It turns out that normally a newborn has not one fontanel, but as many as 6! At first, during the first week of life, four of them close, then the fifth grows - at the age of about two months. And only the sixth - the largest - remains open for quite a long period of time. When does a fontanel overgrow in a child? Let's try to find the answer to this question.

Why do you need a fontanel?

First, let's figure out why nature provided for the presence of this mechanism. It turns out that the fontanel performs several important functions:

• helps the baby to pass through the birth canal;
• allows the brain to actively grow and develop in the first time after childbirth;
• prevents an increase in the temperature of the meninges, since its increase above 38 ° C can lead to convulsions and swelling of the brain.

The overgrowth of the fontanel is a gradual process - the bones of the skull begin to grow together from four sides, which leads to the closure of the connective tissue in this place. Many moms are worried about how quickly this should happen. It turns out that it is impossible to unequivocally answer the question "what time does the fontanel grow in children". Normally, this can happen between the ages of 3 months and up to two years, so if your baby closes during this period, then you don’t have to worry. Sometimes the fontanel may not decrease, but increase - this is also associated with the active growth of the brain.

Early closure of the fontanel: should I be worried?

According to the observations of pediatricians, recently the closure of the “soft crown” in a child occurs quite early. It is assumed that the fontanel quickly overgrows in children whose mothers during pregnancy took vitamin and mineral complexes containing calcium. An excess of this microelement in the child's body can contribute to the early closure of the "soft crown".

The age of up to three months is the period when the fontanel overgrows prematurely in a child, but even in this case, pediatricians say that there is no need to sound the alarm. The baby should be monitored by a doctor who will monitor its development, and, in particular, such an indicator as the size of the head circumference, in order to exclude hydrocephalus.

But in most cases, even when a fontanel overgrows in a child under the age of 3 months, this does not indicate the presence of any developmental abnormalities. According to statistics, by the third month of life, it is already closed in 1-2% of children, up to a year this figure is 45%, and after two years, the “soft crown” remains open in 5% of babies. And this, too, may not affect

The shape and size of the fontanel

Another issue that parents usually worry about is the shape and size of the fontanel. In order to make sure that everything is normal, there is a certain indicator. It is calculated according to the following formula: the sum of the longitudinal and transverse dimensions of the fontanel is divided by 2. This value should be in the range of 0.6-3.6 cm. The shape of the pulsating "soft crown" resembles a convex or concave rhombus.

So, we can conclude that there are no clear terms when a fontanel overgrows in a child. Therefore, you should not worry and worry about this, just visit the pediatrician regularly and enjoy the joyful moments of communication with your baby.

Update: December 2018

The birth of a child is not only a miracle in the philosophical sense. It's also technically a miracle. Nature has thought through this process to such an extent that in order to pass through the birth canal of the mother, the child's head is able to decrease in size, acquire an oblong shape and flatten from the sides.

This is facilitated by the presence of gaps between the bones of the skull, filled with plates of connective tissue. These are fontanelles, the condition, overgrowth and bulging of which so often worries parents.

Despite the fact that there are six of them at birth, five of them grow so quickly that many parents do not even have time to know about their existence. All worries go around the most noticeable fontanel - the frontal or large fontanel (BR).

If the purpose of the small fontanelles ended after birth, then the large one in children continues to perform the functions of shock absorption, preventing fractures and injuries of the skull during falls and bumps.

When does a child's fontanel close?

If your child is already a year old, and his fontanel has not overgrown, then there is no reason for concern. Normally, this physiological process ends in 1-1.5 years. If the timing of its closure in your baby does not fit into the norm, then see a doctor. He will determine what is the cause: a disease or a developmental feature of the child.

What should be the fontanel in the norm?

After the birth of a child, as well as monthly when visiting a doctor, the pediatrician evaluates his condition, size, rate of decrease, and density of the surrounding bones.

Normally, the size of the fontanel in a healthy full-term baby is 2.5 - 3 cm, which is estimated by palpation and measuring the distance between opposite sides of the rhombus. have a larger BR, approximately 3.5 by 3.5 cm. And large children born at 41-42 weeks may have a smaller BR. All of this is normal. By the way, the fontanel month old baby may be slightly larger than at birth. This is due to the intensive growth of the brain.

What should be the size of the BR at a certain age, it is impossible to say for sure. Some sources give the following numbers:

• 1.8-2 cm at three months;
• 1.8-1.6 cm in six months;
• 1.3-1.4 cm at 9 months;
• 0.4-0.8 cm per year.

However, they can be guided only approximately, because:

• All children initially have different sizes (within the normal range).
• The size of the fontanel does not affect the growth rate. A large one can drag on for a year, and a small one for 1.5 years.

However, all fontanelles during examination should not be tense, not bulge, be at the level of the cranial bones. It is permissible for the spring to sink or bulge slightly, and also to pulsate. The frontal and parietal bones, surrounding it should be dense, without areas of softening.

What to do if the fontanel does not close?

If by the age of 18 months the baby's fontanel is still closed, then you need to see a doctor. This may be normal for your child, or it may be a symptom of a pathological condition.

The fontanel in the baby quickly overgrows, what should I do?

If the child has a small fontanel, then a pediatrician, endocrinologist and neurologist will need to be consulted. By the way, in 1% of cases, the spring can overgrow in 3 months. This is unusual, but if all other indicators of development are normal, then everything is fine. But sometimes small sizes accompany pathology.

If the fontanel is too large

A large BR is considered to be larger than 3.5 cm. This may be normal in premature or immature babies. For the rest, a consultation with a pediatric neurologist and an ultrasound scan of the brain, an electroencephalogram to exclude hydrocephalus and are obligatory.

If the fontanel pulsates

The brain is very well supplied with blood, and its vessels are located close to the heart, so the blood flows in them under great pressure and with strong points. This pulsation is transmitted to the cerebrospinal fluid, to the membranes of the brain, to the plate that closes the large fontanel in children. Therefore, a slight pulsation is normal.

However, if the fontanel pulsates strongly, then this may be a signal of the disease. Other symptoms are usually present: dehydration, diarrhea, intoxication, high fever, vomiting (see). In this case, diagnosis and urgent treatment is necessary.

