Baby's head: shape, size, deviations from the norm

Causes of a large head

A large head in a newborn may indicate both a normal increase in the physical parameters of the body in the first year of life, and the development of hydrocephalus - a pathological accumulation of fluid in the brain.

Reference! The pathology can be primary in nature or be a secondary disease of congenital malformations of blood vessels, the central nervous system, tumors of various etiologies.

Most often, dropsy of the brain appears due to an infection that a woman suffered during pregnancy.

Pregnant woman

In addition, other factors influence the development of the disease:

• premature birth;
• hyperthyroidism or diabetes mellitus in the mother;
• state of asphyxia at the birth of a baby;
• insufficient blood supply to the fetal brain during intrauterine development.

Hydrocephalus can develop in infants and adolescents. The supporting impetus for the development of the disease can be:

• severe head injuries;
• intoxication of the body;
• severe meningitis.

If a baby has a large head, it is important to find out the cause of this phenomenon in time. Therefore, you should not postpone your appointment with the pediatrician.

Why do you need to measure the fetal head?

At first it seems that such an indicator is as individual as, for example, the height and weight of an adult. But in fact, the embryo develops according to very strict rules. The dimensions of all parts of the fetal body are extremely important, and are regulated in medical reference books not only by months and weeks, but even by days of gestation!

Lag or advanced development can mean a variety of pathologies of the mother and fetus. This even applies to individual organs, such as the kidneys. But still, doctors are primarily interested in the parameters of the baby’s head in the womb.

In the ultrasound protocol, the size of the embryo is indicated at the very beginning. This emphasizes the importance of brain development, when even a small “error” can result in the most serious deviations from the norm.

Deviations and norms

What to do if your child has a headache in the forehead area

If the child’s head is larger than his body, parents begin to worry about the baby’s health. In order not to once again destroy nerve cells, it is necessary to be able to distinguish normal size from pathology.

Additional Information! At birth, the baby's head circumference is 34-35 cm.

In the first year of life, intensive enlargement of the skull is observed. In the first six months, the size can increase by 1.5 cm, in the 7-12th month of life - by 0.5 cm in 30 days. By 1 month, a baby’s skull normally reaches 36-37 cm. In girls, the head size may be smaller than in boys.

At 2 months

At two months, the size of the head in girls with normal development varies from 37 to 38.5 cm. The circumference of the child’s chest at this age is 2 cm less than the skull.

At 3 months

At 3-4 months, the volumes of the baby’s head and chest will be equal. They will be approximately 40-41 cm.

Normal head at 3 months

If a child has a large head at 3 months, the pediatrician may write a referral for additional examinations.

At 5 months

At five months of age, the skull circumference should be 41-42.5 cm.

Important! If the baby’s skull exceeds the average size, or the increase in head circumference over 30 days is more than 2 cm, this indicates developmental pathologies.

An obvious disease is indicated by an indicator of more than 39 cm in a newborn full-term baby. At 1 year of age, the child’s skull circumference should be 43-45 cm.

What parameters of the fetal head are assessed on ultrasound?

When an expectant mother sees an ultrasound examination report, she, as a rule, cannot understand what certain abbreviations mean. Here are the abbreviations doctors use:

• OG - head circumference;
• BPR/BRGP - biparietal, i.e. the distance from temple to temple;
• LZR - fronto-occipital (distance from the forehead to the back of the head).

Normal values ​​are estimated from tables. For each of them, at a certain stage of pregnancy there are certain fluctuations, which are expressed in percentiles. Most often, the doctor focuses on the average (50), but the overall development of the fetus and the proportionality of body parts are also taken into account.

The growth of the baby's head in the womb occurs unevenly during pregnancy. The highest growth rate can be observed in the second trimester.

Figure 2. Size chart by week

average values ​​are presented

Diagnosis of the disease

How to understand that a baby has a headache - signs and symptoms

If a child’s large head is visible to the naked eye, the disease must be carefully diagnosed in order to prescribe appropriate treatment. Otherwise, hydrocephalus can lead to delayed physical and mental development of the baby.

If the baby's head is growing very quickly, it is necessary to pay attention to the presence of other manifestations that are unusual for the normal development of the baby. Hydrocele of the brain can be indicated not only by the baby’s large skull, but also by other symptoms:

• increased intracranial pressure;
• neurological disorders;
• decline in visual functions.

Intracranial pressure

If parents are able to check the size of the skull on their own, then problems with intracranial pressure can only be identified by an experienced neurosurgeon, neurologist or pediatrician.

ICP norms

The classic symptoms of the pathology are:

• nausea;
• vomit;
• headache;
• swelling of the optic nerve head.

The manifestation of intracranial pressure is often confused with poisoning, gastritis, and problems with the biliary tract. In order not to waste time, if parents have similar symptoms, they need to insist on additional examinations.

