Definition

What is a sunken fontanelle?

A baby is born with several fontanelles. These are more commonly known as soft spots. They provide the skull with the flexibility needed to pass through the birth canal. This flexibility also allows your baby’s brain and skull to grow during the first year of life. In newborns, soft spots are found on the top, back, and sides of the head.

The number of soft spots on your baby’s head depends on their age. The fontanelle on the back of the head usually disappears by 1 to 2 months of age. You may never be able to feel or see this one. The one on the top of the head remains present until your baby is between 7 and 19 months old.

A baby’s soft spots should be relatively firm and curve ever so slightly inward. A soft spot with a noticeable inward curve is known as a sunken fontanel. This condition requires immediate medical attention. It’s usually easy to treat.

How common is a sunken fontanelle?

Asunken fontanelle is common. It can be managed by reducing the risk factors. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of a sunken fontanelle?

The common symptoms of a sunken fontanelle include:

  • Soft spot with a noticeable inward curve

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you or your loved one has any signs or symptoms listed above or you have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes a sunken fontanelle?

There are several potential causes of sunken fontanel.

Dehydration: Dehydration takes place when your body loses more fluid than you drink. The most common cause of water loss from the body is excessive sweating. Read more about dehydration here. This condition is considered a medical emergency. Urgent care may be required.

Kwashiorkor: Kwashiorkor is a serious form of malnutrition caused by a lack of protein. Learn how to spot this condition and how to prevent it.

Failure to thrive: A child is said to have failure to thrive when they don’t meet recognized standards of growth. Find out more about how failure to thrive is defined and treated here.

Toxic megacolon: Toxic megacolon is a rare, life-threatening widening of the large intestine and is usually a complication of inflammatory bowel disease (IBD). Learn about the symptoms, diagnosis, and treatment of toxic megacolon here. This condition is considered a medical emergency. Urgent care may be required.

Diabetes insipidus: Diabetes insipidus (DI) is not a form of diabetes. Instead, it’s a rare condition that occurs when your kidneys are not able to conserve water. Find out how this condition is diagnosed and treated.

Risk factors

What increases my risk for a sunken fontanelle?

Please consult with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is a sunken fontanelle diagnosed?

If your baby has a sunken fontanel, you should seek medical attention as soon as possible.

When the doctor examines your baby, they’ll first do a physical examination. This includes looking at and feeling the affected area. The doctor will also likely assess your baby’s skin elasticity, or turgor. Poor elasticity can also be a sign of low fluid levels. The amount of moisture in the eyes and mouth can also provide clues about your baby’s level of hydration.

Second, the doctor will ask you about your baby’s symptoms. It’s important to provide as much information as possible. The doctor will likely want to know when the problem appeared and how you would rank the severity of the symptom considering the normal appearance of your baby’s soft spots. Note whether the baby has been sick recently or if the baby recently had any bouts of vomiting or diarrhea. Tell the doctor if there was a recent period during which your baby perspired more than usual, if your baby seems thirsty, and whether your baby’s level of alertness seems normal.

The doctor may then order one or more tests. These might involve taking a blood or urine sample. Specific tests may include a complete blood count (CBC). This blood test measures the number of red and white blood cells as well as their components to detect infection or anemia, which can occur with dehydration. A urinalysis involves a number of tests to check urine for abnormalities that might indicate dehydration.

Another test you may need is a comprehensive metabolic panel. This blood analysis involves a number of tests that assess how well various chemicals in the body are breaking down and using food. It can help detect malnutrition.

How is a sunken fontanelle treated?

If your baby’s doctor finds that your baby is dehydrated, they will most likely be put in the hospital on IV fluids via a needle in a vein. In very young babies, dehydration is a medical emergency and should not be treated at home. If your baby is suffering from malnutrition, they may start tube or intravenous feedings as well. If your doctor thinks your baby can be treated at home, here are some things they might suggest:

Give plenty of liquids. You will need to offer baby extra liquids. Breastfeed more often or offer more formula feedings. You can try small sips often instead of full feedings. Do not dilute the formula. If your baby is already on solid foods, you can offer bottles of water or a pediatric electrolyte replacement drink. Do not give your baby soda or fruit juice.

Use a pediatric electrolyte replacement. Keep a bottle made up of electrolyte replacement. Use only approved types and not sports drinks. These help replace potassium, sugar and salt in your baby’s body.

Try an over-the counter pain reliever. When babies don’t feel well or have a sore throat, they tend to refuse feedings. Your doctor may recommend trying an over-the-counter infant pain reliever. Acetaminophen is only recommended for babies two months of age or older and Ibuprofen is only recommended for babies three months of age or older. If you are unsure of dosage, make sure you get the correct amount from a doctor or pharmacist.

Keep baby cool on hot days. If the weather is hot and your baby is dehydrated, keep them cool, away from the sun and out of the heat. Give extra fluids on hot days i.e. water bottles for babies on formula and solids, breastfeed more often for breastfed babies).

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage a sunken fontanelle?

The following lifestyles and home remedies might help you cope with a sunken fontanelle:

Preventing your baby from getting dehydrated helps prevent a sunken fontanelle. If your baby is not eating or drinking well, make sure you offer fluids often. Make sure you feed your baby whenever they are hungry, which is called “on-demand feeding.” If your baby gets sick, feed them small sips of fluids often. If your baby is suffering from malnutrition, make sure you are clear about how much they should be eating for their age and weight. This feeding chart for babies up to 1 year old can help.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: March 7, 2018 | Last Modified: March 7, 2018

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