terms for overgrowth of the fontanel. This cannot be the only symptom of serious diseases - they always have additional signs.

It is forbidden to independently prescribe medicines and use folk methods. For the health of the baby, 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 fontanel, you need to pay attention to its condition: excessively convex or sunken may be a sign of illness or a deterioration in the child's condition.

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