Care of the fontanelle and the head of the baby

At birth, your baby does not have a firm articulation of the bones in his head to facilitate the birth process. Little by little, these join forming the sutures of the skull. Where several sutures are crossed, that is, when more than two bones are joined forming a soft spot covered with membranes, it is called fontanelle.

The skull of your newborn child usually has several fontanelles on the sides, as well as on the back and front. The fontanelle on the back closes around two months and the one in the anterior part can remain open even up to two years, although it is normal for close between 7 and 18 months old. The fontanels allow the correct growth of your child's skull in its first stage of life and therefore, the brain.

What does the fontanelle aspect tell us?

The fontanelle It usually reflects the intracranial pressure and the state of hydration of the baby. So, if you notice that it is bulging, it increases the pressure inside the skull and it is not necessary to be alarmed if the child returns to his normal state when he relaxes. On the contrary, if touching it sinks forming a gap is a warning signal of dehydration of the baby, so you should go immediately to the specialist.

The normal thing is that its aspect varies throughout the day and it is not necessary to get upset by it. That it swells when it cries, that it changes the tension of the latter when the child changes position, or that it beats, since it represents the repercussion of the heartbeat on it.

The fontanelle should not be closed too soon

To all newborns "take measures" in their first days of life to check if they are within normal parameters. Among these, is the size of your head that can vary for various reasons: for a genetic component (inheritance), for sex (that of girls is smaller) or, in certain cases, caused by some disease.

Thus, during its first six months the pediatrician will make monthly measurements to your baby and from the second semester every two months. If the size of the head is between the percentiles 3 and 97 will signal normality. The fontanel usually ranges between 0.6 and 3.6 cm.

It is also important that the fontanelle does not close too soon, because it could prevent his head from growing, affecting, therefore, his brain and causing deformities in the child's head. When this happens we speak of a craniosynostosis and in extreme cases, the specialist must surgically intervene the baby to open it again and avoid major complications.

There are some cases in which the child is born with the fontanelle practically closed; It is then that the growth of the cranial perimeter will be monitored, that if it grows at an adequate rate, it will not need to be operated on.

The way to know if the fontanelle is closing properly is by measuring the brain volume or, when necessary, by means of radiographs and skull tomographies.

Tips to take care of your baby's head

- See if your child has an abnormally large or small size of the fontanelle which may be a reflection of a disease, as may early or very late closure.

- The fontanelle does not require special care and nothing happens to touch it.

- The normal thing is that the fontanelle closes earlier in children than in girls and on average it happens between 13 or 14 months.

- If there is a small blow to the head, do not be alarmed in excess, since the fontanelle prevents the pressure from being concentrated inside the brain tissue.

- The size of the head is not linked to the intellectual capacity; what happens is that if the head closes too soon, the brain has no room to grow and could cause a series of problems in it.

In the care of babies do not have to be alarmists, so only in the case that the fontanelle of your child remains sunken or excessively bulging, for no apparent reason, is when you must go urgently to the pediatrician.

Ana Aznar
Adviser: Doctor Pedro de León Molinari. Pediatrician. Director of the Comprehensive Pediatric Assistance clinic.

Video: Live Q&A: Shape of baby's head, when to be concerned (craniosynostosis)

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