February 20, 2019

5 Warning Signs From Your Baby’s Soft Spot

Some fontanelle changes can reveal internal issues

New father cuddling and holding baby carefully

When you’re a new parent, you learn that you need to protect that soft spot, or fontanelle, on your baby’s head. It rarely requires much attention, but it reminds you just how fragile your infant is.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

That’s why, if something changes — is the soft spot sunken in a little? — you may worry there’s something wrong.

A change in the fontanelle isn’t always a major problem, but it can sometimes reveal internal issues, says Violette Recinos, MD, Section Head of Pediatric Neurosurgery at Cleveland Clinic.

“It is a good indicator of the baby’s potential hydration status and brain status,” she says. “It’s like an automatic pressure sensor.”

What is the fontanelle?

The fontanelle is the space between different plates of a baby’s skull that will eventually come together. This aspect of an infant’s skull structure typically allows for easy delivery through the birth canal and for rapid head growth during the first year of life, Dr. Recinos says.

There are actually two soft spots — one at the back of the head and another on top. The posterior one closes within a few months of birth, while the top fontanelle typically remains until just past a child’s first birthday.

Dr. Recinos explains what changes in the fontanelle can tell you about your infant’s health.

Sunken in soft spot

This is often a sign of dehydration, she says. It may occur if your child is sick and not getting enough fluids.

What you should do: See your pediatrician if the sunken appearance persists and you can’t get your baby to take in more fluids.

Advertisement

Swollen soft spot

After a fall, a swollen soft spot (particularly if it’s accompanied by vomiting) is sometimes a sign of head trauma.

What you should do: Seek medical treatment right away.

Bulging soft spot

Fluid buildup (hydrocephalus) can cause rapid head growth and can make the soft spot look “full,” Dr. Recinos says.

A bulging fontanelle also might signal internal bleeding or a tumor or mass causing pressure in the head.

What you should do: If their soft spot is bulging, that’s a reason to seek care from your pediatrician, she says.

Seek emergency care if your infant exhibits fatigue, vomiting or unusual mental status along with the fontanelle’s fullness. Treatment for these conditions may include surgery to insert a shunt that relieves fluid buildup or to remove any underlying mass, Dr. Recinos says.

Disappearing soft spot

Most of the time the soft spot is obvious, particularly on a newborn. But at times it can seem to disappear quickly.

This may scare parents, but it typically means it’s just a “quiet fontanelle,” not that it has fused together prematurely, Dr. Recinos says.

Advertisement

As long as your child’s head is growing normally, all is probably well, she says. But your pediatrician may suggest an imaging test to make sure the fontanelle is still open.

Occasionally, though, the skull bones do close earlier than normal on one side, causing craniosynostosis. Depending on which bones fused, the baby may develop an abnormal head shape. For example, sagittal craniosynostosis, the most common form, results in a longer head that is shaped somewhat like a football.

What you should do: Children with craniosynostosis may need surgery to open the fused bones and reshape the skull. In some cases, the child will wear a helmet afterward until the site heals and the head shape normalizes.

Soft spot that doesn’t close

If the soft spot stays big or doesn’t close after about a year, it is sometimes a sign of a genetic condition such as congenital hypothyroidism.

What you should do: Talk to your doctor about treatment options.

The bottom line? If you have any questions or concerns about your baby’s soft spot, it’s a good idea to check in with your pediatrician to make sure all is well.

Related Articles

Sad, exhausted parent holding newborn in cage surrounded by drug addiction possibilities
February 15, 2024
Can Babies Be Born Dependent on Drugs?

Neonatal opioid withdrawal syndrome, or NOWS, can develop when a birthing parent uses opioids, nonmedical drugs or even some prescription drugs during pregnancy

Adult hand uses a dropper to deliver a liquid to newborn by mouth
January 18, 2024
Do Infants Need Vitamin D Drops?

A daily dose of vitamin D can help babies build strong bones, as well as boost their brain development

baby crying
November 2, 2023
Why Is Your Baby Crying?

They could be hungry, gassy, colicky or sleepy, or even too hot or too cold

gently removing cradle cap from baby's head with comb and moisturizer
September 17, 2023
How To Get Rid of Cradle Cap in 4 Steps

Moisturizer, a daily bath and some gentle nudging can help

Parent holding newborn while feeding them formula.
September 11, 2023
Babies Shouldn’t Drink Water — Here’s Why

Tiny kidneys and tiny tummies don’t mix well with water

newborn being dried off after a bath
July 13, 2023
Bath Time for Baby: When and How To Bathe Your Newborn

Be mindful about temperature, positioning and efficiency when it’s comes to your little one

Mom burps gassy baby who sits on her lap.
May 21, 2023
Why Gripe Water Isn’t the Best Answer for Your Fussy, Gassy or Colicky Baby

Gripe water isn’t regulated by the FDA, and research doesn’t support its use

Busy mom helps children with homework while holding baby, working on computer and talking on phone.
April 27, 2023
Got Mom Guilt? Here’s How To Navigate It

Caring for your own well-being and setting manageable expectations can dispel that feeling

Trending Topics

White bowls full of pumpkin seeds, dark chocolate and various kinds of nuts
25 Magnesium-Rich Foods You Should Be Eating

A healthy diet can easily meet your body’s important demands for magnesium

Woman feeling for heart rate in neck on run outside, smartwatch and earbuds
Heart Rate Zones Explained

A super high heart rate means you’re burning more than fat

Spoonful of farro salad with tomato
What To Eat If You’ve Been Diagnosed With Prediabetes

Type 2 diabetes isn’t inevitable with these dietary changes

Ad