When your baby is born, he has six soft spots around his skull. The anterior fontanelle is the one that you are most familiar with, as it is the most prominent and takes the longest to close. Soft spots are gaps between your child's skull bones that allow for rapid brain growth. Abnormal changes in soft spots like sinking, bulging, being larger than normal or taking too long to close can indicate a problem.
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If your baby's soft spot is bulging, this is abnormal. A soft spot that feels like it us under pressure or sticking out, even while you baby is sitting upright and relaxed, can indicate a problem. This may mean that fluid is building around your baby's brain causing the pressure around the brain to increase. The soft spot should normally bulge out slightly if your baby is crying, lying down or vomiting. However, if this is not the case, bring your infant to the emergency room. A bulging soft spot may indicate meningitis, encephalitis or hydrocephalus.
Normally a soft spot should be bend slightly in. However, a sunken or deeply bent in fontanelle is not normal. If your baby's soft spot is sunken, this may indicate he is dehydrated or malnourished. Seek immediate care for your little one and encourage him to eat or drink.
Your baby may be born with an excessively large or wide fontanelle. According to the website Medline Plus, these are typically a result of Down syndrome, premature birth, reduced growth or development in utero, hydrocephalus or achondroplasia. Generally, a large soft spot is seen at birth, but if you suspect your child's soft spot to be larger than it should be, contact your doctor. Further tests can evaluate whether or not your child has an underlying problem.
Normally, a baby's soft spot is 96 percent closed by 2 years of age, according to the "American Family Physician." If your baby's fontanelle takes longer to close, it could be a sign of an underlying condition. Typically, delayed closure of a soft spot is a sign of achondroplasia or hypothyroidism. Your doctor will monitor your baby's soft spot at each visit. If you believe there is cause for concern, speak with your doctor.
- "American Family Physician"; The Abnormal Fontanel; Joseph Kiesler, M.D., et al.; June 2003
- Medline Plus; Fontanelles -- Bulging; Neil K. Kaneshiro, M.D., M.H.A.; Jan. 24, 2011
- Medline Plus; Fontanelles -- Sunken; Neil K. Kaneshiro, M.D., M.H.A.; Jan. 24, 2011
- Medline Plus; Fontanelles -- Excessively Large; Neil K. Kaneshiro, M.D., M.H.A.; Nov. 2, 2009