All children are born with a fontanel - a soft area on the crown of the head, covered with thin skin. What size should the fontanel be when the bones of the skull fuse, which could mean a convex or sunken area of ​​skin on the crown of the head? We will answer these questions and also tell you everything 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 fontanelle.

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 baby’s head, 4 small fontanelles of small size are identified - 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 can be open for 1 month and heal a little later. It is believed that this feature is not a pathology if all other parameters are within normal limits.
• 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 “on the crown”. In the photo below you can take a closer look at this area. Its closure occurs during the first 2 years of a child’s life, and its shape resembles an elongated rhombus with diagonals of 2x3 cm. Its condition, frequency and strength of pulsation, as well as its size can tell the 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 the human body has, has its own purpose. Why is it needed? We list the main functions of the crown:

• This area on the baby's head facilitates the birth process. Due to the fact that the bones of the skull are not completely fused, they can “run into” each other, changing the shape of the head. As it passes through the birth canal, the head lengthens slightly and its diameter becomes smaller. A week or two after birth, the baby’s head becomes 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

• During the first year or two of a baby’s life, his brain develops and increases significantly in volume. The internal space of the cranium slowly adapts 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 exchange in the baby’s body. Through this hole in the skull, the brain is cooled in time if the need arises.
• 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 force.
• During the examination of the child, pediatricians and neonatologists assess the size and condition of the fontanel, drawing conclusions about whether the baby is developing correctly. Sometimes the parameters do not correspond to standard values, in which case the pediatrician may prescribe additional examinations to identify the disease early stage.
• Specialists can also examine the child using neurosonography and identify abnormalities in the development of his brain at an early stage. This procedure is possible thanks to the anterior fontanel and is indicated for all newborns.

Timing of fontanel closure

Pediatricians for for a long time Observations noted that the anterior fontanel closes completely on average by the end of the first year of a child’s life. However, there is no reason to say that those whose fontanel is overgrown before 4 months or after 12 months have health problems. For example, Dr. Komarovsky claims that the timing of the healing of the soft crown may be different for each child. The main thing is to visit the pediatrician on time and be sure to undergo examinations prescribed by the doctor.

There are also statistics that show that only 40% of babies have a fontanel that closes by the age of one year, and in 1% it can close before 3 months of age. For other children, closure may be delayed, but usually this occurs 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 the large fontanelle with tabular data.

Table 1:

Let us remind you that the given data 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 fontanelle, and make sure that its parameters correspond to the table values. If everything is in order, it is enough to undergo a scheduled examination with a pediatrician, otherwise, consult unscheduled.

What will the measurements tell us?

Every month, during a routine examination, the doctor will certainly palpate and take measurements of the baby’s fontanel. He records this data in the child’s card in order to observe the dynamics.

Parents can independently measure the parameters of the large fontanelle, comparing them with table 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 tell you? What could mean premature closure of the parietal fontanel or its parameters being too large compared to the norm? It is worth understanding these issues more thoroughly.

Soft crown larger than normal

A fontanel in newborns and children up to one year old, which differs from the standard value by 2-3 mm, is not considered a serious cause for concern. If its parameters are significantly larger, this situation can speak volumes, for example:

• indicate metabolic disorders and insufficient absorption of calcium, which can lead to rickets;
• prematurity;
• trauma received at birth;
• developmental defects;
• poor drainage 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 are worth paying close attention to. We have collected in a 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 at the edges of the fontanel is thinned - it is flexible and pliable. The back of the head is flat on the sides chest bone thickenings are observed.	After confirming the diagnosis, a therapeutic dose of vitamin D and additional sun exposure are prescribed.
Down syndrome	A congenital pathology, it is diagnosed immediately after the baby is born. Down syndrome is characterized by specific facial features, a shortened neck, and a fold in the palm.	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.	Tests should be taken to determine the amount of a specific hormone. After this, the endocrinologist may prescribe hormone replacement therapy.
Achondrodysplasia	This disease is characterized by various manifestations of disorders of bone tissue development - 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 treatment.

Less than normal

Sometimes the soft crown of the baby heals early - already by 3-4 months, or its length and width are significantly less than the standard. The area on the crown becomes hard, but 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 abnormalities in brain development. We will consider in more detail what other signs these pathologies may have.

