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Does An Enlarged Anterior Fontanelle Require Medical Attention?

Posted on Sat, 16 Jun 2018

Question: Hi doc,
my baby is 9 month old. We took him for vaccination yeaterday.& the ped told that his anterior fontanelle is slightly large for 9 months & it should close by 12 months. We XXXXXXX giving him vit d drops. Should we worry? what can be the reasons for the delay?

Answered by Dr. Arun (31 minutes later)

Brief Answer:
Check his vitamin d level and calcium and thyroid

Detailed Answer:
Hi
THANKS FOR WRITING AGAIN.
Don't worry. Anterior fontanelle can take up to 18 months to close. If your baby is otherwise normal, no need to worry. There is still time.
However if your Pediatrician has examined and found it to be larger then I would suggest
1. Get vitamin d levels and calcium levels checked.
2. Do check for thyroid levels if not checked at birth.
3. Regular follow-ups to check for excess fast increase in head circumference to rule out other causes like hydrocephalus etc ( less likely because your Pediatrician would have checked that).
4. If everything is fine, just give some more months to see if it decreases in size.
Wishing good health
Dr Arun

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Arun (51 minutes later)

what are the formal names for these blood tests?

Answered by Dr. Arun (4 minutes later)

Brief Answer:
Formal names

Detailed Answer:
1. Tsh, T3, T4 levels
2. 25 oh vitamin d level
3. Serum Calcium
These are the exact names for the tests.
Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Arun (20 minutes later)

what is the normal headcircumference increase at 9 months?

Answered by Dr. Arun (3 minutes later)

Brief Answer:
0.5 cm per month from 6 to 12 months

Detailed Answer:
First three months infants will gain six centimeters increase which means 2 centimeters per month.
The next three months the rate is three centimeters in three months which means
1 cm per month.
The next six months the rate is three centimeters in six months which means 0.5
cm per month.

So now for next three months count as 0.5 cm per month as normal
Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Arun (2 hours later)

Thank you for the timely reply :)

Answered by Dr. Arun (20 minutes later)

Brief Answer:
Welcome

Detailed Answer:
You are welcome

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Arun (1 hour later)

Hi doc, the HC was increased by 1cm per month in the last months

Answered by Dr. Arun (5 hours later)

Brief Answer:
Not a problem

Detailed Answer:
It is still acceptable. Not a problem.
Only if it is more than that needs evaluation.
Keep following up every month.
Regards
Dr Arun

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Above answer was peer-reviewed by : Dr. Prasad