All You Need To Know About The Baby’s Soft Spot (Fontanelle) And The Importance Of Monitoring It

Baby fontanelle is a concept that every mother faces once she has a baby. Despite the myths surrounding it, it is a fact that it comes with a purpose. There is no coincidence that babies are born with a soft spotted head on which the bones have not yet grown together. For starters, what actually might surprise you, is that babies do not have one fontanelle only, but many! In fact, your newborn’s entire head is soft at birth and you can even feel all the tissues pulsing from underneath the skin. But are there other things you should know about the fontanelle? Yes, there are! And #MommyVeronika will tell them all to you today!

What is the fontanelle?

As already mentioned above, in newborn babies, the skull bones are not firmly connected to each other. Between them are flexible sutures and soft connective tissue membranes called fontanelles. We usually talk about the fontanelle in singular, referring to the biggest one located on the top of the skull but the reality is that there are 6 fontanelles! The most noticeable being the large one, also called front, parietal or top, and the small one, also called back or occipital, because it is located on the back of the baby’s head. Each fontanelle closes at a different time, with the large one closing last – between 8 and 18 months, the small one around 3 months of age, and the rest in the first month of your baby’s life.

What is the fontanelle’s role?

Fontanelles play an extremely important role in childbirth. They allow the baby’s skull to be deformed already during the passage through the birth canal and especially when it goes between the bones of the mother’s pelvis, which in some cases is not an easy task at all. Thanks to the soft spots, the bones from which the baby’s skull is formed are mobile, the circumference of the head can become smaller, the shape can change slightly and thus pass more easily through the birth canal. The soft membranes also have a protective function during birth because they protect the baby’s head and brain from injury.



After the baby is born, the fontanelles can still play an important role – for example, in the increase of intracranial pressure, which can occur as a result of the course of labor or from intrauterine infection. Sutures and soft spots have the ability to compensate for this condition by slightly shifting. If this is not done, the newborn may suffer from a headache. That is why baby neurologists monitor with particular attention any change in the size and tension of the soft spots after birth and up to the age of 1 year.

What are the shapes and sizes of fontanelles?

The largest fontanelle – known as the front, parietal or top fontanelle is diamond-shaped. Its size varies among newborns from 0.5cm by 0.5cm to 3cm by 3cm. A wider fontanelle may mean that less calcium and vitamin D reached the baby during pregnancy. It has been suggested that there is a relationship between the diet of the expectant mother and the size of the fontanelles after birth. The small one (also called back or occipital) is shaped like a triangle and is about 5 mm in size.
It is good to know that within a few days after birth, the soft spots may slightly increase in size as a result of the baby’s skull returning to its normal shape from before passing through the birth canal.

When do the fontanelles close?

The large fontanelle usually closes around the age of 12 to 15 months. There are cases when this can happen earlier – between 8 and 12 months or later – between 15 and 18 months, and rarely after this age, but at the latest until 2 years of age.
The small fontanelle can be closed already at birth (this is found in about 25% of newborns) or close during the 1st, 2nd to 3rd month of the baby’s life.

What does the pediatrician look for when examining the fontanelle?

Within the framework of regular consultations with the pediatrician in the first year of the baby’s life, one of the things that must be monitored is the circumference of the little one’s head and its growth in one month. The closing of the fontanels is a genetically determined process, but it is also related to the amount of calcium and vitamin D that the newborn receives. It is important that the baby eats well with enough breast milk or formula, as well as sunbathing more, if possible, and not forgetting to take vitamin D, if prescribed by a doctor.

If the closure of the large fontanel occurs earlier than the 6th month, it can prevent the normal growth and development of the baby’s brain and lead to serious diseases such as microcephaly. A consultation with a pediatric neurologist will be necessary then. If the anterior fontanel has not closed after 18 months, it may be a sign that the child has rickets, which requires observation and treatment by a pediatrician.

Does the fontanelle need special care?

The short answer to this question is “No”. Of course, caution and attention to the baby’s head are very important. It should be protected from strong pressure and any possible trauma. Combing your little one’s hair is not prohibited, but it is good to be done with a special baby comb or brush, as they have soft teeth or bristles. It is also recommended not to put too tight hats on the baby’s head, because they are not good for blood circulation and normal growth of the baby’s head.

It is important to follow the pediatrician’s prescriptions and advice. He will track the size of the fontanelle and the growth rates of the head to make sure everything is normal. Otherwise, the general recommendations that the newborn should be breastfed, if possible, and taken out for a walk every day, if the weather permits, remain valid.

Should fontanelles be kept from touching?

Claims that fontanelles can be damaged by a touch or that touching them can cause harm to the baby’s brain are myths. Parents can calmly caress their newborn’s head, bathe it and comb its hair. The brain is sufficiently protected at the site of the soft spot so there is no danger of damage just by touching it.
What fontanelles should be protected from are pressure and sharp objects. Of course, if there is an older child at home, make sure to be extra careful with them too.

What is good to watch out for around the fontanelle and its closure?

– On palpation, the large fontanelle is usually slightly concave. If a baby cries or vomits – two actions that lead to tension in the head – the fontanel usually bulges slightly. There are also cases where the anterior fontanelle pulsates when the baby cries. This is due to the straining of the baby’s body, as the impulses of blood increase and the pulsation becomes more pronounced and more clearly visible to the parents.
– If the large fontanel is too sunken, this may be a sign of dehydration and lack of fluids in the body due to vomiting, diarrhea or fever. This can also happen with improper absorption of nutrients.
– If the fontanelle is more prominent than usual, this may be a sign of increased intracranial pressure. If there are other symptoms such as high fever and unusual changes in behavior such as refusal to eat or crying, it is good to notify the baby’s pediatrician immediately.
– If the large fontanelle, instead of shrinking, becomes larger and, in addition, there is a change in behavior – the child is more restless or its reactions become weaker – a consultation with a pediatrician or a baby neurologist must be done.
– If the parietal fontanelle closes too quickly or too slowly, the pediatrician should also be notified. He then will determine what further action should be taken.
– Do not give your child vitamin D or calcium at your discretion! They should only be prescribed to the baby by a doctor, as incorrect doses can have adverse effects on the infant’s body.

xo, MommyVeronika