Neurological problems

With dropsy of the brain, neurological symptoms often appear. The child may experience the following pathologies:

1. Strabismus. Due to improper functioning of the cranial nerves, the functioning of the extraocular muscles is reduced. In advanced cases, the child may experience paralysis of the eyeball.
2. Tremor of the limbs and chin. In the first few months, such manifestations may be physiological in nature. If the clinical picture persists, the symptoms indicate a neurological disorder in the infant.
3. Retarded psychomotor development. The baby does not play, does not try to stand up or sit down, and cannot hold his head up as expected.
4. Increased muscle tone. Due to pathologies of the central nervous system, the child may strongly press his toes while resting on his foot. After six months, the baby has a clear manifestation of grasping reflexes. In advanced cases, the baby may have convulsive seizures.

To diagnose the disease, a consultation with a neurologist is necessary.

Deterioration of vision

The development of pathology negatively affects the baby’s visual organs. Due to intracranial pressure, the baby may experience ophthalmological pathologies. For example:

• syndrome of impaired pupillary reflexes;
• ptosis of the upper eyelid;
• lazy eye syndrome or amblyopia;
• A premature baby may develop retinopathy.

For the slightest visual impairment, you should consult a pediatric ophthalmologist.

Rapid head growth

It is impossible to overlook this symptom. A baby's big head immediately catches the eye. It happens that pathology develops at a slow pace.

Reference! In order to diagnose the disease in a timely manner, the local pediatrician measures the baby’s head circumference every month, then compares the indicators with normal values.

Ultrasound of the brain

In case of a large discrepancy, additional examinations are prescribed:

• magnetic resonance imaging (MRI);
• ultrasound examination of the brain;
• computed tomography (CT).

Examinations help to identify not only changes in the structure of the brain, assess intracranial pressure, but also study the condition of blood vessels. It is impossible to accurately diagnose hydrocephalus without these studies.

How to calculate head circumference in children - video

We present to your attention a short but quite understandable video, after watching which you will learn by what anthropometric criteria the development of a baby is assessed, you can easily learn how to measure the girth of your baby at home, and you can also familiarize yourself with the table of head girth values ​​​​for newborn children, corresponding a certain age.

In addition to this parameter, parents are often interested in what the child’s height should be, depending on the month, which is also monitored by the pediatrician during examination, and the weight gain of newborns. You will be able to familiarize yourself in detail with these indicators and their control.

We hope this information was useful to you and you were able to find answers to all your questions. Write reviews and send comments.

Therapeutic measures

Baby's head sweats during feeding

Severe hydrocephalus requires immediate surgical intervention. In the absence of critical manifestations of the disease, relying on instrumental examination methods, the neurologist prescribes drug therapy to the baby.

Baby swimming

Treatment includes:

• taking diuretics, which help reduce the amount of fluid in the brain;
• for muscle disorders, medications are prescribed that improve the transmission of nerve impulses;
• if the baby has a delay in psychomotor development, the doctor prescribes medications aimed at improving cerebral blood flow and increasing mental activity;
• if necessary, use anticonvulsants;
• from two weeks of age, newborns are prescribed swimming to relieve muscle tension;
• as soon as the baby turns one month old, the doctor prescribes massage and infant gymnastics;
• It is recommended to use decoctions of motherwort and chamomile as sedatives.

When treating the disease, an important place is given to the infant's daily routine. Timely feeding, good sleep and long walks in the fresh air strengthen the body and have a beneficial effect on improving the clinical picture.

Compression and decompression of the skull in newborns

A newborn's head may appear irregular or uneven

In obstetrics, compression is the compression of the skull bones as they pass through the birth canal. Thanks to the presence of fontanelles, the mobility of the skull bones, and the elasticity of the joints, the baby’s head is easily configurable.

During a caesarean section, the skull is not subject to compression. But this is not always a plus. In the absence of compression, there is no powerful push that activates breathing and triggers the internal rhythm of the body.

Returning the skull bones to their place is called decompression. Most obvious deformations disappear with the baby's first breath and cry, as the membranes of the skull open. Breastfeeding also helps eliminate the consequences of passing through the birth canal. When performing sucking movements, the wedge-shaped occipital joint works, which, like a lever, lifts the bones of the skull.

Prognosis for full recovery

With timely treatment of the disease, the prognosis is favorable in 70% of cases. Children who underwent surgery on time or were prescribed medication are practically no different from their peers in terms of physical and psychological development. They can attend kindergarten and school.

Rehabilitation is necessary for a positive outcome

In advanced cases, severe forms of cerebral hydrocele lead to:

• mental retardation;
• personality disorders;
• lack of proper coordination of movements.