If the child has a sunken fontanel

The retraction of the fontanel (sunken) indicates dehydration of the child or malnutrition. The lack of fluid may occur against the background of:

• heat;
• overheating with strong wrapping;
• high temperature and intoxication;
• at severe vomiting, diarrhea.

Lost fluid must be replenished. In case of overheating and temperature of the baby, it is necessary to cool and drink. With an intestinal infection, when one drink is not enough, the child will undergo invasive therapy in a hospital.

What does a protruding fontanel mean?

The BR may bulge (raise above the level of the surrounding bones of the skull) against the background of intracranial pressure, which may be due to diseases such as meningitis, encephalitis, intracranial bleeding, tumors, or for another reason. If, in addition to swelling, the following symptoms are observed, you should urgently call a doctor or an ambulance:

• Heat
• Vomit,
• Bulging after a fall or other head injury
• Convulsions (see)
• Strabismus
• If the swelling is without other symptoms, but for a long time, you should also consult a doctor.

How to take care of him?

No special action is required. Despite the fact that the plate of connective tissue covering it is thin, it is equally strong. Therefore, when combing or examining the fontanel by a doctor, nothing terrible will happen. However, you should not be zealous with scallop movements either. For a child, this may be simply unpleasant. You can also not be afraid to wash your hair or cut your child's hair.

Any newborn baby has small marks on the head - fontanelles. Immediately after birth, the baby develops six marks, four of which close in the first weeks of life. The fifth mark, located on the back of the head, disappears by two or three months. The sixth remains on the baby's head the longest. Knowing what a fontanel is and what function it performs will help parents to more clearly imagine the process of growth and formation of their child.

What is a fontanel

The fontanel in a child is an empty space between the parts of the skull, closed by a dense membrane. The baby also has sutures resulting from the connection of two bones of the skull. Fontanelles appear in the junction of several bones. Some time after birth, these parts of the skull become ossified, and the corresponding marks disappear. The first five out of six membranes close in all children at about the same time, but the formation of the sixth fontanel in a newborn child is a purely individual process. Among its main functions are the following:

1. The main function is to help in the easy passage of the head through the birth canal. During childbirth, the shape of the baby's head is slightly deformed. Tapering, it passes forward more easily through the birth canal. Often, in a baby, immediately after birth, you can find bones that have found each other. Such defects quickly pass, and the shape of the skull is restored.
2. Another no less important purpose of this physiological phenomenon is to help in the active growth and development of the brain. In the first year of life, the baby's brain grows rapidly and intensively. The membranes provide the necessary space for this process, expanding the cranium and allowing the brain to grow to the desired size and volume.
3. The free space between the parts of the skull provides thermoregulation of the brain. In newborns, heat transfer in the body is at the stage of formation and development. Because of this, babies overheat easily. When the child's body temperature reaches about 38 degrees Celsius and above, the fontanelles turn on the ventilation function, thereby preventing the brain from overheating.
4. The fourth function is depreciation. Physiological marks that occur in children immediately after birth provide protection for the baby from possible shocks and injuries. This is not a reason to leave a small child unattended, because a small membrane will not be able to protect the fragile bone structure of an infant from serious blows or concussions.
5. The last role of the fontanel in a small child is to help in the medical study of the brain. The membranes greatly simplify the conduct of neurosonography, ultrasound and other examinations in order to identify potential pathologies and diseases at an early stage. These membranes help medical workers control the process of development and formation of the brain, and if problems are detected, apply timely treatment.

Large and small fontanel in a child

The dimensions of the membranes are calculated by the formula in which the longitudinal and transverse diameters are added, after which the sum is divided by two. The result obtained is indicated as the size of the membrane. Immediately after birth, the parameters of this mark on the back of the head average 0.5-0.7 mm. This is a small fontanel, which closes by the second month of a child's life.

A large fontanel is usually well palpable and stands out. Almost all parents are concerned about the question of whether the size of the large fontanel of their small child is normal, how soon it should disappear and what to do if it does not overgrow for a long time. Doctors say that there is no strict time frame for closing the membrane. Each child develops this process differently.

A large fontanel in a newborn child usually has the shape of a diamond, each side of which is approximately 25 mm. In most cases, the mark disappears at 12-18 months. According to statistics, in the case of boys, this process proceeds faster. There is no relationship between the size of the membrane and the time of its closure. The first three months of life, the mark will increase intensively, since during this period the process of active brain growth usually occurs.

How many months does it take

The fontanel can close at any time. This usually happens between three months and two years. In some babies, it overgrows earlier, in others - later. For comparison, we present the results of statistical studies, according to which in 1% of the crumbs the mark on the head closes up to three months, in 40% - from a year to a year and a half, and in 95% of newborns - by two years. In the remaining five percent, the fontanel overgrows only after two years.

The process of formation of the bone tissue of the cranium in each case proceeds individually. In children from the same parents, characteristic marks disappear in different ages. If the mother consumed too much calcium during pregnancy, there is a possibility that the free space between the parts of the skull will tighten faster. Young parents should not worry about this. It is important that this process takes place within the time limits. If the baby is not worried about well-being, he develops normally, there is no need for worries.

Retraction and protrusion of the fontanel

The fontanel in an infant sticks out a little when there is increased intracranial pressure or other neurological disorders. A bulging fontanel is not the only symptom that indicates the appearance of health problems. If you find that the membrane on your head is slightly swollen, do not panic, but it is better to immediately consult a doctor.

A sunken fontanel usually represents typical feature baby dehydration. This happens with vomiting and prolonged diarrhea in a small child. In this situation, the newborn needs to provide plenty of fluids. It is necessary to contact the pediatrician to find out the reasons that led to dehydration and, as a result, the sinking of the fontanel.

If the fontanel pulsates, is it worth worrying

Many parents, noticing that the child has a pulsating membrane on the head, panic. You shouldn't worry. This is a completely natural and normal phenomenon. Pulsation corresponds to the heart rhythm. The reason for its appearance is the flow of blood flowing to the brain with each heartbeat. In all children, the pulsation is expressed in different ways: in some it is stronger, in others it is weaker. But if there is no pulsation at all, this indicates the appearance of problems with pressure. In this situation, it is better to consult a doctor.

When should a child's fontanel close?