Table 3:

Disease	Signs	Treatment
Craniosynotosis	Irregular growth of bones, which is reflected in the skull. The sutures of the skull heal prematurely, the fontanelle quickly closes, which leads to deformation of the head. Hearing and vision impairments are possible.	Craniosynotosis can be cured; it is important to consult a doctor in time. Surgery is indicated.
Brain development abnormalities	The patient's developmental delay and other signs that a neuropediatrician can see.	The doctor prescribes treatment.

However, these diagnoses are made very rarely; most often the baby inherits a small fontanel or its early closure from one of the parents. This symptom may 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 area of ​​the skull. However, you cannot stop taking the medication on your own if it has been prescribed by a doctor. Early closure of the large fontanel may not be associated with the use of this drug.

If taking vitamin D was prescribed by a doctor, then you do not need to stop it yourself.

A large or small size of the crown does not always indicate pathology. Along with examining this area, the pediatrician will ask parents questions about how their offspring sleeps, whether he burps too often, and whether he lags behind his peers in development. The specialist may also prescribe a series of studies to rule out the presence of serious illnesses in the baby. 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 its condition according to other criteria. Normally, it looks slightly sunken or is flush with the surrounding tissues. In addition, in newborns and children up to six months, the parietal zone may pulsate.

We will list what you should pay attention to Special attention when consultation with a doctor is necessary:

• Sagging of the skin in the crown area may indicate dehydration. This sign becomes even more alarming if it is accompanied by a small number of urinations of the baby, drying out of the mucous membranes, as well as a sluggish, tearful state. In this case, you must immediately contact a specialist.

Recession of the fontanelle 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 or is capricious, the parietal part of the head may become convex and begin 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 rarely occurs on its own; it is often accompanying symptom another disease, the consequences of which may be quite serious.
• Why does the fontanel sometimes pulsate (more details in the article:)? Pulsation of the soft crown of the head in a newborn and infants up to 6 months is the norm; its complete absence is more likely to indicate pathology. The beating of the membrane transmits the pulsation of blood vessels through the cerebrospinal fluid, the fluid that surrounds the brain. It can pulsate quickly when the baby screams or is capricious. The rest of the time, its beats weaken, and after 6 months they become less noticeable. In other cases, consultation with a pediatrician is required.

The baby's fontanelle requires special attention. This place on the top of his head should be protected from drafts and accidental blows, so it is better to wear a cap, which will create an additional barrier near the crown (more details in the article:). It is also not recommended to lower the baby under water, imitating diving. This can cause fluctuations in intracranial pressure.

However, there are procedures that are necessary to proper development child, as well as to stimulate 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 looked after regularly - washed, lubricated with baby oil and promptly gotten rid of the crusts that often form on the baby’s head.

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

• If your daughter boasts a wild head of hair, her mother needs to comb her hair regularly. Don't worry that the comb teeth will damage the parietal area. The skin there is quite strong, just try to comb the baby carefully, then no problems will arise.
• Also, infants can and should have a scalp massage. This procedure is quite within the mother’s power, and the benefits are obvious. The massage will calm the baby, make him sleep more soundly, and also serve as a good stimulant for mental activity. It is not necessary to 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 disease. The criteria that a good pediatrician uses to determine the child’s condition and level of development are very diverse. The task of parents is to notice in time possible deviations in the size and condition of the fontanel. If the pediatrician prescribes vitamin D or recommends other therapy, it is important to follow his advice strictly.

The rate of overgrowth of a fontanel is very individual. It all depends on its initial size (0.6-3.6 cm), on the calcium-phosphorus balance in the baby’s body. Be that as it may, it is the speed of overgrowth of the fontanel that causes particular concern and anxiety among the child’s parents. Let's figure it out, what if the fontanel does not heal...

Norms, norms, norms...

The maximum size of the fontanel at the time of birth is within 2.2-3.5 cm. Due to the straightening of the interosseous sutures and skull bones, the size of the fontanel may increase slightly, but this is primarily due to a change in its shape. Afterwards, the size of the fontanel will steadily decrease, and complete closure will occur on average at 12-18 months of the baby’s life. But these terms are very, very arbitrary. Cases have been recorded where closure of the fontanelle occurred both earlier and later. late dates and yet it was the norm.

