Nature carefully “thought out” the process of the birth of a child. She provided all the subtleties, so that the baby is born healthy. In order for the baby to quickly pass through the birth canal of the mother, its head is transformed and acquires an oblong shape, slightly flattened on the sides. Between the bones of the skull of the baby there are gaps filled with plates of connective tissue. These sites are called fontanels, and young parents have many different questions that concern them.
After birth, the baby has 6 fontanels, most of which grow very quickly. Therefore, parents simply do not notice them. But the main is considered to be the frontal, or large, fontanel, which remains open for a long period. He is responsible for cushioning, protecting the child from injuries and fractures during the fall.
When should the fontanel be overgrown? You will find the answer to this question in our publication.
Where are the fontanelles in the newborn?
The most noticeable of the fontanels is the large fontanel (BR). It is located between the parietal and frontal bones and is quite large, because its size is about 3 cm. This area has a diamond shape and upon careful examination, you can notice how it pulsates a little.
Many parents, wondering when a fontanel should grow in a child, are also interested in why it pulsates. This is because in this area there is a thin connective tissue that allows you to see the vessels of the brain and fluctuations of the cerebrospinal fluid. This process is physiological and absolutely normal. Do not worry. Also on the head of the newborn you can find a small fontanel. It is located behind the large, where the parietal and occipital bones are connected. It has the shape of a triangle, and its size is 5 mm. Very often, children are born with an already closed small fontanel. In other babies, it closes for 1 or 2 months.
A close examination of the child's head reveals two paired fontanelles that are located in the temporal areas. In another way they are called wedge-shaped. The second pair of fontanelles, called mastoid, is located behind the ear. All of them close quite quickly and have no diagnostic significance.
When does the fontanel in a child overgrow?
When trying to find the answer to this question, it is necessary to take into account the physical characteristics of the crumbs and many individual parameters. There are no strict criteria according to which the complete healing of the described site occurs. But most pediatricians are inclined to believe that overgrowing without deviation from the norm occurs at the age of 6 to 18 months. In some cases, the fontanel closes at 6 months or when the baby is one year old. Much less commonly, this occurs between the ages of 3 months and 2 years. It all depends on the individual characteristics of the baby.
Do not obsessively think about how much the fontanel should grow in a child. After all, each baby is a unique creation, all children have their own characteristics and physiological properties of the body. And if a neighbor’s boy has already healed, but your baby doesn’t have one yet, you don’t need to sound the alarm.
Factors affecting the fontanel closure rate
Being interested in the question of when the fontanel should overgrow, it is necessary to understand that there are some factors that affect the healing rate. So, the process depends:
- From a hereditary predisposition. It is important to understand that the size of the fontanelles during the birth of the baby and the rate of their overgrowth primarily depend on the genetic characteristics.
- From the gestational age at which the baby was born. If a baby is born ahead of schedule, it is slightly behind in physical development. Therefore, the deadlines for closing fontanelles are long.
- From the concentration of calcium and vitamin D in the body of the child. If the baby has a calcium deficiency, then his parents will certainly ask themselves the question of when the fontanel should overgrow, as they will notice deviations from the norm. If there is an excess of vitamin D in the body, then the cavity will disappear prematurely. However, the child’s diet is in second place. After all, the main reason for the deviation from the norm is metabolic disorder.
- From whether the mother took any medications during pregnancy. Doctors noted that there is a direct correlation between the size of the fontanel and multivitamin intake, as well as the pregnant woman’s diet.
It should be remembered that a hereditary predisposition directly affects the size of the fontanel in a newborn.
What is the norm?
Immediately after the child is born, the doctor examines the site and evaluates it. After that, he monitors the condition during monthly examinations. The pediatrician without fail pays attention to the size of the crown, the speed of its decrease, as well as the density of the bones that surround it.
If the child is healthy and full-term, the size of his fontanel is 2.5-3.0 cm. The doctor determines the diameter by palpation of the skull and making a measurement between the opposite sides of the rhombus. He will also advise the mother and tell you when the fontanel should grow in the baby approximately.
If the child is large and was born at a period of 41-42 weeks, the fontanel may be smaller.
In the event that the baby is premature, the size of its crown is 3.5 × 3.5 cm. In addition, it is worth knowing that a baby who is already 1 month old may have more BR than at birth. Indeed, during this period, active growth of the brain and bones diverge.
It is quite difficult to determine exactly what the parietal site should be for crumbs at different ages. However, there are approximate parameters, and here they are:
- At the age of three months, the size is 1.8-2.0 cm.
- Upon reaching six months, the fontanel in the baby decreases to 1.8-1.6 cm.
- At 9 months, this site has a size of 1.3-1.4 cm.
- By the year, the size of the fontanel is reduced to 0.4-0.8 cm.
This landmark is an approximation. And all because:
- Each baby has its own fontanel size at birth.
- The process of tightening the BR does not depend on its size.
It is very important to ensure that the described area is not too stressed and fontanelles are at the level of the bones of the skull. Slight swelling or dropping, and also ripple is allowed.
In addition, it is very important that the frontal and parietal bones located around the crown are sufficiently dense, without softening areas.
Deviation from the norm - is it worth it to worry?
How many fontanel should be overgrown and what is considered a deviation? Doctors consider ossification of the fontanel under 3 months too early. This situation can be observed as a result of the following pathologies:
- Craniosynostosis. In this case, the fontanel is rapidly tightened and the cranial sutures are completely fused, which impedes the normal development of the brain. Pathology is congenital or acquired. In most cases, it is accompanied by other violations in the development of the child.