As noted above, in all children, the space between the parts of the skull grows into different time. The large fontanel usually closes between the ages of three months and two years. Often there are cases when characteristic marks disappear earlier or later than the due date. This is a purely individual process that will definitely happen in. If the mark drags on too quickly or, conversely, does not overgrow for a long time, it is better to consult a doctor who will help determine the cause of the anomaly and give appropriate recommendations.

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Parents always have a lot of questions, for example, what sizes of a large fontanel are considered the norm, why is it large or small, the measurement of a large fontanel, and so on. Through research, it was found that many parents do not touch its location on the child's head, as they are afraid of harming the baby's brain. This is a misconception, since the fontanel is a dense shell, the function of which is protection. It is located on the crown of the child, shaped like a rhombus. Why is a large (also called anterior) fontanel needed? In order to make it easier for the baby to be born, passing through narrow birth passages. This is a kind of shock absorber that helps the cranial plates move and move apart. If you look closely at it, you can see a slight pulsation, especially noticeable when the baby cries. You can touch it, and some doctors even advise gently massaging it while combing.

How does a large fontanel close in a child?

The size of a large fontanel of a newborn is approximately 2x2 cm in area, but an excess of 1-3 cm in size is considered a variant of the norm. In the first month, a significant increase in size is possible. And by 3-4 months it decreases to 1x1cm. In the period from 12 to 18 months, a large fontanel should normally close completely. But these terms are averaged, and for each child, closing occurs at its own time (as well as the terms of teething or the first steps).

Parents must visit the children's doctor without fail, doing this regularly for up to a year. And the pediatrician, for his part, will make sure that the baby does not lag behind his peers in development and takes the necessary measures in time.

One of the external indicators of the normal development of a child for pediatricians, neurologists and other pediatric specialists is the fontanel in newborns. It is a small soft pulsating area on the baby's head, under which the brain tissue is located close enough. The surface of the fontanel is covered with a dense film with a small fluff.

Fontanelle of a newborn baby

• The fontanel of a newborn greatly facilitates the process of childbirth, both for the baby and for the mother. Passing the birth canal, the bones of the skull are compressed, and therefore the head of the newborn for the first time after childbirth looks elongated. Then the shape of the head is restored;
• The presence of a fontanel provides optimal spatial conditions for normal brain growth at the pace that is laid down by nature;
• The fontanel is involved in the regulation of heat transfer of the baby and the environment. If the child's body temperature exceeds 38 degrees, then the brain tissue naturally cools through the fontanel;
• Due to the ability to shrink, the fontanel can act as a shock absorber in case of an accidental fall of the child.

Large and small fontanelles

Where is

Determining where the fontanel is located in a newborn baby is quite simple.

A large diamond-shaped fontanel measuring 2 by 2 centimeters is located right in the middle of the crown, or, as they usually say, on the top of the head.

Little fontanel is on the back. Its size is about half a centimeter.

When overgrown

A large fontanel overgrows by about one year of age of the child, sometimes there are slight deviations from this parameter up to about one and a half years. But if the child meets the age norms in other respects, then there is no reason for concern.

A small fontanel in children born at term is already closed. However, it happens that it was discovered after childbirth. Then its closure should be expected in two to three months.

The speed and time of closing the fontanelles mainly depends on how much the baby's body is provided with calcium. If there were no deviations in the mother's diet, the optimal regimen for taking multivitamins was observed, then the overgrowth of fontanelles usually occurs normally.

Deviations in development

Knowing the timing when the fontanel overgrows, as well as the size, you can see any deviations, avoid and prevent the development of many dangerous diseases in newborns. Among them are a few:

1. Rickets. This disease is almost the most common cause of late closure of the fontanel. As a rule, this happens in premature babies who are rarely exposed to the sun, who have a lack of calcium and vitamin D. Read the article >>>;
2. Hypothyroidism. A decrease in the amount of thyroid hormones can also be the reason for slowing down the process of overgrowth of the fontanel;
3. Down Syndrome. Too large sizes of the fontanel indicate the presence of this disease along with other characteristic signs;
4. Overgrowth of the fontanel ahead of time may indicate an excess of calcium , as well as testify to diseases such as craniostenosis, microcephaly;
5. A depressed fontanel is also a serious symptom. This phenomenon indicates acute dehydration of the body.

(image is clickable)

A careful examination of the child by specialists, parents of the baby's condition will be a guarantee early detection deviations and will contribute to the correct appointment of preventive treatment.

Reasons for the early closure of the fontanel

(clickable)

Fontanelle too small or fontanel closing too fast

Protruding fontanel?

Most often, a protruding fontanel is observed against the background of diseases that are accompanied by an increase in intracranial pressure: meningitis, encephalitis, tumors, intracranial bleeding, increased intracranial pressure for another reason.

If a bulging fontanel is combined with one or more of the following symptoms, you should call a doctor as soon as possible:

• Strong temperature;
• The bulging of the fontanel arose after a head injury, a child's fall;
• Vomit;
• Drowsiness or excessive irritability of the child;
• Strabismus;
• Convulsions or epileptic seizures;
• Loss of consciousness;
• Bulging fontanel for a long time without other symptoms.

Fallen fontanel?

Most often, the retraction of the fontanel is observed due to dehydration of the child against the background of temperature, diarrhea, and repeated vomiting. If a sunken fontanel is found, the child should be given plenty of fluids and a doctor should be contacted to treat the disease that caused dehydration.

Fear of harm

Many are very much afraid of somehow damaging the fontanel. Remember! - it's practically impossible. Despite the apparent softness of the fontanel, it is very durable, and it cannot be damaged by ordinary manipulations (washing, bathing, combing, etc.).

Video:

Newborn baby. It is a soft area on the parietal part of the head between the parts of the skull. This area does not have bone tissue, but is closed by a strong membrane. The fontanel in infants makes it possible to shrink during childbirth during the passage of the baby through the birth canal.

What are fontanelles in newborns?

Newborn babies have six fontanelles. The largest is the front, the second largest is the back. There are two more mastoid and two wedge-shaped. Two main fontanelles usually remain open after childbirth: frontal (large) and occipital (small).

Sizes of children's fontanelles

The large fontanel resembles the shape of a rhombus. It is considered normal if its size is in the range of 1-3 centimeters. Most often, such a fontanel in children is 1.7-2.5 centimeters. And at the age of three months, it decreases to 1-1.5 centimeters.

