Baby’s flontanelle (oka ori) a mirror of your baby’s health

New parents are aware of the numerous ways in which their new baby depends on them. The baby depends on the parent learning their cues and keeping them safe and healthy, from proper feeding to safe sleep routines and assistance with burping.

It’s normal to question whether the soft regions, also known as fontanelles or oka ori in Yoruba,  at the top of the baby’s head, are completely fused together. But the truth is that this slight depression on the baby’s head rarely needs any care.

The spots allow the baby’s head to mold to the birth canal during labour and delivery. The fontanelles at the back of the head close a couple of months after birth, while the fontanelles on the top of the head take longer, up to 19 months.

Sometimes, if a baby is crying, lying down, or vomiting, the fontanelle may appear being raised or swollen slightly, but should return to normal when the baby is in a calm, upright position.

However, the fontanelle may also appear sunken. In this case, the baby’s soft spots appear depressed or concave, sinking below the level of the surrounding skull.

Mrs Kehinde Oyebode, the Director of Nursing at the Oyo Ministry of Health, however, declared that a change in the fontanelle isn’t always a major problem, but it can sometimes reveal areas for concern.

According to her, this baby’s soft spots can be an indicator of the baby’s potential hydration status and brain status, among other things.

“A bulging fontanelle in a child may indicate a serious medical issue, including meningitis, which is the swelling of the membranes that cover the brain and spinal cord. It is also seen in children that are severely malnourished or babies that are not well breastfed and therefore not growing well.”

Mrs Oyebode added that a sunken fontanelle usually indicates dehydration, which can result from diarrhoea, vomiting, insufficient fluid intake, and excessive heat exposure.

However, Professor Adebola Orimadegun, a Consultant Paediatrician and Director of the Institute of Child Health at the University of Ibadan, said the state of the baby’s soft spot on the head of an infant or a baby under 5 years is not meant to be an indicator of the nutritional status of a child, although a few conditions can be detected by looking at the shape and its fullness.

He added: “When it is bulging, it is an indication that there is an increase in the pressure in the brain, we call it raised intracranial pressure. That can happen in cases of infection, mass which could be tumour or fluid in the brain when it is an infection like meningitis.

“When it is sunken, of course, it can indicate dehydration in children who have lost fluid during diarrhoea episode or excessive vomiting. So, we use it to also monitor hydration status, but with respect to nutrition, the state of the fontanelle is not an indicator of nutritional status.

“However, if the child is malnourished, the sunken fontanelle will become more obvious because the child’s hair will be fluffy and sparse. So that may be the reason why people are saying it could be related to nutritional status; otherwise a sunken fontanelle itself is not related directly to nutritional status.”

Since a bulging fontanelle could be a symptom of a more significant problem, he stated that taking the baby to the hospital for assessment and treatment is important.

“In fact, a bulging fontanelle is often a cause for immediate medical treatment because of serious underlying issues with the baby’s brain,” he added.

Since the soft spots on a child’s head may also not be a medical condition, it will be necessary for nursing mothers to avoid the use and application of herbal concoctions on them. Again, no scarification marks are needed on the soft spots.

In addition, the use of olive oil, methylsalicylate and eucalyptus oil on the soft spots should be discouraged, as they are of no benefit to the infant.

Although a normal physiological occurrence, it is perceived as a potential sign of disorder.

This fear drives traditional healing practices and social influences within the community, making mothers to seek out traditional remedies, including concoctions, to protect their infants from perceived harm.

Common misconceptions about bulging fontanelle include the belief that it always indicates bacterial meningitis, while most cases are benign.

This lack of understanding contributes to the perpetuation of cultural beliefs that associate the pulsation with potential health issues, prompting the use of concoctions as a misguided treatment.

Soft spots that are bigger than average or stay open longer than about a year can sometimes be a sign of a medical condition.

Researchers say that large fontanelles and fontanelles that don’t close when they’re expected to can be associated with conditions like Down syndrome, rickets, a condition that causes warped bones and bones that break more easily and abnormally high amounts of pressure in the brain.

It’s important to note that these conditions come with other symptoms. So, there is no need to prematurely rush to conclusions that a baby is otherwise developing normally.

No doubt, the baby’s soft spot can be an indication of their overall health. But it’s just one way to assess whether a child is growing as expected.

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