Caring for a newborn is a responsible business. Young mothers have many fears associated with this: how not to harm or break something to the baby. When soft areas are found on his head, which are covered only with thin skin, fears increase. It's scary to even touch a baby. The question immediately arises: when does the fontanelle overgrow in a child, and how to handle it so as not to damage the delicate head?
The fontanelle in a newborn
The meaning and function of the fontanelle
Unlike the skull of an adult, the head of a newborn child has a characteristic feature - non-ossified areas of the skull. The skull bones are not completely in contact with each other, they have gaps called fontanelles. The natural function of these sites is to "help": during the birth of a child, as it passes through the birth canal, the cranial bones have the ability to go behind each other. This somewhat reduces the size of the baby's head, making it possible to do without serious injuries in a woman in labor. Therefore, at birth, children have a not entirely correct head shape. After birth, the head increases in size, takes on a familiar shape, the seams gradually grow together, the fontanelles tighten. Due to the presence of such a natural "shock absorber" - the fontanel, head blows are softened. Also, the fontanelle in newborns performs the heat exchange function of the body as a whole and the brain in particular. It is thanks to the presence of an unclosed fontanelle that it is possible to diagnose the brain by ultrasound. This study is impossible through closed bone tissue.
Location, appearance and quantity
The skull bones are connected to each other by movable sutures, at the joints of which fontanels are formed. In these areas, the brain is covered with connective tissue and skin. The most "main" fontanelle is located on the crown, that is, on the vertex, at the junction of the two frontal and two parietal bones of the skull. It has a shape that can be called diamond-shaped. The size is approximately 3 cm.
In addition to this "main" fontanel, the baby has several such areas on the skull at birth. How many places are there? There are six of them: two unpaired and two paired. The occipital fontanelle also belongs to the unpaired. It is formed by the junction of two parietal and one occipital bones, while it has the shape of a triangle with a size of 5 mm. Paired fontanelles are located on the sides of the head: it is wedge-shaped, located in the temporal region, and mastoid, which is located behind the ear.
The most basic question is when the fontanelles in newborns are overgrown? These five areas close in the first month after birth or heal while still in the womb. The gradual closure of the fontanelles (in most cases only the parietal) is a characteristic sign of the growth and development of the child.
The location of fontanelles on the baby's skull
What does it depend on him newborn size
The condition of the fontanelles in infants at birth is largely determined by the diet of the pregnant mother. The level of calcium and phosphorus in the body is very important for the strength of bones. It is for this purpose that pregnant women are prescribed multivitamins or separately calcium and phosphorus preparations, and they also recommend eating more foods containing these elements.
With normal vitamin levels, the fontanelles will be small and can quickly overgrow. The condition of the fontanelles is usually not assessed immediately after birth, but after 2-3 weeks, when the bones of the skull "fall into place", straighten out after childbirth. Excess calcium can lead to early ossification of soft areas, and injuries can occur at birth.
Also, the size of the fontanelles depends on which week the labor began. If they were premature and the baby was born before 38 weeks, fontanelles and the spaces between the bones of the skull are often larger than in full-term babies. For premature babies, there are rules for closing them.
Measuring the crown at home
Size norm
The most indicative are the sizes of the large rhomboid fontanelle. Measurement of its dimensions is carried out between the midpoints of opposite sides. The average for a full-term baby is in the range of 26-28 mm. After birth, the bones may separate slightly and the fontanelle will enlarge. After a few weeks, the reverse process will begin, the soft area will overgrow. The extreme maximum value at which the size fits into the norm is 32 mm. Exceeding this size indicates a large crown.
Important! A large fontanelle in a newborn at birth does not mean the presence of rickets. Rather, it is characterized by a general softening of the bones and the softness of the bony edges in the fontanel area. In addition, there are other signs of rickets: the presence of changes in the composition of the blood, increased nervous excitability, decreased muscle tone, sour smell of sweat, growth of bumps on the bones of the skull.
Deviations from the norm: reasons and recommendations
Deviations can be observed in premature babies, with a lack of calcium in the mother's body during pregnancy, or, conversely, its excess. Other deviations that may appear:
- congenital or acquired hydrocephalus;
- microcephaly - complete closure of the lateral and posterior fontanelles at birth and a very small size of a large area;
- a symptom of increased intracranial pressure and accumulation of fluid in the head - manifested by a rapid increase in the size of fontanelles after birth;
- damage to the nervous system - fontanelles and sutures between the cranial bones close very quickly;
- organic brain damage - characterized by a decrease in the size of the fontanelles with a small increase in head circumference.
These symptoms require a thorough examination by a neurologist and additional examinations, since additional data are needed for the final diagnosis.
Important! It is a misconception that with a small fontanel there is no need to take vitamin D, even with obvious signs of rickets. In the presence of objective data that indicate the presence of such a serious illness in a child, he must be prescribed drugs containing calcium and a solution of vitamin D. Such treatment in the correct amount does not accelerate the overgrowth of the fontanel.
Baby's head with hydrocephalus
The timing of the closure of fontanelles in children
The question of at what age the fontanelle in a child grows is difficult to answer unequivocally. The timing of the closure of the parietal fontanelle is individual. Basically, a significant fusion of the bones of the skull takes about a year.
Time limits
There are certain norms for the average size of the sides of the large fontanelle, which change, decrease as the child grows up.
