New parents may worry that combing their baby’s hair, giving them a bath or even stroking their baby’s head will damage the fontanel area. However, contrary to popular belief, this tissue, which is not extremely soft and sensitive, is extremely strong and acts as a shield against head trauma in babies. So, what is a fontanelle? When does it close? What are their functions? Curiosities are in our article.
What is a fontanelle?
The skull, made up of multiple bones, protects the meninges and brain tissue. During pregnancy, there are connecting ends between the skull bones and a diamond-shaped opening called the fontanelle. This part is also popularly called the ‘soft spot’. This area between the joints of the skull bones and made up of connective tissue is called the fontanelle. Until the end of pregnancy, there are 6 fontanelles, but on average 5 of them close before birth.
What is the Function of the fontanel?
Because brain growth is so rapid in the first 2 years, the skull bones need to be able to adapt to the growth. Since the skull bones are inflexible, the fontanelle is the only way to compensate for changes in pressure and volume inside the head. In newborn babies, the skull has not yet fully developed and taken its final shape. This helps the bones to overlap during labor, allowing the skull to flex and enter the birth canal. So the fontanelle makes birth easier.
Does Touching the fontanel Harm the Baby’s Brain?
Unless the fontanel is hit very hard, there is no harm to the baby. Contrary to popular belief, the fontanel is not a very sensitive and unprotected area. Therefore, simple interventions such as combing hair, cleaning mansions, washing and touching are not affected.
How to Check the fontanel?
Because the bone tissue is hard, the fontanelle can be felt when the baby’s head is stroked from the forehead to the back with light pressure.
Which Changes in the fontanel are Normal
- It is normal for the fontanel to swell during crying and breathing.
- Sometimes there is a pulsating movement in the fontanelle. This is normal as the fontanel moves with the baby’s heartbeat.
- During coughing, crying and vomiting, the baby may have a slight swelling of the fontanel.
What are the Conditions that Signal Danger Related to the fontanel?
In cases of fluid loss in the body, such as diarrhea and vomiting, the fontanel may collapse. This indicates that fluid loss is serious. Swelling in the fontanelle can occur in cases of meningitis, intracranial masses and increased cerebrospinal fluid. In addition, because of these problems, a child with swollen fontanelle looks unhealthy and has other symptoms. However, in healthy children this is unlikely, so there is no need to worry.
How long does it take for the fontanel to close?
The anterior fontanelle is normally 12-18. closes in a month. However, this period can be extended up to the 24th month. Some babies may also have an opening in the posterior fontanelle. This opening should close in 3 months at the latest.
Premature Closure of the fontanel
If the fontanel on the baby’s head cannot be felt when touched, this does not necessarily mean that it is closed. If the fontanel closes prematurely, the head usually continues to grow through the ends between the scaphoid bones. In such cases, the baby’s head circumference should be measured once a month. Therefore, the fontanel should always be evaluated by the doctor during monthly check-ups. However, premature closure of the fontanel may also indicate some health problems. This results in premature closure of the inter-bone spaces in the head and fontanelle;
- It can also be caused by a disease that prevents the brain from growing and developing (craniosynostosis) or can be associated with certain genetic diseases.
- It can create pressure inside the baby’s skull. If such conditions are suspected, an evaluation by a neurosurgeon may be necessary.
Why does the fontanel close late? In which cases is fontanelle larger than normal?
- Malnutrition
- Vitamin D deficiency
- Hypothyroidism
- Skeletal development disorder
- Hydrocephalus (conditions that increase intracranial pressure and cause enlargement of the skull)
- Subdural hematoma
- Osteogenesis imperfecta
Which diseases is the fontanel considered to be a symptom of?
The baby must be calm and in a sitting position to be evaluated for fontanelles during a routine check-up. The following signs will be considered normal if there are no additional symptoms and the baby’s general condition and well-being are good. However, if symptoms such as collapse or swelling in the fontanelle are observed, it should be evaluated for the related disease.
Collapsed fontanel In some fluid losses in the body, the fontanel may collapse. The way the collapse occurs gives information about the severity of fluid loss. In such cases, it is important to give the baby the necessary amount of fluid urgently.
Swelling in the fontanelle: Swelling in the fontanelle can occur in tumoral formations, meningitis and hydrocephalus.
The fontanel is more protruding than usual: This condition, which indicates increased intracranial pressure, requires a doctor’s control. If the baby has other signs of the disease, early intervention may be necessary.
Is Vitamin D given to babies for closing the fontanel useful?
It is recommended that all infants be given 400-600 units of vitamin D daily from birth, as breast milk is insufficient. This vitamin protects babies from rickets and promotes bone development, which is involved in the formation of the fontanel. This prevents the fontanel from closing late. Even if the fontanel closes early, vitamin D should be continued to ensure healthy bone development.