Doesn't overgrow. Is it dangerous?

Of course, the period of overgrowth of the fontanel is individual in each case. However, if parents notice that the large fontanel is healing too slowly, it is advisable to seek help from a neurologist. And the doctor will definitely determine whether there is cause for concern, prescribing, to be sure, ultrasonography brain

If the fontanel is really delayed in closing, this may indicate:

• About genetic predisposition. In 1982, a special WHO commission came to the conclusion that both the size of a large fontanel and the speed of its closure are genetically determined factors.
• About rickets. Insufficient calcium levels in the body, which is directly related to low intake of vitamin D, can lead to later closure of the fontanelle and to rickets. As a result, bone tissue changes, the child’s gait is disrupted, and his legs become bent. Signs of rickets: the baby is restless, sleeps poorly, sweats profusely, and the baby’s hair is falling out. It is possible to prevent late closure of the fontanelle and associated rickets by normalizing the child’s calcium-phosphorus metabolism. For the purpose of prevention, children are prescribed vitamin D.
• About hydrocephalus (excessive accumulation of fluid in the brain). This disease is manifested by increased intracranial pressure. As a result, the child becomes restless, has muscle dystonia, sleep disturbances or excessive drowsiness, tearfulness, and changes in the blood vessels of the fundus. In addition, with hydrocephalic syndrome, there is a significant monthly increase in head circumference, and in especially severe cases, even divergence of cranial sutures. That is why, first of all, doctors focus on the growth rate of the child’s head, and not on the size of the fontanelle.

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

What is a fontanel

A child's fontanelle is an empty space between parts of the skull, closed by a dense membrane. The baby also has sutures caused by the connection of two skull bones. Fontana appear in the area where several bones connect. Some time after birth, these parts of the skull become ossified, and the corresponding markings disappear. The first five out of six membranes close in all children at approximately the same time, but the formation of the sixth fontanel in a newborn child is a purely individual process. Among its main functions are the following:

1. The main function is to help the head pass easily through the birth canal. During childbirth, the shape of the baby's head is slightly deformed. By narrowing, it passes forward more easily along the birth canal. Often, immediately after birth, you can find bones in a baby that are on top of each other. Such defects quickly disappear, and the shape of the skull is restored.
2. Another equally important purpose of this physiological phenomenon is to help in the active growth and development of the brain. In the first year of life, a baby's brain grows rapidly and intensively. The membranes provide the space necessary for this process, expanding the cranium and allowing the brain to grow to the desired size and volume.
3. The free space between the parts of the skull provides thermoregulation of the brain. In newborn children, heat exchange in the body is at the stage of formation and development. This makes babies overheat easily. When the child's body temperature reaches approximately 38 degrees Celsius and above, the fontanelles turn on the ventilation function, thereby preventing the brain from overheating.
4. The fourth function is shock absorption. Physiological marks that appear in children immediately after birth provide protection for the baby from possible shocks and damage. This is not a reason to leave a small child unattended, because a small membrane will not be able to protect the baby's fragile bone structure from serious impacts or shocks.
5. The final role of the fontanel in a small child is to assist in medical research of the brain. The membranes significantly simplify neurosonography, ultrasound and other examinations in order to identify potential pathologies and diseases at an early stage. These membranes help medical workers monitor the process of development and formation of the brain, and if problems are detected, apply timely treatment.

Large and small fontanel in a child

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

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

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

How many months does it take?

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

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

Recession and protrusion of the fontanelle

The fontanelle in an infant protrudes slightly when there is increased intracranial pressure or other neurological disorders. A bulging fontanel is not the only symptom indicating health problems. If you find that the membrane on your head is slightly swollen, do not panic, but rather consult a doctor immediately.

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

If the fontanel is pulsating, should you worry?

Many parents, noticing that the membrane on the child’s head is pulsating, panic. There's no need to worry. This is a completely natural and normal phenomenon. The pulsation corresponds to the heart rhythm. The reason for its appearance is the flow of blood entering the brain with each heartbeat. In all children, the pulsation is expressed differently: in some it is stronger, in others it is weaker. But if there is no pulsation at all, this indicates problems with blood pressure. In this situation, it is better to consult a doctor.

When should a child's fontanel close?