To correctly determine the size of the frontal fontanelle, add its longitudinal and transverse diameters and divide the resulting sum by 2. The small fontanel resembles the shape of a triangle. Its dimensions usually do not exceed 0.7 centimeters. Although most often a child is born already with a closed small fontanel. But do not worry if the size and shape of the fontanel in a child differs from the standard ones. Each child is individual. A pediatrician should be consulted to determine if this is a concern.

Timing of fontanel closure

Four lateral fontanels in full-term babies close at birth, in premature babies - in the first few days after birth. The occipital fontanel in infants is completely closed at 2-3 months. But there are no exact deadlines for closing the largest fontanel. It's a very individual process. It can overgrow by 12 months, or maybe at 1.5 and 2 years. In recent years, thanks to the acceleration of children, the frontal fontanel disappears by 10 months.

What is the reason for the early closure of the frontal fontanel?

Closing of the fontanel before the third month of the baby's life is considered early. Usually this is due to the expectant mother's enthusiasm for taking multivitamins and the result of which are small and fairly dense fontanelles in the child. Therefore, you should follow the norm in taking vitamins according to the duration of pregnancy.

Why is it dangerous?

Early closure of the fontanel has a significant effect on the full development of the brain, impeding its normal growth. The danger lies in the fact that early overgrown

the fontanel can be the cause of serious illness in infants. Very rarely (but there is still a chance) a baby can have one of two diseases: an anomaly in the development of the brain and craniosynostosis. These diseases are accompanied by a number of other symptoms. If the child's fontanel closes early, but the circumference of his head is normal, this means that the child is healthy.

What is the reason for the late closure of the fontanel?

Late closure of the frontal fontanel is associated with a low content in the baby's body and limits the intake of vitamin D3. And this leads to a change in bone tissue.

Why is it dangerous?

In itself, the late closure of the fontanel does not indicate danger. It is important to study the accompanying symptoms, as this can also be a dangerous signal.

The most common cause of late closure is rickets. It can also be a signal of Down syndrome, achondrodysplasia and other serious diseases. Even if a long-term non-closing fontanel in infants does not cause concern, you should consult a specialist.

What else can the fontanel “tell” about?

There are a few more "signals" that should not be ignored:

the fontanel in infants sinks - there is not enough fluid in the body;

for a long time it is “convex” -;

enlarged sizes - violation of ossification or prematurity.

The whole body of the baby is the embodiment of fragility and insecurity, but there is the most vulnerable, small, pulsating area on his head - the crown or fontanel. This phenomenon in a newborn is one of the most exciting topics for young mothers, and for pediatricians and pediatric neurologists, it is the most important indicator of the correct development of the child. Let's try to figure out: what it is and what functions the fontanel performs in children.

Fontanelle of a newborn

The soft area on the head of a newborn is the distance or the so-called “window” between the bones of the skull. It is covered with dense, elastic connective tissue - a membrane, which, contrary to prejudices, is quite difficult to damage, and which ossifies and hardens by a certain age. Immediately after birth, the baby, normally, has 6 such "windows".

The largest fontanel in a newborn is located on the top of the head, between the two frontal bones. It is called parietal or anterior unpaired, has a diamond shape and reaches a size of up to 4 cm.

The second unpaired fontanel is located on the back of the head between the occipital and parietal bones.

The rest of the "windows" are called paired, because. are located on the sides of the head - in the temporal regions and behind the baby's ears.

As a rule, all fontanelles, except for the anterior one, are no more than 5 mm in size, and the process of ossification of the connective tissue covering them occurs much faster than the anterior one - during the first two months of a child's life, and sometimes even in the womb. Therefore, most often the parents of a newborn do not know about their existence at all.

What are the functions of the fontanel?

Despite the fact that the fragility of the baby is the cause of fears and concerns for his parents, nevertheless, even it is thought out by nature to the smallest detail. This also applies to the topic of this article. The fontanelles on the baby's head perform a number of important functions:

When does the fontanel grow in newborns?

So, we have already mentioned above that the occipital and lateral "windows" overgrow almost immediately after the birth of the child. But when should the largest anterior fontanel heal?

Experts do not name any specific dates for the ossification of the connective tissues on the head of newborns, because, like any process in the body, it proceeds depending on the individual characteristics of the child's body. There is an opinion that the time of their healing can be genetically determined, and also depends on the sex of the newborn.

If we talk about approximate terms, then, as a rule, the fontanel in newborns heals at the age of 6 months to 1.5 years, sometimes this process can continue up to 2 years of the child. Minor deviations should not be a cause for concern for parents, because. they are considered the norm.

Indicators of the norm of the fontanel and their deviations

As we have already found out, normally, the crown of a newborn closes by about two years, has the shape of a rhombus and is 2 to 4 cm in size, depending on the degree of maturity of the baby. Also, the norm will be a slight increase in the first month of a child's life, due to the rapidly increasing brain size. A slight protrusion or retraction of the membrane relative to the level of the skull bones may also be normal.

However, there are exceptions to everything. Sometimes deviations in the timing of overgrowing or the size of the crown may indicate some pathologies.

For example, a long non-healing, large fontanel in a child may indicate a number of diseases such as, for example:

• down syndrome
• hydrocephalus
• hypothyroidism
• rickets

Also, a too small fontanel in a newborn may indicate any health problem, i.e. when early ossification of the connective tissue occurs. In this case, we can talk about such deviations:

• microcephaly
• craniostenosis
• developmental anomalies of the brain
• meningitis
• excess calcium in the body of a newborn

A cause for concern should be a fontanel that is obviously convex or sunken in shape. This may be an indicator of pathologies such as:

• meningitis
• encephalitis
• tumor formations
• intracranial pressure

But it should be remembered that any disease has a complex of symptoms, so it is impossible to draw conclusions based only on the “behavior” of the fontanel of a newborn. If there is nothing more alarming in the behavior of the baby, most likely, its development proceeds in the normal mode. Only a specialist can determine compliance with the norm or deviation from it, visits to which should not be neglected.

Why does the fontanel in the baby pulsate?

