Babies' soft spots aren't hard to handle

Tots to Teens

April 09, 1996|By Dr. Modena Wilson and Dr. Alain Joffe | Dr. Modena Wilson and Dr. Alain Joffe,SPECIAL TO THE SUN

I'm 14 now, and get calls to baby-sit. I like babies and want to earn money but only have been taking jobs with older children. I'm scared because I've heard babies have soft spots on their heads.

My mom says I'm silly. What should I do?

We don't think you should take sitting jobs that make you feel really nervous, but hope that more information will decrease your fear of "soft spots."

First, what are soft spots and why do babies have them? When babies are born, their skulls are works in progress.

Under the scalp are several plates of bone that have not yet completely grown together to make the skull solid. This arrangement has at least two advantages. It makes it easier to the baby's head to get through the birth canal and it allows the skull to get bigger as the brain grows.

Imagine how you'd look (and think) if your head stayed the size it was when you were born.

Neighboring skull bones eventually fit together like pieces of a jigsaw puzzle, but for the first two months there are two places where the corners of several bones don't yet meet -- a small place toward the back of the head called the posterior fontanelle and a larger one near the front called the anterior fontanelle.

It's the anterior fontanelle that is often referred to as the soft spot, but it's really not so soft! It is completely covered by a firm fibrous material where the bones will grow in.

When you touch the scalp over the anterior fontanelle, it will feel like thin cardboard, not like pudding.

Your finger can depress the soft spot slightly without hurting the baby at all, because the underlying brain is cushioned by fluid.

It is important to handle babies gently, because they are relatively fragile. They should never be hit, squeezed hard or shaken.

It is also important to support the head when you pick up or hold a baby, because babies don't have strong neck muscles. The soft spot itself presents no additional problem. We suggest you ask a family friend who has a baby, or your doctor, to show you a soft spot and allow you to touch it, so you'll see that it's safe.

You might also consider a baby-sitting course for people your age. It could help you feel more comfortable caring for babies.

Dr. Wilson is director of general pediatrics at the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.

Pub Date: 4/09/96

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