Advice. To successfully recover, rehabilitation may take more than 2 years. Do not neglect visiting various centers and sanatoriums.

Having a child with a large head is a cause for concern. To rule out the presence of a dangerous disease, do not hesitate to go to the doctor. With a timely diagnosis, it will be much easier to cope with the pathology and minimize its consequences.

How to interpret the calculator results?

The vague term percentile in medicine is used to estimate certain parameters of a child's development (height, weight, etc.), based on a statistical sample in his age group. All these data were obtained from measurements of hundreds of thousands of children and serve as an early indicator of developmental pathologies.

So, in the results of our calculator, the exact percentile will be first in the list, and ranges will be located slightly below - for example, between the 15th and 50th percentile. These numbers in themselves are not critical.

Doctors consider the speed of head growth as an important factor:

1. The child should follow the same percentile line on the graph;
2. If results cross two or more percentile lines (or increase/decrease by at least two ranges), you should contact your doctor. For example, intersections from 75–85 to 15–25;
3. If head circumference is below the 5th or above the 95th percentile, check to see if your baby has always been within those ranges. If it has just recently entered these ranges, consult your doctor.

To make it clear how the percentile head circumference calculator works, let’s illustrate with an example.

Our friend Stan has a daughter, Sophie. She is now four months old. She was born at the perfect time at 40 weeks and scored 9 out of 10 on the Apgar Scale - the so-called method for quickly assessing the health of a newborn.

However, her head circumference has always bothered Stan, as it is in the 25th percentile at birth.

At four months, Sophie's head size is 39.8 cm, so she is now in the 27.78 percentile and falls between the 25 and 50 percentiles. The pediatrician would say that as long as she follows the same percentile line without major downward or upward shifts, Sophie's development is normal.

Useful video about the fontanelle and head size in children from 0 to 12 months

List of sources:

• Nonsyndromic craniosynostosis: current state of the problem / Sufianov, Gaibov // Russian Bulletin of Perinatology and Pediatrics—2013. No. 6.
• Neurosurgery / Mozhaev S. V. M. // GEOTAR-Media, 2009.
• Neuropathology of early childhood: (Guide for doctors)./ Lebedev B.V., Barashnev Yu.I., Yakunin Yu.A.//L.: Medicine, 2005.
• Neurology of childhood. /G. G. Shanko, E. S. Bondarenko, V. I. Freidkov and others; Under general ed. G. G. Shanko, E. S. Bondarenko. // Mn.: Higher school, 2002.
• Assessment of physical development of children and adolescents. Methodical recommendations / gr. authors // Moscow, 2021.

Treatment

Since the etiological factors in the formation of a small head are often associated with genetic abnormalities, which cannot be completely eliminated, therapy will be aimed at:

• careful care of the baby - includes the implementation of all measures recommended by the attending physician, including sanitary and hygienic measures;
• prevention of the addition of secondary inflammatory, infectious or other pathological processes;
• surgical correction of malformations of internal organs;
• plastic surgery - to eliminate visible defects, such as syndactyly, cleft lips or palate;
• medicinal elimination of concomitant symptoms.

How to measure head volume

• Use a flexible measuring tape - a sewing centimeter is ideal;
• The tape should wrap around the most prominent part of the skull - this is one finger above the eyebrows, above the ears and, finally, around the widest part of the back wall of the skull;
• It is best to repeat the measurements three times.

Next, take the largest number and enter it into the “Head Circumference” field. Don't forget to indicate the gender and age of your baby! In the output box you will get the exact percentile it fits into, as well as a graphical explanation.

NOTE! Our calculator is designed for children under 5 years of age only. Data were taken from World Health Organization recommendations and standards were developed based on data from the WHO Child Growth and Development Reference Study for this age

Correct head diameter measurement

To avoid possible mistakes and false assumptions, it is necessary to measure the child’s head volume correctly. Readings should be taken with a measuring tape so that it passes clearly through the occipital protuberance from behind, and through the brow ridges from the front. When measuring your chest, place the tape in front strictly at the level of the nipples, and in the back at the level of the lower corner of the shoulder blade. When measuring parameters, the child must be in a calm state (not crying or screaming), otherwise the indicators will be incorrect.

The numbers that determine the height, weight, chest girth and head circumference of a newborn are basic indicators of the child’s development. It is through them that in the first year of a baby’s life you can monitor his condition and, if necessary, make adjustments to his care. During the first year of children's lives, visits to the pediatrician should occur every month. Basically, this is done specifically to take the listed anthropometric data.

If desired, parents can themselves learn to measure the baby’s height, chest volume and head size. And to obtain weight data, you only need to purchase suitable scales. This does not mean that you can refuse to visit the pediatrician. You will simply have the opportunity to independently observe whether the norm is being maintained.