The fontanelles are part of the baby’s skull and have an indispensable role in the development of the brain. Fontanelle that moves, that beats, that widens, early closing… What to monitor, up to what age? We take stock with pediatrician François Vié Le Sage.
THE fontanels represent two specific areas on the baby’s skull. During childbirth, they will allow facilitate the passage of babyand over the months of his life, they will play a essential role in brain development. Parents can easily touch them, as they are softer than the rest of the skull. They may also deform slightly: the fontanelles may be sunken, bulging, or swollen, or throbbing like a heartbeat. What to watch out for on baby’s fontanelles? When to worry? Answers with pediatrician François Vié Le Sage.
What is a fontanel in babies?
AT the birth, baby’s head bones are not yet well welded, and that is why you can feel soft spaces between the different bones of the skull. “These areas that are both flexible and solid are the fontanels. They will allow the brain to develop, and the skull to follow the development of the brain”, explains the pediatrician.
“There are two fontanels on the baby’s head, two membranous zones, one anterior and one posterior. In the baby’s skull, there are sutures, that is to say the bones are not welded, and the fontanelles make the junction of these sutures”, he adds. ITo large fontanelis located forward, on top of the infant’s skull. AT the back of the head, there is the small fontanel.
“The fontanelles will allow the brain to develop, and the skull to follow the development of the brain”.
At what age does the baby’s skull take its final shape?
Little by little, the infant fontanels will close, and their ossification varies from one baby to another. “The anterior fontanel closes around the age of 20-24 months. The posterior fontanelle, towards the occiput, at the back of the skull, closes much earlier, around the age of 2-3 months and often the child is born with this fontanel already closed”. says the doctor.
“The anterior fontanelle closes around the age of 20-24 months”.
An early closing of the fontanels, is it worrying?
If the fontanel is closed early, “this may pose a problem for skull growth. This is called a craniosynostosisit’s a semi-emergency”, says the health professional. This is a malformation of the skull on the sides, in width and in length, or a deformation of the forehead. This can be corrected by surgery on the skull, by reopening the sutures to allow extension of the skull. The doctor will therefore take advantage of this examination to check the measurement of the head circumferencewhich will be plotted on a growth curve in the health record.
Are the fontanelles fragile?
The fontanelles are not in themselves fragilethey are soft certainly, but they are also very solid. “The fontanels are definitely the strongest area of the skull. When children fracture their skulls, they break their bones more.”, says the pediatrician. Of course, you should not exert too much pressure on the fontanelles.
Parents should also know clean the fontanelles properly. “Parents are often afraid to rub on the fontanelles, because they are soft, they sometimes move. However, do not hesitate to rub with a soft glove, with soap, without pressing hard, because it is often on the fontanelles that there are more milk crusts”, concludes Francois Vie Le Sage.
Why does a fontanel beat?
THE baby fontanels will not always look the same depending on whether the child is crying, coughing, screaming or calm. A beating fontanel is explained, because below the fontanels there are venous sinus where blood circulates. VYou can gently touch them and feel a little beatsign that all is well!
Why is a fontanel hollow?
A fontanel widens also if the child is sleeping and calm, it is normal. On the other hand, in severe cases, “a sunken fontanel may be the sign of very severe dehydration in the child“, emphasizes the expert, qualifying that “it is a sign to be taken as a whole with other parameters, we should not base ourselves solely on this sign.”
Why do the fontanels bulge or swell?
THE fontanelles may be bulging or swollen in reaction to the baby’s behavior, which is also completely normal. However, a persistent bulging or swelling of the fontanel anterior while baby is calm can be concerning. This may be a sign of a intracranial hypertensiona brain tumor, or meningitis. However, these problems are rare.
Just be vigilant if other symptoms appear: diarrhea, digestive disorders, significant decrease in urine, skin folds, depression in the eyes. In this case, you should quickly consult your doctor.
What to look out for with baby fontanelles?
You will notice this very quickly during appointments with the pediatrician: this one monitors infant fontanelsand in particular the head circumference. He will palpate the largest fontanelle, to follow its evolution, which is a sign that the bone structure of the skull forms correctly. From birth to two years of the child, he will therefore touch them to check that everything is fine and systematically take the measurement of the skull, even sometimes until the child is 3-4 years old.
With these observations, the doctor will make sure that there are no pathologies, such as :
- Craniostenosisif the fontanelles close too quickly (not to be confused with a plagiocephaly).
- Hydrocephalusif the growth of the skull is too rapid.
- Ossification problemdue to a lack of calcium and vitamin D, which causes the skull to be too soft and not solidify.
Thanks to pediatrician François Vié Le Sage.