Small fontanel in newborns

Among many parents, a variety of reasonings go around the fontanel. At the same time, for some mothers, such a definition for some reason raises some concerns. It’s even scary to touch this place - all of a sudden, due to careless movement, you can injure the baby ?! But not every woman understands exactly what a large or small fontanel means. Yes, there are several of these in newborns. But what is he like? Let's try to understand this seemingly complex term.

Anatomy lesson

In order to fully disclose the definition of the fontanel (it is also called a temechka), it is worth diving into the anatomy. The human skull is represented by several bones that are connected by seams. These are zigzag, jagged and jagged lines. But this is already in adults.

In the period of intrauterine development, everything is just beginning to develop. Skeleton bones are formed in the form of plates of dense webbed tissue. Subsequently, cartilage tissue forms, which, in turn, is then replaced by bone.

The ossification of the upper and lateral parts of the skull occurs differently than the formation of long tubular bones of the arms and legs. There is no longer the stage of cartilage. In other words, the ossification points begin to appear in the center of each webbed plate. Then they spread in all directions to the edges, covering an increasingly large surface.

Actually, as a result of this, a large and small fontanel in newborns is formed. This process occurs throughout the period of intrauterine development, and by the time the childbirth begins, almost the entire skull of the baby is represented by the bone surface. At the same time, this biological tissue is different from that inherent in the skull of an adult. In a born baby, this is a thin and elastic layer, which is penetrated by a large number of blood vessels.

Mothers should not panic when doctors feel the fontanel on the head of their baby. Despite the fact that this “breathing” area seems vulnerable, in fact, this is not worth fearing. This thin fabric is at the same time quite dense and strong despite the deceptive appearance. Therefore, the manipulations of doctors in no way harm children.

We reveal the definition

Now we are getting to the essence of the large and small fontanel. But for starters, it’s worth once again to make sure that Mother Nature is perfect. But not all of her secrets regarding the origin of man are known to us. But something is open to us. It is about preparing the child for labor. Nature took care of this. The bottom line is that some parts of the bones by the time of the birth of the child remain in the form of webbed plates. But this is nothing more than a fontanel.

In some cases, the plates may increase, which is evidence of prematurity or indicates a violation of the intrauterine process of ossification. In addition, this may be the reason for the development of congenital hydrocephalus (excessive accumulation of cerebrospinal fluid in the brain).

As the child develops, both the large and small fontanel in newborns (including the lateral areas) hardens and becomes an extension of the bones of the skull. In the language of doctors, this is called the closure of the little girl, which is partly true. Moreover, the pace and timing of this process indirectly indicate the normal development and well-being of the baby.

How many fontanelles does a child have?

By the time the baby is born, there are 6 of them - two unpaired (large and small) and the remaining 4 on the sides of the head. Paired records are:

• Wedge-shaped fontanel. It is located in the temporal zone: in the place where the frontal, parietal, sphenoid and temporal bones converge on each side.
• Mastoid crown. Its localization is the area behind the ear, and more precisely where the occipital, temporal and parietal bones are connected.

But among them all, the most important are unpaired webbed plates (about them a little later). As for the rest, they grow over the next days and weeks after the birth of the baby. But why, in fact, need a large and small fontanel? This will be discussed in the next sections.

Functionality

Here you can once again be amazed at our nature. The formation of fontanelles occurs for a reason. First of all, it is worth noting that, at the time of the birth of the baby, the hardened bones of the skull can not only bend, but also shift, which allows him to adapt to the dimensions of the female pelvis during the movement along the birth canal.

As a result, the risk of injury to a mother and her baby is markedly reduced. For this reason, the newly appeared head of the newborn looks deformed. However, you can not worry about this, because already in the first days of the baby’s life, his skull takes on a normal shape.

The second point - soft, pliable, elastic and springy webbed plates can serve as a kind of shock absorber and airbag when the child bumps his head or falls. According to statistics and life experience, most cases of head injuries occur in the first two years of a child’s life. In other words, at a time when the crown is just closing.

And when a small fontanel on the back of the head (or front) overgrows? We will certainly touch on this issue, but a little later, but for now it's worth considering another equally important function. The role of the fontanel is also reduced to the fact that its presence avoids the possible overheating of the brain. But the process of thermoregulation in babies has not yet been properly established and they are not yet able to give off heat, and do it quickly if necessary.

