Babies are born with several soft spots in their skulls which play an important role in development. Sometimes these soft spots can appear sunken in. Learn more about what causes a sunken soft spot and how to respond if the situation arises.
Soft spots are the points where sutures – fibrous material that holds the five plates of a baby’s skull together – meet. Also known as fontanelles, the soft spots allow a baby’s skull to be flexible enough to pass through the birth canal. Located on the top, back and sides of the head, soft spots also provide a baby’s brain and skull plates ample room to grow during the first couple years of life. Babies are born with around six of the soft spots but generally only two can be felt at birth.
How many fontanelles an infant has will depend on his or her age. The soft spot at the back of a baby’s head will normally disappear by the time he or she is one or two months old. The soft spot on the top of baby’s head will remain anywhere from seven to 24 months, though most often will close by the time a baby is 19-months old.
Doctors will check out your baby’s skull and soft spot periodically, so no need to worry.
What if My Baby’s Soft Spot Is Sunken In?
The soft spot should be firm to the touch and curve slightly inward, but not noticeably so. If your baby has a noticeable inward curve, this means the fontanelle is sunken and you should start to become concerned about your baby. Although the number one cause of a sunken soft spot is dehydration, it is important to rule out some other causes of concern.
What the Experts Say
For the most part doctors are on the same page about what causes sunken soft spots. According to Jennifer L.W. Fin, RN featured on The Bump, “The soft spot will sometimes sink. It’s not a cause for major concern unless it’s super-sunken. Also, if your baby is dehydrated, there won’t be tears — her mouth will be dry, no wet diapers, and when you pinch the skin, how quickly it bounces back. You have to look at the bigger picture, not just one symptom”.
What Causes A Baby’s Soft Spot To Sink In?
Sunken fontanelles can happen for a variety of reasons. These include:
Dehydration: This is the most common reason for a sunken soft spot. When your body loses more fluid than you drink, you can become dehydrated. Babies can become dehydrated from vomiting or diarrhea.
Failure to thrive: If a baby does not meet recognized standards of growth, he or she may have failure to thrive.
Diabetes insipidus: This is a rare condition that happens when the kidneys are not able to conserve water.
Toxix megacolon: A rare and life-threatening widening of the large intestine. This is usually a complication of inflammatory bowel disease and it is considered a medical emergency.
Kwashiorkor: A severe form of malnutrition. This is caused by protein deficiency.
How To Treat and Prevent Sunken Soft Spots
Dehydration is the most common cause of a sunken fontanelle, so your child should be closely monitored to make sure he or she is getting enough fluids throughout the day. If the dehydration is sever enough your doctor will treat dehydration with fluids that will be given through the mouth or through an IV line.
Taking Care Of The Soft Spot
After addressing the issue and getting medical care you can start to think about home care and caution you’ll want to take with your baby.
The soft spot sometimes makes parents nervous – myself included. We often fear touching it the wrong way, or accidentally injuring it somehow. Even the pulsing of the spot, which happens as blood flows around baby’s brain and skull when baby is relaxed, can make parents nervous. However, we should not avoid touching our babies’ heads. There will come a time when we have to touch the soft spots, such as when giving baths. The solution to handling the soft spot is quite simple – the soft spot should be handled gently by adults and other children in the household, without applying pressure.
If you are concerned about sunken soft spots or the development of your baby’s skull in general, you should reach out to your pediatrician. Many physicians have triage nurses on call after hours to help you determine if you concerns warrant an appointment.