Fontanelles - excessively large

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Fontanelles

Large fontanelles

Large fontanelles (lateral view)

Skull of a newborn

Soft spot - large

If you think that the fontanelles on your baby's head are excessively large, talk to your health care provider. Most of the time, this sign will have been seen during the baby's first medical exam.

The health care provider will perform a physical exam and ask questions about the patient's medical history, including:

• When did you first notice that the fontanelle looked large?
• Which "soft spots" are affected?
• Is it always the same, or does it change in any way?
• What other symptoms are also present?
• Have large fontanelles been present with previous babies?

Note: An excessively large fontanelle is usually discovered by the health care provider, and the parents may not have been aware of its presence.

The health care provider may check the size of the fontanelles and the head over several months. This can help determine problems of the fontanelle and head growth.

Diagnostic tests may include:

• Head circumference measurements
• Transillumination of the skull (generally in the newborn or infant of only a few weeks)
• Ultrasound of the head
• Head x-rays , CT scan, or MRI
• Blood tests for suspected causes such as a serum thyroxin (T3 and T4) for suspected hypothyroidism

Review Date: 05/10/2006
Reviewed By: Daniel Rauch, MD, FAAP, Director, Pediatric Hospitalist Program, Associate Professor of Pediatrics, NYU School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.