For example, in case of fever. In such a critical situation, the fontanel is a real salvation. After all, it is not for nothing that he has a thin fabric, and, in fact, due to this, excess heat is passed through it.

Small caliber

Now it’s worthwhile to dwell in more detail on a small little Tiechka and understand which bones of the skull form a small fontanel. Its location is on the back of the head, and for this reason it is called even the back. As a rule, in babies it completely closes by the second or third month of their life. For this reason, in the future, pediatricians simply cease to pay attention to him, shifting their eyes to the front of the fontanel.

At the same time, cases when the elastic plate is closed before the baby is born are not so rare. Often it is palpated from premature babies or infants born earlier than the due date. In addition, there is evidence that no more than a quarter of full-term babies are born with an open crown.

As for the size, the "small caliber", therefore, is called that. After all, the dimensions of the small fontanel are usually not more than 5 mm.

Big caliber

As for the “large-caliber” little tempechka, its localization is the area where two frontal and two parietal bones meet. It is he who is also called the anterior or parietal (from the eponymous bone). Among all the fontanelles on the head of children, it is he who is the largest, but also the most significant.

Moreover, it is easy to detect even with the naked eye, which most parents are worried about. In addition, due to its size, the fontanel is closed by the very last, when others are already completely overgrown. But again, this is where its functionality lies.

In its shape, the front little crown resembles a rhombus, while the smaller one resembles a triangle (we already know where the small fontanel is located). Moreover, it is clearly visible that it is in this place that a very soft fabric. Against the hardened bones of the skull, the rhombus stands out noticeably. But in addition to this, the little girl can perform various actions:

• throb
• sink;
• bulge out;
• to get the wrong shape.

And when the doctors in the conversation during the examination of the child mention that the fontanel is overgrown early or closes for a long time, this refers to a large plate.

Dimensions Temechka

Since all other fontanelles (with the exception of the large one) close faster, we will henceforth consider the anterior section due to the same high significance. At the time of the birth of the child, its sizes vary from 22 to 35 mm (the dimensions of the small fontanel are already known to us). Deviations of several millimeters to a smaller or greater side need not be evaluated as a pathology.

But it should be borne in mind that the brain of a born child during the first 2-3 months of his life is growing rapidly. For this reason, during the expansion of the bones of the skull, including interosseous sutures, the fontanel may slightly increase. At the same time, this in no way can be attributed precisely to the growth of this site, all this, mainly due to a change in the shape of the little head. In the following days, it begins to decrease.

The table below shows the average size of the fontanel, depending on the age of the child (months).

To determine whether the size of a large or small fontanel in a baby is within normal limits or whether this can be considered a pathology, only a doctor can. To do this, he carries out calculations according to a special formula. In this regard, parents should not be judged only by the data from the table above, they are given as an example. However, in case of discrepancies, you can contact a specialist for advice.

Closing dates

As for the timing of the complete closure of the anterior tempech, here, due to various criteria for the development of children, everything is due to the individual characteristics of the young organism. And in this regard, these indicators in children differ among themselves.

As noted by pediatricians, in contrast to the term of closure of the small fontanel, a large crown grows noticeably slower. Its full overgrowing can take from 3 months to 2 years. As you can see, this interval is quite extensive, and any closure that occurred precisely in this period should be considered the norm. And judging by numerous observations, this process ends closer to the child's two-year-old age or a little later. Moreover, it proceeds noticeably faster in boys than in girls.

However, if the baby closes the front elastic “membrane” much earlier or later than the mentioned period, there is a need for its examination. Only in this case, the process should not be regarded as unfavorable or pathological. There are a large number of examples where it took 3 years for children to completely close the crown. And while they remained completely healthy.

And when does the small fontanel close? Often, by the time a child is born, he is already overgrown. But if its presence is still detected, then a complete closure will occur within the next two or three months.

The position of the fetus relative to the genital organ

Analyzing the topic of fontanelles, one more important point should be considered, which concerns the determination of the position of the fetus in the cavity of the genital organ. Actually for this purpose, certain studies are carried out during the entire period of bearing a child. But in particular they are important for the period of the third trimester and at the time of labor.