A completely physiological feature for a healthy newborn is a slight pulsation of the membrane. The fact is that the cerebrospinal fluid, the fluid that fills the ventricles of the brain, constantly circulates in the cerebrospinal fluid pathways. This leads to the pulsation of the brain tissue, which we observe in newborns under the connective tissue that covers the distance between the frontal and parietal bones.

The pulsation of the fontanel of the newborn is also provoked by the beating of the heart - each contraction of it leads to a rush of blood to the brain, this leads to the rhythmic movement of the crown of the child.

There are some deviations from the norm, which should alert the parents of the newborn and serve as a reason to see a doctor:

• the fontanel pulsates too intensely
• does not pulsate at all
• the pulsation of the crown is accompanied by a strong anxiety of the child: constant crying; bad sleep; regurgitation; refusal to eat, etc.

In the process of growing up and healing the fontanel, the nature of the pulsation will change somewhat.
If the first two months of a newborn's life, the pulsation of the membrane is almost constant and visible to the naked eye, then by about three months of age it will be noticeable only during crying or when the child is very stressed.

How to care for the baby's fontanel?

Young parents consider the fontanel on the head of their crumbs the most vulnerable, easily injured place and simply prefer not to touch it. This is not quite the right approach, because. this area in a child is covered with the same skin as his entire body, therefore, it requires care and hygiene. There are no special rules for caring for a child's crown, it is enough to take into account some of its nuances:

• it cannot be pressed;
• comb your hair very carefully without touching the fontanel;
• protect the newborn from hitting the head during games, swaddling, bathing;
• if it is necessary to remove the birth crusts from the scalp of a newborn, it must be carefully lubricated with oil half an hour before bathing

Experts also advise regularly changing the position of the baby's body, turning him from side to side, picking him up, laying him on his stomach. When the baby is in one position for a long time, there is uneven pressure on the fontanel area, which can lead to a shift in the bones of the child's skull and, subsequently, to its deformation.

INR analysis is the most reliable method for determining blood clotting. Deviations of its values ​​from the norm can indicate serious problems in the body.

What is MNO?

Human blood contains a complex protein, prothrombin, which ensures that it remains liquid during circulation through the circulatory system and clotting in case of injury. Determination of the amount of prothrombin helps to establish a tendency to bleeding or the formation of blood clots.

Analysis for INR is an indicator of clotting

Blood clotting is determined in the framework of three studies:

• PTT - prothrombized time, which shows how long after the addition of the reagent a fibrin clot is formed in the plasma. Normally, its values ​​\u200b\u200bshould be 11-15 seconds.
• PTI - prothrombin index. This is the ratio between the plasma clotting time in a healthy person and the patient's plasma clotting time. Normal values ​​are 93–107%.
• INR is the international normalized ratio. Represents the ratio between the PTT of the patient and the PTT of the capillary blood of a healthy person. It also takes into account the MIC coefficient (international sensitivity index), which differs for different reagents.

The INR indicator is necessarily determined in pregnant women before surgery or blood plasma transfusion. It is the basis for selecting the optimal dosage of anticoagulants and other drugs.

If a person takes anticoagulants and is in a hospital, it is recommended to check the level of INR daily. And after discharge from the hospital, it is necessary to take appropriate tests every two to three weeks.

Deciphering the results

The INR norm in women and men is different. Moreover, its values ​​also depend on several factors. Consider the average normal INR:

• the INR norm in healthy women and men is in the range of 0.7–1.3;
• surgery is allowed if the patient's INR is 0.85–1.25;
• for pregnant women, values ​​​​of 0.8–1.25 are considered normal;
• after heart surgery, the INR can rise to 2.5–3.5, which is the norm;
• when the patient is taking direct anticoagulants, the INR may be 0.8–1.2;
• when taking indirect anticoagulants, the values ​​\u200b\u200bmay rise to 2.0–3.0;
• INR indicators also differ by age: in people over 50 years old, the norm decreases slightly.

If the indicators are different from the norm, this may indicate some health problems. Therefore, the results of the study should be deciphered by a specialist in order to detect deviations in time.

What do the low values ​​mean?

If the clotting index is low, the risk of blood clots increases. Because of them, the blood supply to vital organs is disrupted, which can lead to functional failures.

First of all, it is necessary to establish the exact reason why the INR values ​​\u200b\u200bare below normal. This happens in the following cases:

• deficiency of vitamin K in the body;
• a side effect from taking hormonal, anticonvulsant, diuretic drugs;
• physical injuries accompanied by blood loss;
• thromboembolism during pregnancy or after childbirth.

The result of the study may be erroneous if technological errors were made during blood sampling or the material taken was stored for too long. You also need to carry out proper preparation before the procedure. For two days before it is forbidden to use alcoholic drinks, fried and smoked food.

Therefore, if deviations are found, a re-analysis is mandatory. After establishing the cause, the appropriate treatment is selected. Anticoagulants may also be prescribed.

Reasons for increasing INR

A high level of INR indicates hypocoagulation. In this case, there is a high risk of bleeding even with minor injuries.

Elevated INR values ​​can be observed for the following reasons:

• heart disease, including pre-infarction conditions and heart attack;
• diseases of the liver and gallbladder;
• the presence of malignant neoplasms in the body;
• increased level of erythrocytes in the blood;
• diseases of the gastrointestinal tract;
• taking antibiotics and hormones, side effect which may have a high INR.

After 50 years, it is necessary to constantly monitor blood clotting. Checking the INR level is recommended annually. If the patient has an INR above 6.0, he should be urgently hospitalized. In this case, the likelihood of death is high.

The birth of a child is not only a miracle in the philosophical sense. It's also technically a miracle. Nature has thought through this process to such an extent that in order to pass through the birth canal of the mother, the child's head is able to decrease in size, acquire an oblong shape and flatten from the sides.

This is facilitated by the presence of gaps between the bones of the skull, filled with plates of connective tissue. These are fontanelles, the condition, overgrowth and bulging of which so often worries parents.

Despite the fact that there are six of them at birth, five of them grow so quickly that many parents do not even have time to know about their existence. All worries go around the most noticeable fontanel - the frontal or large fontanel (BR).

If the purpose of the small fontanelles ended after birth, then the large one in children continues to perform the functions of shock absorption, preventing fractures and injuries of the skull during falls and bumps.

When does a child's fontanel close?

