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Ages & Stages

This topic is particularly directed toward those of you who have been mistakenly led to believe that all newborns are born picture perfect with pretty little round heads. Let us just say that for anyone who has gone through or will experience vaginal delivery, it is nothing short of a blessing that a baby’s skull is made up of soft bony plates that are capable of compressing and overlapping to fit through the narrow birth canal—a process referred to as molding.

For some babies—such as those who “drop” well in advance of being born (in other words, settle themselves head first deep into their mother’s pelvis well in advance of delivery), or those who must endure long labors and narrow birth canals—the result is often a newborn head shape that more closely resembles a cone than a nice round ball.

If you run your fingers over your newborn’s skull, you may also find that you can feel ridges along the areas where the bony plates of the skull have overlapped. In short, cone heads are quite normal. Fortunately, over the next several weeks the bones of your baby’s skull will almost assuredly round out and the ridges will disappear, assuming, that is, that your baby doesn’t spend too much time on his back with his head in any one position—a common but easily avoidable cause for the development of a flat back or side of the head known as plagiocephaly.

The Soft Spot

You will notice 1 if not 2 areas on your baby’s head that seem to be lacking bony protection. These soft spots, referred to as fontanelles (anterior for the larger one in the front, posterior for the smaller and typically less noticeable one in the back), are normal gaps in a newborn’s skull that will allow your baby’s brain to grow rapidly throughout the next year. Many parents are afraid to touch these soft spots, but you can rest assured that, despite their lack of a bony layer, they are well protected from typical day-to-day baby handling. Other things to know about the soft spot(s) include:

  • In young infants, a sunken soft spot (when combined with poor feeding and dry diapers) can suggest dehydration. Our advice to you: Don’t read too much into this because it can be a subtle finding or sometimes be present in normal babies. Instead, make sure you have a good grasp on how to recognize dehydration and check with your doctor if you have any concerns—with or without a sunken soft spot.
  • In some instances, the soft spot on the top of your baby’s head may seem to be pulsating. There is no need to worry—this movement is quite normal and simply reflects the visible pulsing of blood that corresponds to your baby’s heartbeat.

Bumps and Bruises

In addition to molding, it is not uncommon for newborns to have a bit of swelling or bruising of the scalp immediately following  delivery. The swelling usually is most noticeable at the top back part of the head and is medically referred to as a caput (short for caput succedaneum). When bruising of the head occurs during delivery, the result can be a boggy-feeling area, called a cephalohematoma. Bruising and swelling are usually harmless and go away on their own over the first days and weeks of life, but can be a contributing factor for jaundice.

Gone Today, but Hair Tomorrow

Sure, babies are sometimes born with full heads of hair, but it’s far more likely for them to be born with little to none. And those with hair today are likely to find it gone tomorrow. That’s because any hair your baby is born with is likely to thin out significantly over the next few months before ultimately being replaced with “real” hair. It is also entirely possible that whatever hair your newborn does have will change color by several shades and several times over his lifetime.

 

Last Updated
8/7/2013
Source
Heading Home With Your Newborn, 2nd Edition (Copyright © 2010 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.