As noted above, in all children the space between the parts of the skull grows into different time. The large fontanel usually closes between three months and two years of age. There are often cases when characteristic marks disappear earlier or later than expected. This is a purely individual process that will definitely happen in. If the mark heals too quickly or, conversely, does not heal for a long time, it is better to consult a doctor who will help determine the cause of the anomaly and give appropriate recommendations.

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

How does a large fontanelle close in a child?

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

What conditions of the large fontanel should alert parents? Prevention

Parents must visit the children's doctor, doing this regularly for up to a year. And the pediatrician, for his part, will make sure that the baby does not lag behind his peers in development and will take the necessary measures in time.

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

Fontana of a newborn baby

• The newborn's fontanel greatly facilitates the birth process, both for the baby and for the mother. While passing through the birth canal, the bones of the skull are compressed, and therefore the newborn’s head looks elongated for the first time after birth. Then the shape of the head is restored;
• The presence of a fontanel provides optimal spatial conditions for normal brain growth at the pace established by nature;
• The fontanel is involved in the processes of regulating heat exchange between the baby and the environment. If the child’s body temperature exceeds 38 degrees, then brain tissue is naturally cooled through the fontanel;
• Due to its ability to compress, the fontanel can act as a shock absorber if a child accidentally falls.

Large and small fontanelles

Where is

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

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

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

When it overgrows

The large fontanel is overgrown by about the age of one year, sometimes there are slight deviations from this parameter until about one and a half years. But if the child meets age standards in other respects, then there is no reason to worry.

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

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

Developmental disorders

Knowing the timing when the fontanelle closes up, as well as its size, you can see any deviations, avoid and prevent the development of many dangerous diseases in newborns. Among them are several:

1. Rickets.
2. This disease is almost the most common cause of late closure of the fontanel. As a rule, this occurs in premature babies who are rarely exposed to the sun and have a lack of calcium and vitamin D. Read the article >>>; Hypothyroidism.
3. A decrease in the amount of thyroid hormones may also cause a slowdown in the process of overgrowth of the fontanel; Down syndrome.
4. Too large a fontanelle indicates the presence of this disease along with other characteristic signs; Overgrowth of the fontanel ahead of schedule may indicate excess calcium
5. , and also indicate diseases such as craniostenosis, microcephaly; A depressed fontanel is also a serious symptom.

This phenomenon indicates acute dehydration of the body.

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

Reasons for early closure of the fontanelle

(clickable)

The fontanel is too small or the fontanel closes too quickly

Protruding fontanel?

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

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

• High fever;
• The bulging fontanelle occurred after a head injury or a fall of the child;
• Vomit;
• Drowsiness or excessive irritability of the child;
• Strabismus;
• Convulsions or epileptic seizures;
• Loss of consciousness;
• Protrusion of the fontanel for a long time without other symptoms.

Sunken fontanel?

Most often, retraction of the fontanel is observed due to dehydration of the child against the background of fever, diarrhea, and repeated vomiting. If you notice a sunken fontanel, make sure your child drinks plenty of fluids and contact a doctor to treat the illness that is causing the dehydration.

Fear of damage

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

Video:

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

What are the types of fontanelles in newborns?

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

Sizes of children's fontanelles

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

For correct definition the size of the frontal fontanel should be added to its longitudinal and transverse diameters and the resulting sum divided by 2. The small fontanel resembles the shape of a triangle. Its dimensions usually do not exceed 0.7 centimeters. Although most often a child is born with a closed small fontanel. But do not worry if the size and shape of the child’s fontanelle differs from the standard. Each child is individual. A pediatrician should be consulted to determine whether this is a concern.

Timing of fontanel closure

The four lateral fontanels in full-term babies close before birth, in premature babies - in the first few days after birth. The occipital fontanel in infants closes completely at 2-3 months. But there are no exact dates for the closure of the largest fontanel. This is a very individual process. It can be overgrown by 12 months, or maybe at 1.5 and 2 years. In recent years, thanks to the acceleration of children, the frontal fontanelle disappears by 10 months.

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

Closing of the fontanel before the third month of the baby’s life is considered early. This is usually due to the expectant mother’s passion for taking multivitamins, which results in small and fairly dense fontanelles in the child. Therefore, you should follow the norm in taking vitamins according to your pregnancy.

