Why do fontanels exist

As time passes, the fontanels of some children closed; therefore, we had two options in presenting the results. If we wished to utilize all the data, we could bootstrap the sample and directly derive nonparametric percentiles from the simulated data sets. We could not use parametric statistics because a closed fontanel size zero was not a fontanel anymore.

However, information regarding the distribution of fontanel size of the children whose fontanels were not closed could be useful. To do that, in each age group, we could eliminate children with closed fontanels and use parametric statistics to compute the percentiles. Those results would have to be well understood and treated with care because the meaning of the percentiles changes with age.

After approximately 10 months of age, the percentiles show a distribution of less typical cases, but they may be very useful in a clinical practice. The most commonly used method of fontanel size measurement is that of Popich, which allows comparison with studies conducted by other researchers. We found no difference between the traditional method and oblique measurements, which is similar to the results of Jackson et al.

Fontanel size can increase during the first 2 months of life; 9 , 20 , 22 , 23 however, we did not observe such a trend in our cohort, similar to the reports of other researchers. We did not observe negative effects on neurodevelopment in any of the children whose fontanels closed during the first 3 months of age.

Three children developed microcephaly, and another three children developed macrocephaly, which is in agreement with the suggestion of Duc and Largo that early closure of the fontanel did not necessarily result in microcephaly.

We decided to select the 97th percentile, but perhaps to be on the safe side, we should suggest a closer investigation of children with fontanels measuring above the 95th percentile. Children with fontanels measuring above the 95th percentile should be monitored closely and investigated further for potentially associated diseases such as rickets, hypothyroidism, and increased cranial pressure. Approximately half of the normal variation in head size can be familial. In summary, the percentile charts generated in this study allow us to decide which case warrants further evaluation, preventing unnecessary diagnostic tests.

Oblique measures can be used instead of mean fontanel measurements. Early closure of the fontanel in children is not rare, and it does not necessarily result in microcephaly. Close follow-up is required, as is paying attention to head circumference, head shape, and neurodevelopment. The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Acquisition of data: Boran. Analysis and interpretation of data: all authors. Drafting the article: Boran, Furman.

Critically revising the article: all authors. Reviewed submitted version of manuscript: all authors. Approved the final version of the manuscript on behalf of all authors: Boran. Statistical analysis: Furman, Sakarya. Arch Dis Child 29 : — , West Afr J Med 18 : 55 — 59 , Dev Med Child Neurol 44 : — , Turk Arch Pediatr 34 : 70 — 73 , JAMA : — , Arch Dis Child : — , Pediatrics 78 : — , Iran J Child Neurol 9 : 15 — 23 , Acta Paediatr Suppl : 20 — 27 , Am J Perinatol 27 : — , Kiesler J , Ricer R : The abnormal fontanel.

Am Fam Physician 67 : — , Scott Med J 36 : 20 — 22 , Indian Pediatr 31 : — , Ann Trop Paediatr 8 : — , Natale V , Rajagopalan A : Worldwide variation in human growth and the World Health Organization growth standards: a systematic review. BMJ Open 4 : e , Ann Trop Paediatr 15 : 89 — 91 , J Child Neurol 23 : — , Ceylon Med J 58 : 96 — , Clin Pediatr Phila 53 : — , The newborn infant. In: Kliegman RM, St.

Nelson Textbook of Pediatrics. Philadelphia, PA: Elsevier; chap Varma R, Williams SD. Updated by: Neil K. Editorial team. Cranial sutures. Cranial sutures are fibrous bands of tissue that connect the bones of the skull. By: Tim Taylor. Last Updated: Jul 3, All Rights Reserved. Home Baby Newborn Health and safety.

Clare Herbert Community midwife. The soft spots are known as fontanelles. There are two fontanelles on your baby's head and they may vary in size slightly.

The soft spot on the back of your baby's head is called the posterior fontanelle. It's usually smaller than the other fontanelle and shaped like a triangle. The fontanelle on the top of her head is the anterior fontanelle. It is larger and diamond-shaped. Babies' skull bones are soft and easily moulded to help them squeeze through the birth canal.

This process is called moulding. Your baby's head is the largest part of her, so moulding is nature's clever way of temporarily making it smaller.