Examination of the Newborn's Head

Importance of Head Examination

• Essential to assess and document the head thoroughly.

Skull Anatomy in Newborns

• Suture Lines: Connective tissue between skull plates; not fused at birth.
  • During delivery, the skull may mold, creating a cone head appearance.
  • Molding: Temporary, resolves in 72 hours.
  • Overriding Sutures: Occurs when skull plates overlap due to molding; resolves in days.

Fontanelles

• Anterior Fontanelle
  • Location: Top of the head.
  • Shape and Size: Diamond shape, 2-3 cm.
  • Closure: Typically closes between 12-18 months.
  • Significance:
    • Bulging indicates increased brain pressure.
    • Sunken indicates possible dehydration.
• Posterior Fontanelle
  • Location: Back of the head, smaller and triangular.
  • Closure: May be closed at birth, usually closes by 2-3 months.

Common Lesions

• Caput Succedaneum (Caput)
  • Superficial soft tissue swelling.
  • Crosses suture lines.
  • Resolves in 2-3 days.
• Cephalohematoma
  • Bleeding between bone and periosteum.
  • Does not cross suture lines; can grow larger post-birth.
  • Takes weeks to resolve; may harden.
  • Rarely associated with skull fractures.

Newborn Head Control

• Babies are born "floppy," unable to hold heads up.
• Head Lag: Normal initially; concerning if present at 6 months.
  • Sign of potential neurological or muscle function issues.

Next Steps

• Watch the video on neonatal face examination.