Should You Take Your Baby to the Hospital for a Swollen Fontanel?

Swelling and redness of the fontanelle?

My baby is eleven months old, with a corrected age of ten months.
While playing, he suddenly fell and hit his head against my teeth.
My teeth are not aligned properly, and he hit the protruding part of my tooth with such force that it caused me pain for a long time.
The area around the gum has turned red and is swollen significantly.
Should I take him to the hospital? Thank you!

Haha, 20~29 year old female. Ask Date: 2020/05/07

Dr. Pei Rensheng reply Pediatrics

Hello! The anterior fontanelle typically closes between 9 to 18 months of age.
Before it closes, there are rich blood vessels beneath the fontanelle, which may bleed or swell due to severe trauma.
A soft hematoma within the scalp should not be drained, as it usually resolves on its own within a few weeks.
Please be aware of the following conditions: 1.
Alertness: Increasing drowsiness, decreased responsiveness, and abnormal deep sleep may be precursors to coma.
If the patient is difficult to awaken, it indicates a serious condition, and immediate medical attention is required.
2.
Unequal pupil size: This is caused by increased intracranial pressure and is a serious sign.
3.
Projectile vomiting: After a head injury, powerful projectile vomiting may occur.
If vomiting persists, seek medical attention immediately.
Wishing you health and happiness! Sincerely, Ren Sheng.

Reply Date: 2020/05/07

More Info

When it comes to a swollen fontanel in an 11-month-old baby, especially after a head injury, it is crucial to take the situation seriously. The fontanel, or soft spot on a baby's head, is an area where the skull bones have not yet fused together. While it is normal for the fontanel to have some degree of flexibility, any sudden swelling, redness, or significant change in its appearance after an injury warrants immediate medical attention.

In your case, since your baby fell and hit their head against your teeth, resulting in a swollen and red fontanel, it is advisable to take your baby to the hospital or an urgent care facility. Here are several reasons why this is important:
1. Potential for Concussion: Head injuries in infants can lead to concussions, which may not always present with obvious symptoms. Signs of a concussion can include irritability, excessive crying, difficulty waking up, vomiting, or changes in eating habits. A healthcare professional can assess your baby for any signs of a concussion and determine if further imaging, such as a CT scan, is necessary.

2. Increased Intracranial Pressure: A swollen fontanel can indicate increased pressure inside the skull, which can be caused by bleeding or swelling in the brain. This is a serious condition that requires immediate evaluation. Symptoms of increased intracranial pressure may include a bulging fontanel, vomiting, lethargy, or seizures.

3. Infection Risk: Although less common, a swollen fontanel can also be a sign of infection, such as meningitis. Meningitis can present with fever, irritability, and a stiff neck. If your baby shows any of these symptoms, it is critical to seek medical care promptly.

4. Monitoring and Observation: Even if your baby appears to be fine after the injury, it is essential to have them evaluated by a healthcare professional. They can provide guidance on what to watch for in the coming hours and days, ensuring that you are aware of any concerning signs that may develop.

5. Peace of Mind: As a parent, your instinct is to protect your child. If you are feeling anxious about your baby's condition, seeking medical attention can provide reassurance. Healthcare professionals can offer advice, support, and a thorough examination to ensure your baby’s well-being.

In summary, given the circumstances of your baby hitting their head and the subsequent swelling and redness of the fontanel, it is highly recommended that you take your baby to the hospital for evaluation. Early intervention is key in managing potential complications from head injuries in infants. Always trust your instincts as a parent; if something seems off, it is better to err on the side of caution and seek medical advice.

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