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Ask Dr. Y. Vasavada Your Own Question
Dr. Y. Vasavada
Dr. Y. Vasavada, Pediatrician
Category: Paediatrics
Satisfied Customers: 3324
Experience:  M.D.(ped) passed at first attempt, in practice continuously for last 37 years. Certi. in Comp
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What are the signs to watch out the soft anterior Fontanelle

Customer Question

What are the signs to watch out for if the soft anterior Fontanelle has been accidentally pushed in a 7 week old? She didn't cry or react when it occurred in the process of finishing a feed. What symptoms would there be if there had been any damage to underlying tissue, or is the tissue covering the brain at that spot actually tougher than I realise? Thanks
Submitted: 2 years ago.
Category: Paediatrics
Expert:  Dr. Y. Vasavada replied 2 years ago.
Hello, In case of brain injury at soft spot, baby may become irritable or more sleepy, depending upon whether hurt has caused irriation of brain substance or more damage causing impending coma. From history nothing of sort seems to have happened, so just observe her for a day for any out of ordinary behaviour or symptoms.Significant trauma of soft spot also will have abrasion over skin and redness, swelling of scalp soft tissue.
Expert:  Dr. Y. Vasavada replied 2 years ago.
Brain substance under soft spot is also pliable and will just deform momentarily, not causing any lasting damage. Only damage can occur from all-round compression like fluid filling up etc.
Customer: replied 2 years ago.
Thanks. So if baby is feeding normally since, alert when awake and not unhappy, there's no cause to think there would be any lasting brain damage? She's incredibly sleepy anyway at 7 weeks - just a very placid baby - but no more so since the incident. There's no swelling of the Fontanelle, nor a mark on it. I think half the babies in the works would have problems if it was as easy as that to cause damage! It was just an accidental firm single push as I was manoeuvring her and I felt my finger depress in, but as I say she did not cry or seem distressed. She's irritable anyway when feeding and in the aftermath but she's got reflux.
Expert:  Dr. Y. Vasavada replied 2 years ago.

You are welcome.

Yes I believe she is safe and no need to worry. Please try to keep a wrap like head gear for a day or two. Good luck to her.

Customer: replied 2 years ago.
I'm sorry - I don't understand "keep a wrap like head gear". I'm sure she's fine. My anxieties in general stem from her reflux ultimately which is why feeding can be difficult and she has apnoeas. Perhaps you could clarify something for me, finally. If she had an apnea bad enough to cause significant oxygen restriction and consequently brain damage, she would not simply start breathing again and be immediately pink and fine of her own accord. What I mean to say is that apnoeas where she resumes breathing herself, and regains her colour well and quickly (or where it doesn't change at all), will not have any impact on her neurological function? It's scary to find that she's paused breathing, often while feeding, and sometimes I get distracted in night feeds when tired and don't realise the Apnea has happened, but she resumes breathing herself and seems fine afterwards
Expert:  Dr. Y. Vasavada replied 2 years ago.
Till the soft spot closes, it is advisable to use a cotton cloth cap.
Brain has a reserve and can withstand lack of oxygen few minutes. If the apnoea was self correcting and baby turned pink within couple of minutes, there would be no lasting brain damage possible.
Feeding requires good breath coordination and sleepy baby may stop breathing momentarily while feeding but this rarely is cause for concern.