If your child is already a year old, and his fontanel has not overgrown, then there is no reason for concern. Normally, this physiological process ends in 1-1.5 years. If the timing of its closure in your baby does not fit into the norm, then see a doctor. He will determine what is the cause: a disease or a developmental feature of the child.

What should be the fontanel in the norm?

After the birth of a child, as well as monthly when visiting a doctor, the pediatrician evaluates his condition, size, rate of decrease, and density of the surrounding bones.

Normally, the size of the fontanel in a healthy full-term baby is 2.5 - 3 cm, which is estimated by palpation and measuring the distance between opposite sides of the rhombus. Premature babies have a larger BR, about 3.5 by 3.5 cm. And large babies born at 41-42 weeks may have a smaller BR. All of this is normal. By the way, the fontanel of a month-old baby may be slightly larger than at birth. This is due to the intensive growth of the brain.

What should be the size of the BR at a certain age, it is impossible to say for sure. Some sources give the following numbers:

• 1.8-2 cm at three months;
• 1.8-1.6 cm in six months;
• 1.3-1.4 cm at 9 months;
• 0.4-0.8 cm per year.

However, they can be guided only approximately, because:

• All children initially have different sizes (within the normal range).
• The size of the fontanel does not affect the growth rate. A large one can drag on for a year, and a small one for 1.5 years.

However, all fontanelles during examination should not be tense, not bulge, be at the level of the cranial bones. It is permissible for the spring to sink or bulge slightly, and also to pulsate. The frontal and parietal bones, surrounding it should be dense, without areas of softening.

What to do if the fontanel does not close?

If by the age of 18 months the baby's fontanel is still closed, then you need to see a doctor. This may be normal for your child, or it may be a symptom of a pathological condition.

If the child has a small fontanel, then a pediatrician, endocrinologist and neurologist will need to be consulted. By the way, in 1% of cases, the spring can overgrow in 3 months. This is unusual, but if all other indicators of development are normal, then everything is fine. But sometimes small sizes accompany pathology.

If the fontanel is too large

A large BR is considered to be larger than 3.5 cm. This may be normal in premature or immature babies. For the rest, it is obligatory to consult a pediatric neurologist and perform an ultrasound of the brain, an electroencephalogram to exclude hydrocephalus and increased intracranial pressure.

The brain is very well supplied with blood, and its vessels are located close to the heart, so the blood flows in them under great pressure and with strong points. This pulsation is transmitted to the cerebrospinal fluid, to the membranes of the brain, to the plate that closes the large fontanel in children. Therefore, a slight pulsation is normal.

However, if the fontanel pulsates strongly, then this may be a signal of the disease. Other symptoms are usually present: dehydration, diarrhea, intoxication, high fever, vomiting (see frequent regurgitation or vomiting in infants). In this case, diagnosis and urgent treatment is necessary.

If the child has a sunken fontanel

The retraction of the fontanel (sunken) indicates dehydration of the child or malnutrition. The lack of fluid may occur against the background of:

• heat;
• overheating with strong wrapping;
• high temperature and intoxication;
• with severe vomiting, diarrhea.

Lost fluid must be replenished. In case of overheating and temperature of the baby, it is necessary to cool and drink. With an intestinal infection, when one drink is not enough, the child will undergo invasive therapy in a hospital.

What does a protruding fontanel mean?

The BR may bulge (raise above the level of the surrounding bones of the skull) against the background of intracranial pressure, which may be due to diseases such as meningitis, encephalitis, intracranial bleeding, tumors, or for another reason. If, in addition to swelling, the following symptoms are observed, you should urgently call a doctor or an ambulance:

How to take care of him?

No special action is required. Despite the fact that the plate of connective tissue covering it is thin, it is equally strong. Therefore, when combing or examining the fontanel by a doctor, nothing terrible will happen. However, you should not be zealous with scallop movements either. For a child, this may be simply unpleasant. You can also not be afraid to wash your hair or cut your child's hair.

zdravotvet.ru

Why does the fontanel in a child not overgrow? What to look out for

The development of an infant in the first year of life greatly worries young parents. Moms worry if the teeth are “late”, or the neighbor’s baby is already walking, and his child is still afraid to let go of the support. One of these burning topics is the issue of overgrowing the fontanel. Mothers often worry about why the fontanel in a child does not overgrow. Will try to answer.

The role of the fontanel

Most mothers know that the fontanel is necessary for the child to successfully pass through the birth canal. The head of the baby, due to the presence of the fontanel, is somewhat deformed and compressed, so the process of childbirth is easier.

It is for this reason that the shape of the head of a newborn child can surprise an ignorant person. But after a few days, due to the elasticity of the tissues of the fontanel, the head takes on a normal shape.

Few people know, but the baby at birth has not one, but as many as six fontanelles (anterior, wedge-shaped (left. right), mastoid (left, right), posterior). It's just that the first five grow very quickly, literally in the first days and weeks of life. The largest fontanel, located at the crown, remains open longer.

This is necessary to ensure the normal growth of the bones of the skull. The fastest growth and change in the bones of the skull is carried out in the first 2 years, and the fontanel also contributes to this to some extent. By the way, if it happened that the fontanel closed a little ahead of time, then there is nothing to worry about, the growth of the bones of the skull will not stop from this.

In addition, the fontanel also performs protective functions. For example, it protects the baby from head injuries. It's no secret that even the most attentive parents of children periodically fall and at the same time can hit their heads. Upon impact, the fontanel plays the role of a kind of shock absorber, so ordinary falls do not bring harm to health. The time of complete overgrowth of the fontanel coincides with the age when the baby already knows how to walk well and the likelihood of falls is somewhat reduced.

Another important function of the fontanelle is participation in the functions of thermoregulation of the body. So, part of the heat is removed through the fontanel if the child is sick and has a temperature. It is thanks to the fontanel that the baby's brain suffers less from high temperature, which reduces the likelihood of developing phenomena such as convulsions, etc.

The fontanel helps not only the baby, but also the doctors. Through this place, an important examination of the brain can be performed, which is necessary if the child has neurological problems.

Norms

The front fontanel, located on the top of the baby, has the shape of a rhombus, and its dimensions can vary from 5 to 30 mm. If the mother wants to take the size of the fontanel on her own, then she needs to determine the distance between the two most distant points and divide the resulting measurement in half.

