EXPERT ADVICE: The Fontanelles

Don’t panic ― that soft spot on your sweetie’s head is a normal part of their development.

Babies-EXPERT-ADVICE-The-Fontanelles

Shanelle Thomas, 32, still remembers meeting her newborn baby girl, who arrived after 12 hours of labour almost four years ago.

“They immediately put her on my chest and my heart burst with happiness,” Thomas recalls. “I never wanted to let her go.”

After all the necessary newborn checks were done, the new mama was bonding with and using her fingers to trace every one of her baby’s feature, when she suddenly realised that there was a slight depression on her little one’s head.

“I felt is as I stroked her hair ― it was at the top of her skull,” says Thomas. “I was worried that it might be a cause for concern.”

Initially, Thomas and her husband thought that the soft spot was caused by the forceps that were used during delivery. However, on consulting their daughter’s paediatrician, the couple learnt that it was a normal part of a newborn’s growth.

“We found out that the soft spot was called a fontanelle. The soft area makes it easier for baby to squeeze her way out of the birth canal and it also accommodates her growing brain,” Thomas notes.

As your baby’s soft spot may look and feel a little unusual, it’s completely natural for new parents to feel a little anxious about it. Paediatrician Dr Anita Menon answers your questions.

What is a fontanelle and why are babies born it?

Fontanelles are soft spots or gaps in the skull of an infant. There are two main fontanelles ― the anterior [at the top of the head] and posterior [at the back of the head]. The presence of the fontanelles at birth allow for compression of the skull bones when the baby is delivered through the birth canal. The fontanelles also allow stretching of the skull as the brain expands in the first one to two years of life.

How long will the baby have these soft spots for?

The anterior fontanelle usually closes by 18 months of age and the posterior fontanelle closes by 2 to 3 months of age.

Is a baby more susceptible to head injuries because her skull is not fully developed?

It’s important to note that the presence of the fontanelles does not predispose a baby to head or brain injuries. The fontanelles are covered by tough membranes, scalp skin and hair. There is usually no need for any special care.

Is it normal for the soft spot to throb?

It is normal to see or feel a pulsation on the fontanelle as it reflects the rhythm of the heart. It is due to the normal pulsation of the cranial arteries within the brain or in the meninges [covering of the brain].

When should we worry about the fontanelle?

A bulging fontanelle may be due to raised intra-cranial pressure, which may be a result of meningitis [an infection of the brain lining], encephalitis [a brain inflammation] or hydrocephalus [excessive fluid in the brain].

A dramatically sunken fontanelle may be caused by severe dehydration or extreme malnutrition. Sometimes, the fontanelles may fail to close when baby has severe hydrocephalus or may be slow to close in preterm babies and in babies with Down syndrome.

Other times, premature closure of the fontanelles [also known as craniosynostosis] may result in an abnormal head shape and facial features. It may impede brain growth, cause raised intracranial pressure and lead to other issues such as vision problems, developmental delays and learning difficulties.

GET TO KNOW OUR EXPERT…
Dr Anita Menon, a consultant paediatrician at Dr Anita’s Kid’s Clinic, has a special interest in infectious diseases. 

Photo: iStock

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