In this case, depending on the type of presentation of the fetus, the method of its birth on the light will depend. And if it is longitudinal, that is, the axes of the uterus and the baby coincide, which means that childbirth can take place naturally. Experienced specialists can determine this by the position of the small fontanel - left, front, when viewed from the exit side of the female pelvis. It also indicates an occipital presentation. But the transverse or oblique position of the child in the cavity of the genital organ is already a pathology.

Fortunately, optimal presentation is more common - in 99.5% of cases, the remaining 0.5% of births are due to oblique or transverse presentation of the fetus. And it is worth noting that the position of the child, which is not the norm, is often a direct indication for cesarean section surgery. With a pathological situation, certain obstacles arise for the birth of a child. Therefore, the appropriate procedure is assigned.

To everything else, it is important not only the position of the child in the cavity of the genital organ in relation to the axes (him and the mother), it matters what exactly is directed towards the entrance to the woman’s pelvis:

• head;
• buttocks (gluteal previa);
• buttocks with legs (mixed presentation).

The last two cases are of the pelvic type, which, in turn, is regarded as a pathology. In this case, this can be associated with a number of complications, including spontaneous termination of pregnancy at a later date. Therefore, if during the next scheduled examination of a pregnant woman (closer to childbirth), she hears that the small fontanel is on the left, then the child is in the only correct position.

The rapid overgrowth of the little girl

It is unlikely that parents are able to determine that their child’s fontanel closes early, or that it is too small. Another thing is a doctor. And if he comes to this conclusion, he will certainly assess the general condition of the child. Early overgrowth of an elastic and at the same time dense area in newborns can indicate a number of pathological signs.

There are very dangerous diseases and no less serious disorders among infants, which are exactly manifested by similar symptoms. But accordingly, in addition to the early closure of the fontanel, other characteristic signs appear that indicate a particular problem. Among them may be the following cases:

• Craniosynostosis. Pathology of bone tissue in children is quite rare and just arises against the background of early overgrowth of the little crown. This causes an increase in intracranial pressure, deformation of the head, and also leads to impaired hearing or vision. Pathology can be congenital or acquired.
• Microcephaly. The small size of the large fontanel may indicate the development of this pathology. In this case, the baby's head is pathologically reduced, including the brain itself. As a result, babies are lagging behind in development. The provoking factors of the disease include congenital rubella or herpes viral infection.
• Leukomalacia. Here, the brain tissue is softened due to the effects of congenital diseases (syphilis).

Fortunately, such problems are rare.

At the same time, if the little head closes rapidly, but at the same time the parameters of the child’s head correspond to his age, and his health is good, then this should not be regarded as a pathology. Perhaps this is also the reason that the large or small fontanel closes faster than expected, lies in the individual characteristics of the young organism. Then there is simply no reason for concern.

Therefore, if during the examination of the child, the parents hear from the doctor the phrase that the fontanel is rapidly overgrowing, but does not focus on its condition, then you should not be scared.

Why doesn’t the temech overgrow?

In addition to the situation described above, another case may arise, and exactly the opposite - the little thing remains open. What could be the reason? But in many forums, parents often discuss this point. If the fontanel does not close when the child is a year or two, it is worth remembering that there were cases of its overgrowing at the age of three. Moreover, this did not have any effect on the development of babies. In addition, in each case, the closing dates of a large or small fontanel are purely individual in nature.

At the same time, the likelihood of a disease should also not be ruled out. And the fact that the little thing does not overgrow may indicate the development of pathology:

• rickets;
• disruption in the work of phosphorus-calcium metabolism and the metabolism process;
• congenital skeletal disease;
• hypothyroidism;
• Down syndrome;
• achondrodysplasia.

Such conditions are not limited to only an unclosed Temiech; accordingly, other manifestations can be observed. Assessing the size of the fontanel in a child, you should first pay attention to how the growth of his skull occurs. It is also necessary to take into account the general condition of the baby.

And if the child does not bother anything, he eats well, sleeps, there are no deviations in development and other health problems, then parents should not panic. In this case, the size of the little head is assigned a secondary role. To exclude the likelihood of pathology in relation to the large or small fontanel, it is worth visiting a doctor, who in case of which will dispel or confirm all fears.

In addition, until the child turns one year old, he must undergo scheduled examinations, which will allow him to identify any violations in a timely manner. Therefore, in any case, parents should not have cause for concern. And instead of panic, it is better for them to fully engage in their baby, which will only benefit everyone.