As a rule, two measurements are taken - longitudinal and transverse, these measurements are recorded on the map approximately in this form - 1.5 x 0.5 cm.

The initial size of the fontanel does not affect the rate of its overgrowth, but according to the observations of pediatricians, overgrowth in boys occurs a little faster.

On average, the age of overgrowth of the fontanel is 16-24 months, however, deviations in both directions are quite acceptable. The norm is the overgrowth of the fontanel after a year. However, the process of tightening the fontanel, as well as all other processes in the body, proceed individually.

Normally, the fontanel on the baby's head is almost invisible visually, but if you run your hand over the head, you can easily feel it. It is not considered a deviation if the fontanel protrudes slightly above the surface of the head or sinks quite a bit.

Mothers are often frightened if they notice that the skin in the area where the fontanel is located is pulsating. If this happens infrequently (as a rule, during the period when the child is excited), then there is nothing to worry about.

Monthly rates

To make it easier for parents to understand, we present the average size of the fontanel in infants by month. But keep in mind that the given norms are approximate, so if you find small deviations, you should not panic. Although, of course, you need to ask questions to the pediatrician.

So, the size of the fontanel, depending on the age of the baby:

• 0-1 months - 20-30 mm;
• 1-3 months - 18-20 mm;
• 4-6 months - 16-17 mm;
• 8-9 months - 12-14 mm;
• 11-12 months - 4-8 mm.

What affects the speed of tightening?

The following factors can influence the growth rate:

• Prematurity. This is one of the most common reasons why a fontanel does not grow in a child for a long time. These babies are usually physical development they lag a little behind, but by the age of 2-3 they successfully catch up with their peers who were born at term.

• Growth rate. Some children grow ahead of the dates indicated in the tables; in such children, the fontanel overgrows somewhat faster.

• Food. It has been observed that in children receiving breast milk, overgrowth of the fontanel occurs faster than those who feed on mixtures. After all, it is mother's milk that is ideally balanced for full development.

• Hereditary and congenital syndromes. Late overgrowth of the fontanel is possible with congenital hypothyroidism, Down's syndrome and other diseases.

• deficit nutrients. The speed of tightening the fontanelle depends on the presence of vitamin D3 in the body.

What does the doctor pay attention to?

Children under one year of age are examined by a pediatrician monthly. Each time, the doctor should pay attention to the condition of the fontanel and measure the circumference of the head. These two parameters are very important for assessing the condition of the baby and the characteristics of its development.

The following points may alert the doctor:

• the fontanel is clearly visible on the head, it represents an owl cavity or, on the contrary, protrudes above the bones of the skull;

• the fontanel grows too slowly or too quickly.

If the fontanel looks like a hollow, then you can suspect that the child's body is dehydrated. This can happen due to an illness that is accompanied by diarrhea, vomiting, fever. If dehydration is insignificant, then the child is prescribed special solutions that need to be drunk. But if such simple measures do not help, or dehydration is severe from the very beginning, you need to call the ambulance so that the child can be helped in a hospital setting.

If, on the contrary, the fontanel protrudes noticeably above the bones of the skull, then this symptom can indicate such serious diseases as hydrocephalus, intracranial pressure, meningitis, etc. In this case, neurosonography can be prescribed - a special examination conducted through the fontanel.

This examination is absolutely safe for the baby, it will not cause him pain and discomfort. In its principle, neurosonography is similar to ultrasound. Thanks to this examination, it will be possible to identify any, even minor disorders in the brain.

If the baby is prescribed such an examination, the mother does not need to be scared. As already mentioned, it does not hurt, and you can do the procedure as many times as required. The procedure itself takes no more than 15 minutes, no special preparation is required for it.

Pathologies are considered if a large fontanel overgrows in the first three months of a child's life. In other cases, earlier tightening is considered a variant of the norm. The rapid overgrowth of the fontanel can be caused by an excess of vitamin D3. This happens if the mother takes some kind of supplements containing this vitamin in large quantities while breastfeeding the baby.

Too fast tightening of the fontanel is not so common. Much more often, mothers are worried that the fontanel in the child is poorly overgrown. In fact, this phenomenon is common, often complete ossification of the bones of the skull is observed only by the age of three.

To find out the causes of this phenomenon, the pediatrician may recommend donating blood to find out the level of calcium and phosphorus, as well as undergo other tests to rule out rickets.

However, according to Dr. Komarovsky, there is no direct connection between the speed of tightening the fontanel and rickets. Although this symptom should not be ignored.

In fact, rickets is a condition characterized by a lack of calcium in the body. If it is detected in the early stages, then the disease is quite easily treated and does not leave any consequences. But in the absence of treatment, serious consequences are observed up to the deformation of the bones of the skeleton. Therefore, at a low rate of overgrowth of the fontanel, children may be prescribed calcium and vitamin D supplements.

4allwomen.ru

The fontanel does not grow

In order to make it easier for a child to pass through the birth canal, the bones of his skull converge, on his head there is a so-called fontanelle - an elastic gap between the bones of the skull. Over time, it should completely overgrow. However, this does not always happen, and parents may notice that the fontanel in the child does not overgrow.

When is the fontanel completely overgrown?

There are fontanelles on the head of the child:

As a rule, a small fontanel overgrows by the time of birth or by the end of the first week of a newborn's life.

A large fontanel closes on average by the baby's first birthday, but can close at 16 months, which is also the norm for development.

Why does the fontanel not overgrow for a long time?

However, it happens that a large fontanel may not overgrow for a long time. This is due to the following reasons:

• rickets;
• hydrocephalus;
• metabolic disease;
• hypoxia in childbirth.

It is possible that during pregnancy a woman spent little time on fresh air, did not consume enough dairy products and vitamin-mineral complexes. As a result, the child in the future has difficulties with the overgrowth of the fontanel.

What to do to overgrown the fontanel?

If the child's fontanel does not close for a long period of time, then it is necessary to drink a course of vitamin D3. In order to strengthen the bones of the baby, you need to adjust his diet and introduce foods that contain a large amount of calcium, cottage cheese, egg yolk.

If parents are concerned about the size of the fontanel in their child, you can show it to a neurologist, who will additionally prescribe neurosonography. It is possible that blood and urine tests may be required to determine the level of phosphorus and calcium.