Why is it dangerous?

Early closure of the fontanel has a significant effect on the full development of the brain, preventing its normal growth. The danger is that early overgrown

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

What is the reason for late closure of the fontanel?

Late closure of the frontal fontanel is associated with low levels of vitamin D3 in the baby’s body. And this leads to changes in bone tissue.

Why is it dangerous?

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

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

What else can a fontanel “tell” about?

There are several more “signals” that should not be ignored:

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

for a long time it is “convex” -;

increased size - impaired ossification or prematurity.

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

Newborn's fontanel

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

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

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

The remaining “windows” are called paired, because are located on the sides of the head - in the temporal areas and behind the baby’s ears.

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

What functions does the fontanelle perform?

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

When does the fontanelle close up in newborns?

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

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

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

Indicators of the norm of the fontanel and their deviations

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

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

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

• Down syndrome
• hydrocephalus
• hypothyroidism
• rickets

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

• microcephaly
• craniostenosis
• brain development abnormalities
• meningitis
• excess calcium in the newborn's body

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

• meningitis
• encephalitis
• tumor formations
• intracranial pressure

But you should remember that any disease has a complex of symptoms, so it is impossible to draw conclusions based only on the “behavior” of the newborn’s fontanel. If there is nothing else alarming about the baby’s behavior, most likely his development is proceeding normally. Only a specialist can determine compliance with the norm or deviation from it; visits to whom should not be neglected.

Why does the fontanelle pulsate in a baby?

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

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

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

• the fontanelle pulsates too intensely
• doesn't pulsate at all
• pulsation of the crown is accompanied by severe anxiety of the child: constant crying; bad sleep; regurgitation; refusal to eat, etc.

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

How to care for your baby's fontanel?

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

• you can’t put pressure on it;
• comb your hair very carefully without touching the fontanel;
• protect the newborn from head impacts during games, swaddling, bathing;
• if it is necessary to remove birth crusts from the scalp of a newborn, it must be carefully lubricated with oil half an hour before bathing

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

All parents have noticed a non-ossified pulsating area on the head of their newborn baby - the fontanel. Many even try not to touch this place for fear of harming the child. But the doctor must feel the fontanel during a routine examination. After all, it serves as one of the indicators of the child’s health and development.

With age, the fontanel becomes ossified. When the fontanel overgrows in newborns depends on many factors - these are the individual characteristics of the baby, and disorders of the development and health of the baby. Therefore, the condition 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 baby’s skull. These areas allow the skull to transform to facilitate birth process. In addition, thanks to the fontanelles, the cranial vault adapts to the rapidly growing brain of a newborn.

After birth, the baby has six fontanelles:

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

Called posterior or occipital. It is very small, only 0.6 mm;

• • The anterior one, which connects the 2 frontal and 2 parietal bones

At birth, its size is about 30 mm;

• There are two types of lateral fontanelles: wedge-shaped and mastoid

The wedge-shaped ones are located closer to the temples, the mastoid ones - to the back of the head;

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

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

In addition, fontanelles have other functions:

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

Newborns are quite poor at maintaining the required body temperature due to the immaturity of their thermoregulation mechanisms. The fontanelle helps heat transfer during overheating, protecting the child’s brain and the body as a whole.

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

It is a kind of shock absorber between the bones of the skull. It is in infancy and early age a child has the worst control over his body, so nature protected the little person’s head from frequent falls and blows in this way.

1. 1. Some diseases in a child are determined by the condition of the fontanelle.

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

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

Once the soft area has healed, this will no longer be possible, because the skull 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 the two frontal and two parietal parts of the skull. The site has a diamond shape. The size of the fontanel may vary. As the head grows, it decreases. So from the initial dimensions of about 3*3 cm, it gradually decreases to 5 mm and becomes overgrown.

When it overgrows

The large fontanel should be overgrown closer to 12-18 months. However, this depends on how much calcium is in the baby’s body. If there is enough of it, then the fontanel can last up to a year. Small deviations in the timing of overgrowth from the norm are not critical. In the absence of other signs of pathology, they cannot indicate disorders in the body.

The timing of fontanel overgrowth can be influenced by the following factors:

• • Prematurity of the child

Such children usually lag behind their peers in development. Therefore, the fontanel may heal more slowly. Usually by 3 years the lag goes away.

