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</div><div><span>Fontanelles - enlarged</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Fontanelles - enlarged</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Enlarged fontanelles are larger than expected soft spots in the head for the age of a baby. </p><p>The skull of an infant or young child is made up of bony plates that allow for growth of the skull. The borders at which these plates intersect are called sutures or suture lines. The spaces where these connect, but are not completely joined, are called soft spots or fontanelles (fontanel or fonticulus).</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Considerations</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>Fontanelles allow for growth of the skull during an infant's first year. Slow or incomplete closure of the skull bones is most often the cause of a wide fontanelle.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Larger than normal fontanelles are most commonly caused by:</p><ul><li>Down syndrome</li><li><a test="test" href="./001571.htm">Hydrocephalus</a></li><li>Intrauterine growth retardation (IUGR)</li><li>Premature birth </li></ul><p>Rarer causes:</p><ul><li>Achondroplasia</li><li>Apert syndrome</li><li>Cleidocranial dysostosis</li><li><a test="test" href="./001658.htm">Congenital rubella</a></li><li><a test="test" href="./001193.htm">Neonatal hypothyroidism</a></li><li>Osteogenesis imperfecta</li><li>Rickets </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>If you think that the fontanelles on your baby's head are larger than they should be, talk to your health care provider. Most of the time, this sign will have been seen during the baby's first medical exam.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>What to Expect at Your Office Visit</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>An enlarged large fontanelle is almost always found by the provider during a physical exam. </p><ul><li>The provider will examine the child and measure the child's head around the largest area. </li><li>The provider may also turn off the lights and shine a bright light over the child's head.</li><li>Your baby's soft spot will be regularly checked at each well-child visit.</li></ul><p>Blood tests and imaging tests of the head may be done. </p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Soft spot - large; Newborn care - enlarged fontanelle; Neonatal care - enlarged fontanelle</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/1127t.jpg" alt="Skull of a newborn" title="Skull of a newborn" class="side-img"/><a href="../imagepages/1127.htm">Skull of a newborn</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/17179t.jpg" alt="Fontanelles" title="Fontanelles" class="side-img"/><a href="../imagepages/17179.htm">Fontanelles</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/9334t.jpg" alt="Large fontanelles (lateral view)" title="Large fontanelles (lateral view)" class="side-img"/><a href="../imagepages/9334.htm">Large fontanelles (lateral view)</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/9335t.jpg" alt="Large fontanelles" title="Large fontanelles" class="side-img"/><a href="../imagepages/9335.htm">Large fontanelles</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Kinsman SL, Johnston MV. Congenital anomalies of the central nervous system. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. <em>Nelson Textbook of Pediatrics</em>. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 609.</p><p>Piña-Garza JE, James KC. Disorders of cranial volume and shape. In: Piña-Garza JE, James KC, eds. <em>Fenichel's Clinical Pediatric Neurology</em>. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 18.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 11/6/2023</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.</p>
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