Indicators of the normal size of the fontanel by the age of the child
| Age, months | The average size of the sides of the fontanelle, mm |
|---|---|
| 0-1 | 27-29 |
| 1-2 | 22-25 |
| 2-3 | 23-24 |
| 3-4 | 20-21 |
| 4-5 | 16-18 |
| 5-6 | 16-18 |
| 6-7 | 16-16 |
| 7-8 | 14-16 |
| 8-9 | 14-15 |
| 9-10 | 12-14 |
| 11-12 | 5-8 |
The situation is considered normal when the fontanelle in a newborn heals in the period from 1 to 1.5 years. It is believed that the timing and speed of closing the fontanelle is due to a genetic predisposition, which no medicine can change. In the period up to 3 months, a small area should heal, and the paired side ones should already be closed.
Important! In premature babies, the fontanelle may heal later - by 2-2.5 years. All developmental delays are eliminated by 3 years, subject to all the recommendations of doctors for care.
Early closing
It is believed that early closure of the crown of a newborn will cause underdevelopment of the brain. Figuratively speaking, the brain will have nowhere to "grow", and the child will grow up defective. This is a dangerous misconception, since the growth of the skull is not due to fontanelles, but due to the presence of seams between the bones of the skull. With the normal development of the child and a monthly increase in the size of the head circumference, early closure is not a pathology and does not pose any danger.
In addition to heredity, the following factors affect the timing of overgrowth:
- the general rate of growth of the child - if the child quickly adds in height and weight, then the crown grows faster;
- way of feeding a baby - in breastfed babies, the timing of overgrowth is ahead of artificial ones.
Closing the crown at the age of less than 3 months indicates a violation in the child's body of the percentage of vitamin D and an increased content of calcium. Most often this is caused by a violation of the regimen of taking vitamin and mineral complexes during pregnancy.
Breastfeeding promotes timely overgrowing of fontanelles
Fontanelle care
No special or special care is required for this delicate part of the head. You can touch it with your hands. The main thing is not to press into this area. When combing hair, do not press with a brush, act carefully. If yellow or brown crusts appear on the fontanelle, do not immediately peel them off with nails or other sharp objects. It is enough to apply baby oil on the head, any vegetable oil will also do. After 30 minutes, comb out with a children's comb with rounded plastic teeth. It is perfectly safe to cut a child whose fontanel has not yet closed. Nothing will happen to him.
The normal state of an ungrown fontanelle is the correspondence of its level to the bones of the skull. At the same time, with a cry and strong crying, he may bulge a little. A slight pulsation is also allowed, which is due to the close passage of the cerebral artery. This may look a little intimidating, but it is normal. This is where the name of this section of the skull came from. In other countries it is also called "fountain".
If, in a calm state, the fontanelle sinks or bulges out, it is necessary to consult a neurologist. This could be a sign of increased intracranial pressure. The retraction of the fontanelle may be due to severe dehydration after vomiting or diarrhea. This condition is critical and requires urgent action: immediate emergency care and quick restoration of the child's water balance. Soldering is necessary by any possible means, optimally - for oral hydration.
Pediatricians advise to lay the baby alternately on one side, then on the other side. This is necessary for uniform formation of the skull and prevention of "caking" of delicate areas. If the child is constantly on one side, the load on the crown will be uneven and can lead to internal pathology.
Bulging posterior fontanelle
If the timing of the fontanelle overgrowth has passed
Since the timing of overgrowth is largely determined by genetic inheritance, it is possible that late closure is a characteristic feature of the father's or mother's family. Nevertheless, the question of when exactly the crown of a newborn is overgrown, and why it takes a long time, is very exciting for parents. The excitement is especially strong when children are compared with the children of acquaintances and friends who are close in age. In fact, the size and timing of overgrowth in children are individual, as are their height, weight and eye color.
Probable deviations
We can talk about slow healing if by 1.5 years the crown of the newborn is still not closed, and its dimensions are 10-12 mm. However, there are other alarming symptoms. It is incompetent to judge the disease by only one sign. The probable causes associated with various diseases and accompanied by concomitant pathologies are as follows:
- Rickets - a long period of healing of the soft area against the background of disturbed sleep, anxiety, increased sweating of the scalp and a gradual change in the shape of the skull. The consequences of rickets are improper formation of the limbs, malocclusion, thickening on the ribs, sunken chest, deformation of the pelvic bones. If a disease is suspected, it is necessary to undergo a comprehensive examination by a neurologist.
- Hydrocephalus is sluggish healing accompanied by excess fluid accumulation in the brain. The consequences are very sad: delayed speech development, lethargy, problems with the expression of emotions;
- Dwarfism is a pathology of bone tissue, expressed in growth retardation, due to genetic inheritance.
External symptoms of rickets
According to Dr. Komarovsky, early closure (up to 3 months) or non-closure after 1.5 years is a reason to visit a neurologist and be examined to identify possible pathologies. According to statistics, by the year the crown is overgrown in 25% of babies, by 2 years - in 95%.
Deviations from the norm in size and timing are not a reason to suspect a serious illness in a child only on the basis of this factor. When making a diagnosis, it is necessary to collect as much information as possible regarding the development, well-being and growth of the baby. Parents need to monitor and note changes in his condition, consult a doctor with questions and suspicions.