• • If a child grows quickly with adequate nutrition, then the fontanelle may close faster

If the diet is rich in carbohydrates or proteins, growth may slow down.

• Method of feeding a baby

In children breastfeeding the fontanel overgrows faster because breast milk is most completely absorbed by the body.

However A 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

In how many months the fontanel will heal depends on the individual characteristics of the body 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 a pediatrician who will monitor his condition. In a newborn, the fontanel seems to be pulsating. In some countries it is called a fountain. If such 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 may be a sign of diseases such as hydrocephalus (water on the brain), meningitis, encephalitis. If the swelling of the fontanelle is accompanied by convulsions and high temperature, then the child requires urgent medical attention;

• • A sunken fontanel may be a sign of malnutrition and dehydration.

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

• • The size of the fontanel exceeding the norm may be one of the signs of Down syndrome;
  • A fontanel that does not heal for a long time 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 fontanelle, but at other characteristic symptoms;

• A slowly growing fontanel may be a sign of an endocrine system 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.

Care for fontanelles

Often parents are afraid to even touch the fontanel site. But there is no need to worry. Connective tissue is strong enough to withstand touch and various hygiene procedures. Of course, some caution must be observed, but the child can safely wash his hair, comb his hair, and perform other care procedures.

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

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

Myths about fontanelles

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

1. If the fontanel is quite large and does not heal well, then the child has rickets.

However, this is not necessary. In addition to the rate of overgrowth of the fontanel, rickets also has other signs: sleep disturbance, severe sweating, tearfulness, muscle sagging, and others. Therefore, the diagnosis must be made by a doctor. The duration of overgrowth of the fontanel depends on other factors.

1. Do not touch the fontanel, you can damage the brain

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

1. If the fontanel overgrows quickly, then you should 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 has prescribed a drug, then it is necessary to take it. For all other questions, it is better to seek additional advice;

1. For all children of the same age, the size of the fontanel should be the same

This is wrong. Exist certain standards, 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. If the fontanel closes prematurely, the brain will stop enlarging and the child will be mentally retarded

This is wrong. Brain development is not associated with the timing of fontanel closure. The skull is not a monolithic structure. The bones of the skull are connected by elastic sutures that lengthen as they grow. The skull grows until the age of 20.

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 be careful about this area.

If the child is healthy and cheerful, 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 waste time.

A young mother is constantly worried whether her baby’s fontanel is normal, whether it is too big or, conversely, small? In this case, there is no need to listen to the advice of grandmothers; only a pediatrician will be able to tell after an examination what condition the baby’s fontanel is in. I am sure that every mother should have a general idea of ​​what a fontanelle is and what deviations from the norm there may be, so that once again there was no reason to worry.

Many mothers came to see me and trembled when I felt the fontanel of their children. This is, of course, an extreme. But the other extreme is to approach it completely irresponsibly this issue. Remember, ordinary manipulations (washing your hair, combing, examination by a pediatrician) cannot disrupt the integrity of this area.

Fontana in babies - what is its role and normal shape

As the brain grows, so do the bones of the child's skull. The most productive period for this is the first 2 years of a baby’s life, during which time the bones of the skull are constantly growing and changing. By the way, even if the fontanel has closed a little ahead of schedule, this does not mean that now the bones will stop growing.

Along with the sutures of the skull, which are open until the age of 19, the fontanelle occupies an important place in the growth of the size of the skull. The main function of this non-ossified part of the baby's skull is so that during the birth process the bones of the skull can take the desired shape to pass through the woman's birth canal. This is why newborns often have a rather strange head shape in the first days.

After childbirth, this area also performs very important functions:

1. In the first two years of life, the bones of the skull can still transform. This protects the child's head from serious injuries that may occur after the baby falls. During this period, parents may make a mistake: while dressing the baby and accidentally hitting their head, the baby may fall off the sofa or bed, and many other cases. But these injuries will not affect the child’s health, because upon impact the brain will rest against the soft connective tissue fontanel. The time for complete tightening coincides with the age of the child when he is already firmly on his feet and the risk of falling is significantly reduced.
2. The fontanelle is involved in the baby's thermoregulation. Due to the imperfection of the heat transfer process, young children often overheat or become hypothermic. We regularly meet mothers who really like to wrap their baby in a way that is not in accordance with the air temperature. For the child to return to his normal temperature again, it is enough to remove the cap.
3. Thanks to this area of ​​skin, children undergo an ultrasound of the brain.

