What happens if you hit a babys soft spot

By: Jessica Huhn, Dec 21, 2021

Why does baby have soft spots on their head, and how to care for them? When do baby’s soft spots usually close up? We answer parents’ most common questions about baby’s soft spots, also called fontanelles. 

What are fontanelles (baby soft spots)?

Your baby will be born with two soft spots, or fontanelles, on their head. 

• The first one is called the anterior fontanelle, and that’s the diamond-shaped soft spot on the top of their head.
• The second one is called the posterior fontanelle, and that’s the triangle-shaped soft spot at the back of their head. (You might not notice this one.)

Baby has soft spots, or fontanelles, on their head because their skull is still growing and developing. 

Babies’ skulls are made up of several different soft bones (known as plates) that haven’t yet fused together. 

The gaps where these skull plates haven’t yet fused together are baby’s soft spots.

This creates a flexible skull shape that’s important for two main reasons.

•  First, the flexible skull lets baby’s head pass through the birth canal without damaging their brain.
• Second, the flexible skull leaves plenty of room for baby’s brain to grow over their first two years. Baby experiences rapid head and brain growth over their first two years, and the skull needs to be flexible to accommodate this.

Learn more about baby's fontanelles from Nurse Dani of Intermountain Moms: 

How do I care for baby’s soft spots?

Baby’s soft spots may look very delicate. But baby actually has a thick membrane under their scalp, that keeps their brain protected. 

As long as you touch baby’s soft spots gently, you won’t hurt baby. So don’t be afraid to gently touch baby’s soft spot.

It’s perfectly safe to brush their hair using a baby comb or brush, even over the soft spots.

It’s also safe to gently touch the soft spots when you hold baby. 

And during bathtime, you’ll need to gently scrub their scalp --- including their soft spots --- to get rid of the flakes that build up. This helps prevent cradle cap. 

The only thing to watch for is this ---  don’t put pressure on baby’s soft spot. 

And it’s always good to remind your other children, your family members and your friends to be gentle when touching baby, especially around their head. 

What do normal fontanelles look like?

Knowing what baby’s soft spots are supposed to look like can help you determine what’s normal and when you should be concerned. 

Normal soft spots:

• Look flat --- not sunken, swollen, or bulging
• Feel soft and flat, while curving slightly downward
• May look raised or look “bulging” when baby vomits, cries, or is lying down --- but goes back to normal when baby is upright and is no longer vomiting or crying. (This is because crying and vomiting temporarily increase the pressure in baby’s skull.)

What if baby’s soft spot pulsates?

If baby’s soft spot pulses with their heartbeat, this is completely normal! As the heart moves blood through baby’s body, you can sometimes see this movement through baby’s soft spots, in time with their heartbeat. Don’t be concerned about a pulsating soft spot! 

When should I be concerned about baby’s soft spots?

Here’s when you should be concerned about the appearance of baby’s soft spots:

Baby’s soft spot is sunken

If baby’s anterior fontanelle is sunken, this could be a sign that baby is dehydrated. Other signs of dehydration include a dry mouth, not enough wet diapers, irritability, and crying with no tears.

Baby dehydration is serious and requires immediate medical attention. If you suspect baby is dehydrated, call your pediatrician immediately. 

Baby dehydration could be caused by feeding difficulties, overheating, a fever, vomiting, or diarrhea.

Baby’s soft spots stay bulging or swollen

If baby’s soft spots are bulging even when they are resting and not crying, this could indicate a problem. The same goes if baby’s soft spot is hard and swollen.

There could be swelling in baby’s brain, or too much fluid in their brain. Both of these conditions are very serious and require immediate medical attention. If baby’s soft spot is bulging, or hard and swollen, contact your pediatrician right away.

Baby hit their soft spot

If baby hits their soft spot, call your pediatrician immediately. They will need to make sure baby didn’t cause a head injury or concussion. 

Baby may have a head injury if they hit their soft spot, are unwilling to feed, vomit or have seizures, start to cry nonstop, have trouble waking up, and/or have bloody eyes or a bloody nose.

A bulging or swelling soft spot, plus bruises behind the ears, could be a sign of a concussion. Call 911 immediately if baby shows these signs. 

Baby doesn’t appear to have soft spots

In very rare cases, a baby’s skull plates fuse together too early, and that baby won’t have soft spots. This is caused by a condition called craniosynostosis. This condition may affect brain growth, and may require surgery to remedy. 