- Microcephaly. With this disease, we can talk about severe deviations in the development of the central nervous system. A pronounced sign is a reduced head size, a violation of proportions relative to other parts of the body.
- Anomalies in the development of the brain. Here we are talking about violations of its structure, a decrease in size and weight.
The deviations described are rare, and manifestations in the form of a rapidly growing fontanel are not enough for an accurate diagnosis. As a rule, the child has other symptoms of the disease. Each mother will be interested in what age the fontanel of a child should grow if she observes that it closes more slowly. Such a deviation from the norm is much more common than the first, and may indicate the following problems:
- Congenital thyroid disease. In this case, the child has drowsiness, low activity, poor appetite, constipation, digestive disorders, swelling.
- Rickets. Quite often, such a disease occurs in premature babies. It also occurs with a lack of vitamin D and calcium in the baby's body. In a child, sleep is disturbed, appetite decreases, nervous excitability increases. He also begins to sweat a lot, while the sweat smells of an acidic smell.
- Chondrodysplasia This pathology is a genetic disease of bone tissue. The child has a growth lag, he also has shortened limbs. The disease leads to dwarfism.
- Down disease, in which the child lags behind in development.
Of course, all parents think about when the fontanel should grow in the child. Fortunately, serious pathologies are rare in babies, and in order to confirm the diagnosis, it is necessary to be comprehensively examined.
Opinion of Dr. Komarovsky
How much should the fontanel in a child grow in the opinion of Dr. Komarovsky? This doctor says that the timing for each baby is purely individual. And there is nothing surprising in the fact that even in a healthy child, BR can grow up only by two years, this is normal. It is also unlikely that a baby who develops without alarming signs of the disease has rickets or other ailments. You can not make a diagnosis only because the fontanel overgrows too slowly or quickly. The doctor also says that in this case, an additional intake of vitamin D will not hurt. Do not worry about when the fontanel should overgrow. Komarovsky recommends not to panic for no reason.
What does the doctor pay attention to when examining the crown of the head?
Are there any parameters according to which the state of the BR is assessed upon examination by a doctor? Yes, the doctor evaluates the situation according to the following criteria:
- Examines the fontanel and finds out how much its size corresponds to the age of the baby.
- Establishes how many fontanelles a newborn had at the moment of birth and compares their number with today's.
- It looks at how fontanelles have changed, how fast they are decreasing, and whether their shape has changed.
- Feels the edges to prevent softening.
- Determines whether the site is sluggish, sunken, bulging, or stressed.
The doctor not only knows how many months the fontanel should overgrow taking into account all the factors, but it will also be able to determine whether the condition of the child is pathological.
A newborn has a bulging fontanel
Quite often, a bulging fontanel is accompanied by encephalitis, cerebral hemorrhage, or meningitis. In such diseases, high intracranial pressure is observed, which leads to the fact that the described area swells.
However, there is no need to make hasty conclusions and panic. Brain disease is a serious pathology, and a symptom such as bulging fontanel cannot be the only one. If the parents observe other threatening signs of deviations from the norm in the child, it is necessary to consult a doctor as soon as possible.
Here are the symptoms that you should definitely pay attention to if the child has a bulging fontanel:
- Temperature that is almost impossible to bring down.
- Attacks of nausea and vomiting.
- Lethargy and drowsiness.
- The presence of seizures.
- Loud cry of the baby or irritability.
- Loss of consciousness.
- The appearance of strabismus.
You should also be wary if the site began to bulge after a child’s injury resulting from a shock or fall.
Sunken fontanel
If you are interested in the question of what time the fontanel should grow, and suddenly noticed that it seemed to be pulled into the skull box, this may indicate dehydration of the baby. BR changes shape, dropping below the bones of the skull and indicates an acute lack of fluid. If there is a high temperature, repeated vomiting and upset stomach, then this indicates a significant loss of fluid. This condition is pathological. The skin becomes overdried, the child does not feel well, cracks appear on his lips.
It is very important to give your child a drink or breastfeeding. After this, you should immediately consult a doctor in order to correctly replenish the lost fluid and get an appointment for further treatment. It is best to call an ambulance.
Why does the fontanel in the baby pulsate?
In the process of vital activity of the body, an active supply of blood to the brain occurs. The vessels of this organ are located close to the heart muscle, and when the blood moves, tremors and pressure increase are observed. In this case, the pulsation spreads to the lining of the brain and the plate, which covers the frontal fontanel. If slight pulsation is observed, then this can be considered the norm. However, if the pulsation is too strong, you should consult a doctor to find out the cause of the violation.
Conclusion
The article examined the question of how long the fontanel should grow in a child. Despite the fact that there are rates of overgrowth of the BR and usually this process ends by one and a half years, in some cases there are slight deviations in healthy babies. Therefore, speaking about when the fontanel of an infant should overgrow, it is important to understand that there are no clear boundaries. However, parents should be wary if the child quickly grows together with BR, and he has not yet three months. In this case, as in others, it is better to seek the advice of a doctor.
Also, there is a more rapid closure of the fontanel when the baby fully eats and gains weight well, but this is not a pathology. So, in babies who are breastfed, there is a more rapid overgrowth of the described area than in artificial babies.
It is strictly impossible to self-medicate and prescribe medications to your child yourself or use folk remedies. It is very important to follow the rule: contact a pediatrician in case of suspicion. The specialist will prescribe additional examinations, and this will preserve the health of the child. You should not only pay attention to the size of the fontanel, but also observe its condition.