IN THIS ARTICLE
- What are baby’s fontanels?
- When will my baby’s fontanels go away?
- What are signs of an abnormal fontanel?
Welcome to motherhood, where everything you do and see, you’ll question. It’s all so new, mysterious, and difficult to know what’s normal and what we should be concerned about. One of the greatest joys you’ll ever experience is when you hold your baby, but with that also comes the realization of how fragile they really are.
One of those mysteries are the fontanels, the soft spots on your baby’s head. These often cause alarm with new parents, who are unsure what they are, if they are safe to touch, and how long they may take to go away
What are the fontanels?
The fontanels are joints called cranial sutures that hold the bones of your baby's skull together until the bones fuse. The largest of the four fontanels is located at the front of the baby’s skull (anterior). The anterior fontanel is the soft spot you feel just behind your baby's forehead. The next largest fontanel sits at the back (posterior) of the baby’s head. Each side of the skull also has a tiny fontanel.
When do the fontanels go away?
The fontanel on the back of the head usually disappears by 1 to 2 months of age. You may never be able to feel or see this one. The one on the top of the head, which is called the “soft spot,” remains present until your baby is between 7 and 19 months old. A baby's soft spots should be relatively firm and curve ever so slightly inward. If you notice abnormalities with your baby’s fontanels, check with your pediatrician who can tell if the appearance and shape of the fontanels are normal.
Dr. Alan Greene, a pediatrician from California, points out changes in the shape and texture of the fontanel that may signal a problem.
“The fontanelles should feel firm and very slightly curved inward to the touch. A tense or bulging fontanelle occurs when fluid builds up in the brain or the brain swells, causing increased pressure inside the skull,” Greene advised. “When the infant is crying, lying down, or vomiting, the fontanelles may look like they are bulging.”
There are several fontanels on a newborn's skull, located mainly at the top, back, and sides of the head. Like the sutures, fontanels harden over time and become closed, solid, bony areas.
• The fontanel in the back of the head (posterior fontanel) most often closes by the time an infant is 1 to 2 months old.
• The fontanel at the top of the head (anterior fontanel) most often closes between 7 to 19 months.
Contact your doctor immediately if your infant has an excessively bulging fontanel, especially if it occurs along with fever or excessive drowsiness. Dr. Violette Recinos of the Cleveland Clinic pointed out the following warning signs that can signal an irregular fontanel.
5 signs of an irregular fontanel
- Sunken-in soft spot — This is often a sign of dehydration. It may occur if your child is sick and not getting enough fluids.
- Swollen soft spot — After a fall, a swollen soft spot (particularly if it’s accompanied by vomiting) is sometimes a sign of head trauma.
- Bulging soft spot — Fluid buildup, also known as hydrocephalus, can cause rapid head growth and can make the soft spot look “full.” A bulging fontanel also might signal internal bleeding, or a tumor or mass that is causing pressure in the head.
- Disappearing soft spot — Most of the time the soft spot is obvious, particularly on a newborn. But at times it can seem to disappear quickly. This may scare parents, but it typically means it’s just a “quiet fontanel,” not that it has fused together prematurely.
- Soft spot that doesn’t close — If the soft spot stays big or doesn’t close after about a year, it is sometimes a sign of a genetic condition such as congenital hypothyroidism.
In any of these cases, Recinos suggested that parents talk with their doctor about the cause of the irregularity and treatment options.
Don’t be alarmed at a pulsing fontanel
There will be times when you see your baby’s pulse in their fontanel. Don’t worry about this, it just means your baby's circulatory system is working normally. The fontanels cover areas of the skull that have not yet fused together. They’re soft, making veins and arteries visible, so you can relax and know that this is perfectly normal.
Is it safe to touch the fontanel?
“Touching your baby’s soft spot will cause brain damage.” This old wives' tale is false. Mom Gretchen White said she loved running her fingers over her little one's head, but was shaken up by an experience that she had with her mom and mother-in-law. “I lost my mind and started to cry because my mother and mother-in-law both said I harmed my baby,” White said.
Let’s talk about this. If you had a vaginal birth, your baby has already been through more than you touching the top of their head. Don’t freak out if you happen to touch the fontanels. Be assured that — no matter what well-meaning relatives might try and tell you — you're not touching his brain.
Are you wondering what you’re touching? It is a thick and protective membrane, and the soft spots actually exist so that your baby can safely pass the narrow birth canal.
So, while the fontanels might be a bit of a mystery to new parents, rest assured that they’re perfectly normal and will disappear by the baby’s 2nd birthday. You’ll have plenty of other things to worry about until then.
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