At every checkup, your pediatrician will check to make sure baby has soft spots, and that the soft spots look healthy, for this and other reasons. It’s important to note, though, that some babies have soft spots that are difficult to feel or see, but that are still present.

When do the fontanelles usually close up?

Baby’s anterior fontanelle (the one on the top of the head) could close as early as 9 months of age, and will often close up by 18 months of age. It will almost always close up by 2 or 3 years of age. 

The posterior fontanelle (on the back of the head) will usually close up far sooner, and you might not even notice it. On average, that soft spot will usually close between 1 and 3 months of age, and will almost always close by 6 months of age.

Every baby is different, though, so don't be concerned about how early or late the fontanelles close. 

-------------------------------

All health-related content on this website is for informational purposes only and does not create a doctor-patient relationship. Always seek the advice of your own pediatrician in connection with any questions regarding your baby’s health.

These statements have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure or prevent any disease.  

See the FDA Peanut Allergy Qualified Health Claim at the bottom of our homepage.

A fontanelle is a ‘soft spot’ of a newborn baby’s skull. It is a unique feature that is important for the normal growth and development of your baby’s brain and skull. Your health team will check your baby’s fontanelles during routine visits.

If you touch the top of your baby’s head you can feel a soft spot in between the bones — this is a fontanelle.

A newborn baby’s skull is made up of sections of bone known as plates that are joined together by fibrous joints called sutures. The sutures provide some flexibility and allow your baby’s head to narrow slightly as it travels through the birth canal. The sutures also enable your baby’s head to grow in the first years of life.

There are 2 fontanelles on your baby’s skull. These are the skin-covered gaps where the skull plates meet. The anterior fontanelle is at the top of your baby’s head, and the posterior fontanelle is located at the back of your baby’s head.

When will my baby’s fontanelles close?

The posterior fontanelle usually closes by the time your baby is 2 months old. The anterior fontanelle can close any time between 4 and 26 months of age. Around 1 in every 2 babies will have a closed fontanelle by the time they are 14 months old.

Can I touch my baby’s fontanelles?

Yes, you can gently touch your baby’s fontanelles. If you run your fingers softly along your baby’s head you are can probably feel them. Your doctor will touch your baby’s fontanelles as part of their routine medical examination. There is no need to be concerned or worried about touching your baby’s fontanelles as long as you are gentle.

What does a normal fontanelle look like?

Your baby’s fontanelle should feel soft and flat. If you softly touch a fontanelle, you may at times feel a slight pulsation — this is normal. If a fontanelle changes, or feels different to how it usually does, show your doctor or midwife as it may be a sign that your baby’s health may need to be checked.

Sunken fontanelle

If you notice that your baby’s fontanelles are low or sunken, your baby may be dehydrated.

However, you may notice other signs of dehydration in your baby before their fontanelles becomes sunken.

Other signs of dehydration include:

Bulging fontanelle

A bulging or swollen fontanelle may be a sign of a number of serious but rare conditions including meningitis or encephalitis (infections in the brain), cerebral haemorrhage (bleeding in the brain), hydrocephalus, an abscess or another cause of increased pressure in the brain.

If you think that your baby’s fontanelles are bulging or sunken, seek medical advice immediately.

What if a fontanelle closes too soon?

Your baby’s fontanelles may close early. This can happen for several reasons. Your baby may have hyperthyroidism (high levels of the thyroid hormone) or hyperparathyroidism (high levels of parathyroid hormone). Another cause of early fontanelle closure is a condition known as craniosynostosis. Craniosynostosis occurs when one or more of the fibrous joints (sutures) between the bone plates in a baby’s skull fuse too early, before the brain has finished growing. As the brain continues to grow, it pushes on the skull from the inside but cannot expand into the closed over area. This causes the skull to have an unusual shape.

If you notice that your baby’s fontanelles seem to have closed early, if you can feel a ridge along your baby’s skull, or if you think that your baby’s head has an unusual shape, take your baby to see their GP or paediatrician.

What if a fontanelle doesn’t close?

Your baby’s fontanelles may not close on time for several reasons. Common reasons for delayed fontanelle closure include congenital hypothyroidism (low thyroid hormones from birth), Down syndrome, increased pressure inside the brain, rickets and familial macrocephaly (a genetic tendency to have a large head).

If one or both of your baby’s fontanelles haves not closed by the time they are 2 years old, speak to your GP or paediatrician.

If you have any concerns about your baby’s fontanelles you should make an appointment to see your child health nurse, GP or paediatrician.