It is worth noting that after birth a child has 6 fontanelles. We, pediatricians, pay special attention to only two, because the other 4 are overgrown during the first week of the baby’s life.

Sizes of fontanelles in a newborn and older child

The posterior fontanelle in a newborn is on average 0.6 mm. By about 8 weeks of age, the child’s cervix closes completely.

Typically, the anterior fontanel has the shape of a diamond, the dimensions of which vary from 5 mm to 30 mm. In order to calculate the size of a given area, it is necessary to measure the distance between the most distant points and divide the resulting number by 2. The longitudinal (along the main axis of the skull) and transverse (across the longitudinal axis of the skull) dimensions are usually determined. Dimensions are recorded in two numbers: 1.1x0.5 cm.

Sizes of a large fontanel by month

Age, months	Size, mm
0-1	26-28
1-2	22-25
2-3	23-24
3-4	20-21
4-5	16-18
5-6	16-18
6-7	16-18
7-8	14-16
8-9	14-15
9-10	12-14
10-11	9-12
11-12	5-8

The anterior fontanelle closes at about 24 months. I noticed that this process goes a little faster in boys than in girls. If a baby is born with the anterior fontanelle larger than usual, this does not mean that it will take longer to close. Despite the fact that the table shows average values, this does not mean that with a slight deviation from the norm, something goes wrong with the child. Do not worry ahead of time and about the age when this unossified area of ​​the skull will completely heal. Most recently, we opened a service on our website Question and Answer, and guess what one of the first questions was asked by our reader... If you still have questions about why the fontanel does not heal, then welcome to our Questions and Answers section .

Please note that neither a decrease in closure periods nor an increase in them are pathological. The process of tightening the fontanelle occurs individually for each child and depends on the following factors:

• The baby is premature. Typically, premature babies are slightly behind their peers in physical development, this manifests itself in the later overgrowth of the non-ossified area on the baby’s head. But by the age of 3 everything evens out and children begin to develop equally.
• Growth rate. With adequate nutrition and good weight gain, the fontanel usually closes earlier. Conversely, if the baby’s diet is overloaded with proteins or carbohydrates, the fontanel may grow together a little later.
• Method of feeding. The child has breastfeeding This area closes earlier than in a baby on formula. This is due to the fact that breast milk contains nutrition that is more balanced and suitable for the baby’s gastrointestinal tract.
• Deficiency of vitamin D3 in the body.
• Hereditary diseases. It has been established that Down syndrome, congenital hypothyroidism or achondrodysplasia (a genetically determined disorder of bone formation), hydrocephalus can slow down the fusion of the fontanel. Microcephaly (small head) or craniosynostosis, on the other hand, results in very early closure.

What deviations from the norm may there be?

Normally, this area may be slightly sunken or slightly convex. Not normal age of closure - earlier than 3 months. If the child is older, everything is fine. The fontanel may occasionally pulsate, especially during periods of excitement of the child; many mothers notice this and get scared, but this is considered normal and confirms that the baby is healthy. Another option is when the pulsation occurs constantly and does not go away with age, you should definitely contact a neurologist who will prescribe an ultrasound of the brain (neurosonography).

What type of fontanelle is considered abnormal:

• The fontanel has fallen greatly and at the same time the child is dehydrated due to an illness that was accompanied by vomiting, diarrhea, and fever.
• when this area protrudes strongly, the child has a fever and even possible convulsions. This condition requires an immediate call to an ambulance. If there are no symptoms, but for a long time you notice that the fontanel is swollen too much, then contact your pediatrician. This may be a symptom of meningitis, encephalitis or a tumor. Self-medication in this case is unacceptable!

What examinations are carried out if a deviation from the norm is suspected:

• consultation with an endocrinologist;
• a trip to a geneticist and neurologist;
• a urine test to perform a Sulkowicz test to determine whether the baby’s body is absorbing calcium well.

Important! This article contains general information only and is not intended to substitute for advice from a qualified professional.