Parents should remember that each child is individual, as well as the pace of his development and the characteristics of his health. Therefore, the timing of overgrowth of the fontanel may be different. However, you should not worry too much and panic if the fontanel does not overgrow, but the child feels comfortable, sleeps well, eats and has good mood during the day. A simple dynamic observation by a neurologist will allow you to control the process of overgrowth of the fontanelle, and properly selected nutrition with a high content of calcium will accelerate its closure. And parents only need to observe the behavior of their child and his health.

Related articles:

womanadvice.ru

When should the fontanel in babies overgrow? Should parents worry about overgrowing too fast or too slow?

Many concerns of parents are associated with a pulsating area on the head of a newborn - a fontanelle. Anxiety causes care for the baby, there is a fear of harming him when exposed to an unprotected area. Parents are especially interested in when the fontanel in an infant overgrows, which is the norm, what deviations are possible.

Peculiarities

The fontanel is formed at the junction of the cranial bones of the child, connected by soft membranous tissue. It is dense enough to protect the brain from external influences: you can not be afraid to wash, comb and stroke the baby's head.

In the process of intrauterine development, 6 fontanelles are formed:

• Two pairs on the sides (in front of the auricles and behind them) are rather narrow, more like seams. They are delayed by the time of birth or immediately after it and are invisible to parents:
• Small in the occipital region (approximately 5 mm in diameter) - in most cases it closes during fetal development, more often observed in premature babies. Its overgrowing with bone tissue lasts from several days to two months;
• The large one, located on the crown of the head, is tightened last. Its dimensions vary between 22-35 mm.

An infant can be born with a pathologically large fontanel as a result of prematurity, hydrocephalus (accumulation of excess fluid in the ventricles of the brain), or disorders in the development of the skeletal system. The reduced size of the parietal and complete closure of the remaining fontanelles is possible with a disproportion of a too small skull and brain compared to other parts of the body. Such cases require medical supervision, additional studies to determine the causes. The rate of overgrowth of the fontanel in babies with congenital pathologies may differ compared to children without deviations.

Important!

generally accepted norms

The parietal fontanel is characterized by a rhomboid shape, the width and length of which are in the range of 5–35 mm. To calculate the size, you need to determine maximum dimensions soft area along and across, add the resulting numbers and divide by two. The average parameters of the parietal fontanel, depending on age, are shown in the table:

Dimensions are approximate, a deviation of a few mm up or down is acceptable. In the first three months, a slight increase in the fontanel is possible due to the intensive growth of the brain.

There is a dependence on the sex of the child (in boys, the soft area tightens faster) and heredity: if one of the parents had early or late overgrowth without pathologies, a peculiarity may appear in the baby.

When should the fontanel drag on?

Dr. Komarovsky notes that normally tissue ossification occurs between the ages of 3 and 24 months. The exact time individually, depends on the characteristics of the development of the child. Closure is rare in three-month-old babies - about 1%, in about 40% an overgrown fontanelle is observed at the age of one, by two years the process is completed in 95% of babies. Later overgrowth is possible, in the absence of developmental abnormalities, it is considered normal.

fast overgrowth

The fontanel can drag on for a baby up to 6 months. With normal growth and development, this is not a deviation. Ossification is considered too early soft tissue fontanel at the age of three months. Occurs as a result of pathologies:

• Craniosynostosis is a deviation in the formation of bone tissue, in which the fontanel is quickly tightened and the cranial sutures are completely fused, preventing the normal development of the brain. May be congenital or acquired, in most cases observed in combination with other developmental disorders;
• Microcephaly - expressed in a decrease in the size of the head, refers to severe deviations in the development of the central nervous system. The main symptom is a reduced head circumference, a violation of proportions relative to other parts of the body;
• Anomalies in the development of the brain - violations in its structure, a decrease in size, weight.

Such deviations are rare, not limited to manifestation in the form of a rapidly overgrowing fontanel.

slow closing

This problem is more common, occurs if the baby:

• Congenital pathologies of the thyroid gland. Manifested by drowsiness, swelling, low activity of the baby, poor appetite, digestive problems, constipation;
• Rickets - they often affect premature babies. May occur with a lack of vitamin D or calcium in the body. Symptoms are sleep disturbance, appetite, increased nervous excitability, sweating with the appearance of a specific sour smell;
• Bone disease caused by genetic abnormalities - achondrodysplasia. Accompanied by growth retardation, shortened limbs, leads to dwarfism;
• Down's disease is a developmental delay.

Serious diseases are quite rare, a comprehensive examination is necessary to confirm the diagnosis. To make a diagnosis, you need to consult a neurologist, an endocrinologist.

Common myths

The most common misconceptions associated with the overgrowth of the fontanel:

• Early closure limits brain growth. The bones of the skull are connected by sutures, which are completely fused after 20 years. They provide normal growth heads and brain development. In case of early overgrowth of the fontanel, the condition of the seams is checked: if they are not closed, then there is no danger for the further development of the child.
• Rapid overgrowth is caused by taking vitamin D and calcium supplements. They are prescribed taking into account the development of the baby for the prevention of rickets, only a lack of substances can affect the growth of bone tissue, which slows down the process and increases the period of overgrowth. The very intake of minerals, vitamins does not cause an acceleration of tissue ossification, it is an individual feature or occurs with violations in the development of the baby.
• If by the year the fontanel in a child does not overgrow, then he has rickets. The disease is manifested by a number of signs and cannot be determined only by the rate of ossification of the membranous tissue on the baby's head.
• A small fontanel in a baby at birth should grow faster and vice versa. The timing of tightening does not depend on the initial size of the membrane, but on the characteristics of the organism.

There is no exact time when a large fontanel in newborns overgrows. The process takes place individually, it is influenced by various factors. It is impossible to independently make diagnoses in case of deviations from the generally accepted terms for overgrowth of the fontanel. This cannot be the only symptom of serious diseases - they always have additional signs.

It is forbidden to self-prescribe medicines and use folk methods. For the health of the baby, it is important to follow the rule: discuss any concerns with the pediatrician, who, if necessary, will prescribe additional studies. In addition to the size of the fontanel, you need to pay attention to its condition: excessively convex or sunken may be a sign of illness or a deterioration in the child's condition.

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