After a long journey of 9 months, when your little one finally comes into your arms, that cute smile, little hands, feet and the sensitive touch is really spell bounding. Sometimes, we fear to hold the baby tightly. We have also heard many times from our family members to be more careful while holding a new born in the arms. It is very important to carry a baby carefully, so that his head does not flop forward, and it is also advised to not to touch the top portion of the head. This caution is basically advised because of soft spots on the newborn’s head. These soft spots are called fontanelles.
The skull is made up of many bones. These bones usually join together to form a solid base that supports and protects the brain. The area where the bones join is known as sutures. In an infant, the space between the bones of a skull, where two sutures join firmly to form a membrane are known as fontanelles. The fontanelles allow the growth of the brain and skull during the infant’s first year as they are not joined together firmly at the time of birth. As there is no bone in that particular area, you can see or feel a pulse under the fontanelles. There are mainly two types of fontanelles with a variation in size:
- Anterior Fontanelle
- Posterior Fontanelle
Anterior Fontanelle – It’s like a soft spot at the top of the head. It is usually larger in size and is diamond or kite shaped. It normally closes at the time of 9 months but can be extended to 18 months of age.
Posterior Fontanelle – They are also look alike soft spots but occur at the back of the head. It is usually smaller in size and of triangular shape. It comes to close by the latest age of 8 weeks in a full-term baby.
You will be surprised to know that the baby’s head bones are too soft and relatively connected by a tissue that helps the baby to pass through the birth canal. The softness and flexibility of the bones help them to slide over the other and thus come out in open air smoothly. This whole process is known as moulding.
It is very important to have a check-up immediately after the birth. A routine medical check-up is also mandatory to assess the health of the newborn baby. In India, the baby usually gets a massage by pouring warm oil over the soft spots gently. In South India, a soft powder named – Raasnadhi Podi is applied over the soft spots to keep away cold and coughs.
Fontanelles also help to identify baby’s overall health. Your doctor will monitor the overall health after checking the head bones, whether they are developing naturally or not. It is very important to take extra care and place the baby in a crib to avoid any type of falls and unsafe incidents. It’s also safe to cover the baby’s head while stepping out from home in order to prevent the effects of weather variations.
Don’t ever try to follow any exercise by just listening to others as there is no proof which shows that applying pressure on baby’s head, will help to make it round. There is no doubt that these soft spots are well protected but still they need to be handled gently. Make sure any family member or a masseur does not press your baby’s head during the massage. As it may cause more harm than good.
The fontanelles remain slightly curved, firm and normal when the baby is in a calm, head-up position, but it will start bulging when the baby is crying, lying down and vomiting. It starts swelling because of the increased pressure of fluid in the skull.
Usually, the fontanelles get removed with a particular period of time. But if it gets closed too early or too late, then it may be a sign of a problem. So, don’t ever ignore the causes and the symptoms:
What Causes a Sunken Fontanelle?
The first cause of a sunken fontanelle is dehydration. Shortage of water and other essential fluids in the body, because of vomiting or diarrhea, is the main cause of dehydration. Symptoms of dehydration include
- Less urine output
- Urine of dark yellow shade
- Sunken eyes
- Feeling low
- No output of urine
The second main cause is Malnutrition. When infants are not getting important nutrients which are mandatory for their healthy growth, this lack of nutrients causes sunken fontanelle.
Some other causes are:
- Swelling (inflammation) of the brain, mainly due to infections.
- Excess buildup of fluid inside the skull.
- Increased intracranial pressure.
- Infection of the membranes covering the brain.
Have a look at the symptoms It is very important to keep an eye on your baby’s fontanelles. It helps to give you important clues about the overall state of the baby’s health.
- If the baby is having watery motions, the spots get sunken and lead to dehydration.
- If the spots are bulging, it may lead to a serious illness known as meningitis.
Do not hesitate to call your health provider or consult with a pediatrician if:
The fontanelles start bulging along with fever or excess drowsiness. It’s a time for the baby to be shifted to emergency care. Your doctor can easily diagnose the problem by checking the elasticity of the baby’s skin. Poor elasticity is a sign of low fluid levels. The level of moisture in eyes and mouth is a very helpful clue to check the baby’s level of hydration. It is also very important to discuss each and every symptom of you baby’s health with the doctor so that he can advise the diagnostic tests that need to be done immediately, that includes
- CT scan of the head.
- MRI scan of the head.
- Spinal tap (lumbar puncture)
Best ways to treat it: After a proper diagnose, if dehydration is the main cause, then it is important to fulfil the basic requirement of fluids in the body, either by mouth or through an intravenous (IV) line inserted into their arm. And if malnutrition is the cause, then fulfil the need of nutrients and fluids properly.
The growth of the baby’s head is a natural process. So, don’t try to play with it. This is nature’s clever way of temporarily making it smaller!
Image Courtesy: uploadwikimedia, areteneurosurgical, babyandcompany.