Why Caring for Your Baby's Soft Spots Shouldn't Make You Anxious

A soft spot (fontanelle) is there to create spaces between the major bones of the baby's skull. These spaces are there because a newborn baby's skull isn't fused together yet, which is what allows them to move through the pelvis during a vaginal delivery. A fontanelle or soft spot can feel soft to the touch, which is how they got their name.

Why do babies have soft spots on their heads?

A fontanelle/soft spot is an opening in a newborn's skull where the bones haven't grown together. They are an important part of normal infant development and serve important roles for a baby. Soft spots aid in the birthing process, and later, they allow for an infant's brain to grow rapidly.

During birth, the soft spots leave space for the bones in the head to move during delivery, helping the baby's head fit through the narrow birth canal without damaging the body. Later, as your child grows, the soft spots create space for the brain to experience rapid growth during the first few years of life.

How fontanelles affect a baby's head shape.

Fontanelles can play a role in how a baby's head is shaped. There is space for the bones of the skull to move around during the baby's first year of life, so the pressure on this area can influence a baby's head shape.

Molded head 

When baby's heads stay in the birth canal for a long period of time, there can be a lot of pressure on the skull. This can affect how their head looks after they are born. They can appear cone-shaped or pointed, which is known as caput succedaneum. Thankfully, within a few days, their head will take a more rounded shape.

Flat head 

Until a baby's soft spot closes and the skull bone fuse, the shape of an infant's head can change. For instance, if they go to sleep on their back or sit in a car seat for a long period of time, the back of your little one's head can become flat.

Until the fontanelles close and the bones of the skull join together, the shape of the baby’s head can change. The "Back To Sleep" campaign advises that babies sleep on their backs to reduce the risk of SIDS. But this also increases the chance of flat head syndrome.

To allow your baby's head to move around and not get too much pressure on any one area of the skull, begin to change their position often throughout the day. Your child's doctor should advise that they only be placed on their back to sleep, but during the daytime, you can switch up your baby's position to help your baby's development, avoid prolonged pressure on the back of the skull, and prevent a flat head.

Some helpful ways to encourage different positions:

• Baby wearing

• Carrying your baby

• Tummy time

• Hold a toy over their head when they're on their back, and move it from side to side so they move their head to look at it

• Hold them in your lap and read them a story

Types of fontanelles

Infants are born with six fontanelles that slowly close over the first year of life. The biggest one is between the forehead and crown of the head, known as the anterior fontanelle. Most people know about this one, but there are others!

• Anterior fontanelle: This is located on the top of the head, and is a diamond-shaped fontanelle known as "the soft spot."

• Posterior fontanelle: This smaller opening is located at the back of the baby’s skull. It is triangular in shape.

• Mastoid fontanelles: There are two of these located at the intersection of the temporal, parietal, and occipital bones, found towards the back of the head.

• Sphenoid fontanelles: These two soft spots are located on either side of the skull.

When will my baby's fontanelles close?

The bony plates of an infant's skull don't completely close during childhood, because the baby's brain grows rapidly. The brain needs room to grow. Once the bones grow to fill the open spaces in the skull plates, the fontanelles are considered closed.

The fontanelles close in this order: posterior fontanelle (after the first few months), anterior fontanelle (13-24 months), mastoid fontanelles (6-18 months), and sphenoid fontanelles (around 6 months).

Fontanelles can close earlier or later than these averages, and still be completely healthy. Contact your doctor if you're concerned.

What Happens If You Touch the Soft Spot on Your Baby's Head? 

The good news: your baby's skull is made with tough membranes that cover the openings between the skull bones, protecting the soft tissue inside. It is important to learn to gently touch your baby's body, but everyday contact with "soft spots" is totally fine.

Parents should not worry about things like touching their baby's head, washing their baby's hair, using combs and brushes, having their infant wear hats or headbands, or having other children touch the baby.

How should you care for the soft spot on an infant's head?

Taking care of a newborn's soft spot doesn't have to be complicated, but it can be nerve-wracking for new parents! Your baby's doctor will check their fontanelles during their checkups and monitor for any issues that may arise. Monitoring continues over the course of the first year, but there really isn't anything special parents need to do to help the baby's soft spot close safely.

Parents should know:

Their baby's soft spot should look flat against their head (as opposed to a sunken soft spot or bulging area). They should be able to feel that the soft spots are soft, flat, and slightly curved.

Be aware that the soft spot can change and look bulging if a child is crying or vomiting. The soft spots might also pulsate in time with the baby's heartbeat, which is also normal.

Possible issues with fontanelles:

Sunken fontanelle: The fontanelle can seem like it curves inward slightly, but a very sunken soft spot might be an indication of things like dehydration, which is dangerous for an infant.

Causes of dehydration include issues with breastfeeding, having a stomach bug, or spending too much time in the hot sun. Parents should be aware of their child's urine output, sleep problems, irritability, and dry mouth, which can indicate dehydration.

Bulging fontanelle: If a baby's fontanelles are too big or don't close within the expected time frame, it can indicate medical problems like hypothyroidism, Down syndrome, or rickets. The pediatrician can monitor your baby's fontanelles over time to make sure they close properly.

A fontanelle that closes too soon: If your baby's fontanelles close too soon, and can be a condition called craniosynostosis. It can affect the baby's brain growth and the shape of the baby's head. When the baby's fontanelles close too soon, it can also cause pressure buildup in the baby's skull. Many times, this condition requires surgery to correct.

Caring for your baby's fontanelle doesn't have to be scary. 

With some understanding and education, parents can be aware of everything they need to know about their baby's soft spots and skull bones. Caring for a baby's soft spot is actually simple, and thankfully, a child's pediatrician will monitor them closely throughout their infancy to make sure your baby's soft spot is right on track.

Sources:

https://www.parents.com/fontanelle-baby-soft-spot-8627736