What is an abnormal soft spot?

Fontanelles that are abnormally large may indicate a medical condition. A wide fontanelle occurs when the fontanelle is larger in size than expected for the age of the baby. Slow or incomplete ossification of the skull bones is most often the cause of a wide fontanelle.

What does a normal soft spot look like?

Your baby's fontanelles should look flat against their head. They should not look swollen and bulging or sunken down into your child's skull. When you gently run your fingers over the top of your child's head, the soft spot should feel soft and flat with a slight downward curve.

When should I be concerned about my babys soft spot?

If you notice that your baby's soft spot appears swollen for an extended period of time, that is cause for concern. It could be a sign that your baby's head is swelling. If your doctor suspects brain swelling, they may request imaging tests and blood work to find out what's the cause.

What causes abnormal fontanel?

The most common causes of a large anterior fontanel or delayed fontanel closure are achondroplasia, hypothyroidism, Down syndrome, increased intracranial pressure, and rickets.

Is it normal for soft spot to be slightly sunken?

Less often, it can appear to be concave, or sunken. It's okay if it curves inward slightly to the touch. But if the soft spot is significantly sunken, it's usually a sign that your baby is dehydrated and needs fluids immediately.

Skull fontanelles

What does an indented soft spot mean?

A sunken fontanel occurs when the soft spot on a baby's skull becomes more deep set than usual. One of the major causes is dehydration. The human skull is made up from several bones that are connected by tough fibrous tissue called sutures.

What does a sunken soft spot feel like?

The fontanelles should feel firm and very slightly concave to the touch. A noticeably sunken fontanelle is a sign that the infant does not have enough fluid in its body.

How do you describe a normal fontanelle?

When assessing the fontanelles, use the flat pads of your fingers to palpate (gently feel) the surface of the head. Ensure you make note of any retraction or bulging, as the normal fontanelle feels firm and flat (not sunken or bulging).

When should I worry about a bulging fontanelle?

It is just as likely that an infection or trauma caused the crying or vomiting, as well as the swelling. Anyone who notices a bulging fontanel on their baby should take them to the hospital or call 911.

What does a bulging fontanel look like?

Changes in texture or appearance can be a sign of serious health issues. Parents should watch for soft spots that are curved outward on their baby's head and feel very firm. This is known as a bulging fontanel and may be a sign of brain swelling or fluid buildup in the brain. A bulging fontanel is an emergency.

What are the signs of craniosynostosis?

What does a sunken fontanel look like?

You may never be able to feel or see this one. The one on the top of the head 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. A soft spot with a noticeable inward curve is known as a sunken fontanel.

What is craniosynostosis?

Craniosynostosis is a birth defect in which the bones in a baby's skull join together too early. This happens before the baby's brain is fully formed. As the baby's brain grows, the skull can become more misshapen. Click here to view a larger image. Click here to view a larger image.

Why does my baby's head have a ridge?

In an infant only a few minutes old, the pressure from delivery compresses the head. This makes the bony plates overlap at the sutures and creates a small ridge. This is normal in newborns. In the next few days, the head expands and the overlapping disappears.

When should I be concerned about my baby's head size?

The simple definition of the word macrocephaly is "large head." Doctors apply that diagnosis when a baby's head size is in the 98th percentile. This means that the baby's head is bigger than 98% percent of other babies of the same age. Sometimes, doctors detect macrocephaly during an ultrasound before the baby is born.

What does a large soft spot mean?

Fontanelles that are abnormally large may indicate a medical condition. A wide fontanelle occurs when the fontanelle is larger in size than expected for the age of the baby. Slow or incomplete ossification of the skull bones is most often the cause of a wide fontanelle.

Does meningitis cause bulging fontanelle?

Conclusion: The finding of a bulging fontanelle has very low sensitivity and specificity for bacterial meningitis. Most causes of a bulging fontanelle in febrile infants are self-limiting diseases. The routine approach of performing a lumbar puncture in febrile infants with a bulging fontanelle should be reconsidered.

Can a small fontanelle be normal?

An infant with a normal head shape, size, and growth should reassure the primary care provider that an anterior fontanel that is small or not palpable at an early age has no pathology and can be followed at regular well-child visits.

How would you describe a fontanelle on a physical exam?

The anterior and posterior fontanelle should be soft to palpation. The anterior fontanelle should be between 1 and 3 cm in size and the posterior fontanelle should admit a fingertip. Following a vaginal delivery, over-riding of the skull bones may temporarily reduce the size of the anterior fontanelle.

What happens if baby's soft spot is pressed?

Can I hurt my baby's brain if I touch the soft spot? Many parents worry that their baby will be injured if the soft spot is touched or brushed over. The fontanel is covered by a thick, tough membrane which protects the brain. There is absolutely no danger of damaging your baby with normal handling.

How big should a soft spot be?

90 % of soft spots (the anterior fontanelle) close between about 7 and 19 months of age. The soft spot is often a diamond shape. But it doesn't always feel like that. It can be anywhere from a couple inches across to just finger tip in size.

Is it normal for my baby to have a dent in the back of her head?

There are actually two soft spots — one at the back of the head and another on top. The posterior one closes within a few months of birth, while the top fontanelle typically remains until just past a child's first birthday. Dr. Recinos explains what changes in the fontanelle can tell you about your infant's health.

At what age is craniosynostosis diagnosed?

Slight imperfections in your baby's head are normal, especially in the first month after birth. But as your baby grows, a misshapen head could be a sign of something else. The earlier you can get a diagnosis—ideally, before the age of 6 months—the more effective treatment can be.

How do you rule out craniosynostosis?

Imaging studies.

A computerized tomography (CT) scan or magnetic resonance imaging (MRI) of your baby's skull can show whether any sutures have fused. Cranial ultrasound imaging may be used. Fused sutures can be identified by their absence — because they're invisible once fused — or by a ridging of the suture line.

Is craniosynostosis serious?

If left untreated, craniosynostosis can lead to serious complications, including: Head deformity, possibly severe and permanent. Increased pressure on the brain. Seizures.