Head Symptoms in Babies

A bulging fontanelle is when the soft spot on the top of a baby's head appears to be swelling outward or feels tense and firm when the baby is upright and calm. While brief bulging during crying or straining is normal, a persistently bulging fontanelle can indicate increased intracranial pressure and requires prompt medical evaluation.

Positional plagiocephaly is a flattening of one side of a baby's head, or brachycephaly is flattening at the back. It is very common, affecting up to 47% of infants, and typically results from spending time in one position. It is usually cosmetic and improves with repositioning, though severe cases may require a helmet.

Hair loss in babies is extremely common and usually benign. Most newborns lose some or all of their birth hair in the first 6 months as it transitions from fine lanugo to mature hair. Friction from lying on their backs (positional hair loss) is also very common. True pathological hair loss in infants is rare.

Head banging is a common rhythmic movement where a baby or toddler repeatedly bangs their head against the crib, wall, or floor. It affects up to 15-20% of healthy children and is typically a self-soothing behavior that begins around 6-9 months and usually resolves by age 3-4. While alarming to parents, it is rarely a sign of a developmental problem.

Head injuries in babies and toddlers are common as they learn to roll, crawl, and walk. Most are minor bumps that resolve with comfort and ice. However, infants are at higher risk for serious injury because their skulls are thinner, their neck muscles are weaker, and they cannot describe symptoms. Any fall from a significant height or forceful impact warrants careful observation.

Macrocephaly means a head circumference above the 97th percentile or more than 2 standard deviations above the mean for age and sex. Many cases are benign familial macrocephaly (parents also have larger heads), but it can occasionally indicate conditions requiring evaluation such as hydrocephalus or increased intracranial pressure.

Microcephaly is defined as a head circumference below the 3rd percentile or more than 2 standard deviations below the mean for age and sex. It can be congenital (present at birth) or acquired (develops after birth). While some babies simply have smaller heads genetically, microcephaly can indicate problems with brain growth and development.

A sunken fontanelle is when the soft spot on the top of a baby's head appears noticeably depressed or concave. While a very slight dip is normal, a markedly sunken fontanelle is one of the most reliable early signs of dehydration in infants and requires prompt attention.