By Andrea Sattler, MD, Primary Care Pediatrics, Nationwide Children’s Hospital
*Through a collaboration between Blanchard Valley Health System and Nationwide Children’s Hospital, the content of this article was provided courtesy of Nationwide’s 700 Children’s® blog by pediatric experts.
You may have noticed one or two areas on your baby’s head that do not feel like they contain a bony covering. These are your baby’s soft spots, or fontanelles. Babies have two fontanelles. One is located near the front of their heads. This is the larger of the two fontanelles and is called the anterior fontanelle. The other fontanelle is much smaller and located near the back of the head. This is the posterior fontanelle.
The skull is made of several bones. In fact, there are eight different cranial bones that make up the top of our skulls. Over time, these bones fuse together to form the adult skull. In infants, these bones are not yet fused together. The soft spots are the spaces located between the different bones in the skull. They allow your baby’s head to be flexible enough for childbirth. They also allow the head and brain to grow as the baby gets older. Your baby’s fontanelles can also provide helpful clinical information. For example, they may be low if a baby is not feeding well and is dehydrated.
It is always a good idea to support the head and neck when you are holding your baby. Although the soft spot contains no bony covering, the brain is still protected by a thick covering. This covering will protect your baby’s brain during regular activities such as washing your baby’s hair and scalp or putting on a hat or headband. If you are concerned that your baby’s head has been injured, contact your baby’s pediatrician or go to the emergency department.
At times, you may notice that your baby’s soft spot is pulsating. While this may seem unsettling at first, it is completely normal. The pulsations correlate with your baby’s heartbeat and the pulsing of blood through their body.
The soft spot on the back (the posterior fontanelle) closes sooner than the one on the front (the anterior fontanelle). This typically occurs by three months of age. The anterior fontanelle takes a little longer to close and is typically gone by the time a baby is nine to 18 months old. Your primary care provider will check your baby’s soft spot at each wellness exam to make sure that it is an appropriate size and that it is not closing too quickly. The primary care provider will also check your baby’s head shape and size to make sure that their head is growing appropriately.
