Update: December 2018
The birth of a child is a miracle not only in philosophical understanding. This and
technically a miracle. Nature has thought this process to such an extent
that for passing through the birth canal of the mother, the head of the child
able to decrease in size, to acquire an oblong shape and
This is facilitated by the presence of gaps between the bones of the skull,
filled with connective tissue plates. These are fontanelles,
condition, overgrowing and bulging which so often bothers
Despite, что их при рождении шесть, пять из них зарастают
so fast that many parents don’t even have time to learn about their
the existence of. All worries pass around the most noticeable fontanelle.
– frontal or large fontanelle (BR).
If the destination of the small fountains ended after birth,
then big in children continues to perform depreciation functions,
preventing fractures and injuries of the skull during falls and bumps.
When does the spring of a child close?
If your child is already a year old, and his spring is not overgrown,
no cause for concern. Normally this physiological process
ends in 1-1.5 years. If the timing of its closure to your baby
do not fit into the norm, then see a doctor. He will determine that
is this cause: a disease or developmental feature
What should be the spring OK?
After giving birth, and also monthly when visiting a doctor,
a pediatrician assesses his condition, size, rate of decrease,
density of surrounding bones.
Normal size of the fontanel in a healthy, full-term baby is equal
2.5 – 3 cm, which is estimated by palpation and measurement
distances between opposite sides of the rhombus. Premature
children have a larger BR, about 3.5 to 3.5 cm. And large
children born on 41–42 weeks may have a smaller BR. Everything
this is a variant of the norm. By the way, the spring of a month old baby
may be somewhat more than at birth. This is due to
intense brain growth.
What should be the size of the BR at a certain age, say
just can not. Some sources indicate the following figures:
- 1.8-2 cm in three months;
- 1.8-1.6 cm in half a year;
- 1.3-1.4 cm at 9 months;
- 0.4-0.8 cm per year.
However, you can only focus on them approximately
- All children initially different sizes (within normal limits).
- The size of the spring does not affect the growth rate. Big can
drag on a year, and a small one in 1.5 years.
However, all springs during the inspection should not be tense, not
bulging, to be at the level of the cranial bones. Permissible so that
the spring slightly sank or protruded, and also pulsed. Frontal and
parietal bones surrounding it should be dense, without areas
What to do if the spring does not close?
If by the age of 18 months the baby is still closed the spring,
you need to see a doctor. This may be the norm for your
child, and may be a symptom of a pathological condition.
|Pathology||Impact on BR�||Additional study||Your actions|
|Rickets||As a result of calcium deficiency, the bones soften, including
skull bones. BR is long open, the edges of the bones are softish to the touch.
Appear lethargy, sweating in a dream, baldness of the neck. On
ribs and wrists form bone growths. Bend
shins (see rickets in infants)
||Therapy with therapeutic doses of vitamin D|
|Achondrodysplasia||Disease of bone tissue, which leads to dysplasia.
The skeleton becomes disproportionate, the limbs are short, and the head
massive and wide. Long does not delay the BR.
||Onзначают гормон роста соматотопин|
|Congenital hypothyroidism||A lack of thyroid hormones, which also regulate and
bone growth leads to prolonged overgrowth of the fontanel. Besides
In addition, the child has constipation, a nasal voice, sometimes combined with
umbilical hernia. Children are lethargic, drowsy, often large.
||Thyroid hormone replacement therapy|
|Hydrocephalus||The increased pressure of the liquor prevents the cranial bones from converging.
Together with the BR, which rises above the bones, increases and
Head circumference. Additionally, the child may have seizures,
developmental delays, problems with hearing and eyesight.
Treatment противосудорожными, мочегонными препаратами,
Sometimes they carry out shunting.
The spring in a baby quickly grows, what to do?
If the child has a small fontanel, then consultation is required.
pediatrician, endocrinologist and neurologist. By the way, in 1% of cases a spring
may overgrow in 3 months. This is unusual, but if everyone else
development indicators are normal, all is well. But sometimes small
Dimensions disprove pathology.
|Pathology||Impact on BR�||Additional study||Treatment|
|Craniosynostosis||The sutures of the skull and fontanelles quickly and early fuse. Can
occur deformation of the skull, jaw, secondary hydrocephalus.
||Surgical suture incision|
|Microcephaly||Anomaly of brain development in which the bones of the brain
the skull ceases to grow, and the facial continues to grow. Head
the brain remains small and underdeveloped. Developmental delay.
|Increased function of the parathyroid glands||Disruption of calcium and phosphorus metabolism leads to an increase in
blood calcium. The early closing of the spring is combined with pain in
bones, arrhythmia, kidney damage, gastrointestinal
If too big fontanel
Large BR is considered when sizes greater than 3.5 cm. This may be
normal in premature or immature babies. For the rest is required
консультация детского невролога и выполнение Brain ultrasound,
electroencephalogram to exclude hydrocephalus and elevated
If the pulsation of the spring
Head мозг очень хорошо кровоснабжается, а сосуды его
are located close to the heart, so the blood in them flows under a large
pressure and with strong points. This pulsation is transmitted to the liquor,
on the membranes of the brain, on the plate covering the large spring of
children. Therefore, a small ripple is normal.
However, if the spring is pulsing strongly, then it can be
signal of disease. Other symptoms are usually present:
dehydration, diarrhea, intoxication, high fever, vomiting (see
frequent regurgitation or vomiting in infants). In this case, it is necessary
diagnosis and urgent treatment.
If the child has fallen spring
Decline of the fontanel (fallen) says about the dehydration of the child
or malnutrition. Fluid deficiency can occur on the background of:
- heat waves;
- overheating with strong wrap;
- high temperature and intoxication;
- with severe vomiting, diarrhea.
Lost fluid needs to be replenished. When overheating and
the temperature of the baby must be cooled and watering. When intestinal
infections, when drinking alone is not enough, the child will hold
invasive therapy in the hospital.
What does the bulging spring mean?
BR can emit (rises above the level of the surrounding bones
skull) on the background of intracranial pressure, which can be at
diseases such as meningitis, encephalitis, intracranial
bleeding, swelling, or for another reason. If, except for bulging
the following symptoms are observed, you should immediately call a doctor or
- Loss of consciousness
- Vomiting, diarrhea in infants
- Bulging after a fall or other head injury
- Seizures (see causes of cramps in a child)
- If bulging without other symptoms, but for a long time, also
should see a doctor.
How to care for him?
Especially no action is needed. Despite,
that the connective tissue plate covering it is thin, it is in
durable as well. Therefore, when combing or inspecting the fontanel
doctor, nothing bad will happen. However zealous when
Scallop movements should not be done either. Child it may be
simply unpleasant. You can also not be afraid to wash your hair or cut