Hi. Welcome to our lecture on the newborn head.
We thought this might be helpful for you before you start
about abnormalities in the newborn head.
We have a few other lectures dedicated to that.
The newborn head is relatively pliable compared to ours.
This is really special. It's a special unique quality it has
which allows it to go through the birth canal.
The newborn skull is similar to ours in that it has the same
the occipital, parietal and frontal bones.
However, as you can see here, the borders between the
regions are kind of large
and there's two areas called fontanelles that are especially
These fontanelles allow for brain growth and they eventually
They're made of a fibrous material that eventually ossifies
and turns into part of the skull.
The posterior fontanelle is present until about one to two
months of age and then, it closes.
The anterior fontanelle is present until about 18 months of
It's a little bit different for every infant but those are
the average times of closure.
The sutures are just the borders in between each region.
You're more likely to see the terms for the sutures used in
x-ray reports or CT reports.
It's not super important always that nurses know what -
which sutures are which.
This is how a newborn's head circumference is measured.
A tape measure is put above the eyebrows at the widest part
of the head,
around the widest part of the head. It's done always during
Then, it's plotted on a graph and compared to previous
These measurements are plot on a graph that basically
considers the age and gender
because the different - there are differences, slight
differences in head circumference
based on age and gender.
The average head circumference for a newborn is about 33 to
35 centimeters or 13 to 14 inches.
It may temporarily vary after birth because of what we
already talked about,
the molding, the squishing that occurs, especially during a
However, this should self-adjust and get back to normal size
and contour after about two to three days.
One fun fact that some people don't know is that one quick
little reference for head circumference
is to measure head circumference
and then, compare it to the newborn's crown rump length or
if you can put a newborn into sitting position.
Basically, the top of their head is extended to the bottom -
to their bottom.
This is a measurement that's used a lot in early pregnancy
to try to date a fetus
and figure out their gestational age.
It can also be used as a quick reference for whether the
head circumference of a newborn
is about right because they should be similar.
If the newborn's head circumference is about four
centimeters or more, more, greater
than their crown rump length.
Hydrocephalus should be considered.
Let's take a quick look at the child's skull versus the
As you can see, the cranium or the bones of the head
are more elongated and bulbous in a child's skull.
They eventually grow into it, but at first, they're quite
The frontal and parietal areas specifically are larger.
A child's brain actually does most of its growth in the
first two years of life.
By the age of two, the brain is about 75% of its adult size
which is pretty incredible.
And now, you may understand a little more as to why toddlers
especially are so top-heavy and so prone to injury.
This is the NCSBN Clinical Judgment Measurement Model.
It's a framework being used now for many NCLEX Next
Generation case studies and exam questions.
You'll probably hear about it in nursing school if you
and you may have some test questions that use it as a
Let's relate some of the content from this lecture
on normal findings in the newborn head to recognizing cues
and analyzing cues.
Really, we're going to flip it this time.
Since we just talked about normals, think about why that's
In order to recognize cues or analyze cues,
an infant or a newborn that has - that may have an abnormal
you have to first know what normal findings are.
So as pertaining to the head, the head circumference at
should be on average on a full-term infant about 33 to 35
if you measure it correctly, above the eyebrows, around the
widest part of the head.
Any misshapen head due to birth and any cone heads
should be pretty resolved by the first two or three days.
The infant's skull is normal to feel kind of pliable, a bit
soft, softer than ours for sure,
and the infant's skull should definitely have two open
fontanelles at birth.
There's probably a larger one in the front called the
and a smaller one in the back called a posterior fontanelle.
These fontanelles among other things allow for brain growth
in the first couple years especially.
So those are the major normal newborn head findings
that'll help you recognize cues and analyze cues when you
don't see them.