Although skull bone seems to be a large bone, it is made up of several bones that are connected to one another with a tough membrane. The space between two bones that is covered by the membrane is called fontanelle. There are two major fontanelle, the anterior and posterior in the infant. Fontanelle in babies is also referred as soft spot. During birth it provides flexibility for the skull bones to pass through the birth canal. The flexibility also allows the brain to grow inside the skull.
Over a period of time after birth, fontanelles disappear and the skull bones fuse together.The posterior fuses within 1 to 2 months after birth while the anterior fontanelle disappears between 15 months to 2 years. Normally the fontanelle is firm and slightly curved inwards when touched. If the soft spot is markedly curved inwards it is called sunken fontanelle. Sunken fontanelle needs medical attention as it occurs due to several reasons.
What Are The Causes Of Sunken Fontanelle?
There are several causes of sunken fontanelle:
- Dehydration: Dehydration is one of the prominent causes of sunken or depressed fontanelle. Dehydration occurs when enormous amount of body fluid is lost. Babies tend to get dehydrated rapidly as compared to adults because of their small size. The baby may become dehydrated due to high fever, diarrhea, vomiting, lack of intake, etc. Parents must look out for signs that are suggestive of dehydration in babies. Sunken fontanelle is one of the prominent signs. Other associated signs of dehydration are decreased urination, dark yellow urine, dry skin and lips, sunken eyes, cold extremities, lethargy, absence of tears when crying.
- Malnutrition: Malnutrition is another cause for sunken fontanelle. Infant may be malnourished if the intestine is not able to absorb the nutrient properly. It may also occur due to lack of feeding, mainly formula feed or breast milk. Food intolerance, problems related to feeding, and certain inborn disorders all can lead to malnutrition.
Diagnosis Of Sunken Fontanelle
Sunken fontanelle can be diagnosed by the doctor on examining the child. He will examine the soft spot and find whether it is really sunken. Besides this, the doctor will also look out for other symptoms and signs of dehydration and malnutrition. He will examine whether the skin is dry; he will also inquire if baby is suffering from diarrhea and vomiting or if he is sleepy all the time. He will also inquire the feeding habits of the baby.
The doctor may also ask for certain tests such as urine routine, stool test and blood analysis. Stool test is helpful in case of diarrhea where as blood test is useful to determine whether the baby is suffering from anemia or any other abnormalities in the body.
Natural Treatment For Sunken Fontanelle
In case of dehydration the doctor may admit the baby in hospital for intravenous fluids. The main aim in dehydration is to correct the fluid and electrolyte balance in the baby. Intravenous fluid administration will replenish the lost fluid and salt from the baby’s body. If the underlying cause for sunken fontanelle is malnourishment, the baby may be tube fed.
If the pediatrician thinks that dehydration is mild and the baby can be treated at home, he may suggest certain home measures such as:
- Breast feed the child as often as possible. Baby must be given enough fluid. Frequent sips of water and fluid are better than feeding in large amount at one time. Do not give the baby any aerated fluids or fruit juice. Give electrolyte replacement drinks. Simple sugar and salt solution is also beneficial.
- In case of infective diarrhea, the doctor may tell the parents to give prescribed medicines. He may also prescribe medications to stop vomiting, if the baby is vomiting constantly.
- Keep the baby in cool place if the climate is too hot. Heat can cause perspiration and hence increase fluid loss from the body.