Concerns About My 1-Year-Old's Development and Health Issues

The baby is currently 1 year and 7 months old, and there is a depression in his fontanelle?

Hello doctor, my baby is currently one year and seven months old.
He has a depression in his fontanelle that is about 10 centimeters long and one and a half fingers wide.
He often has diarrhea and has not consumed more than 150 ml of milk since birth.
Additionally, he has only eight small teeth, four on the top and four on the bottom.
He frequently has fevers and colds.
During a previous hospitalization, it was discovered that he has hydronephrosis, but it is just under observation until the next check-up in July.
His forehead is very prominent, and there seems to be a groove on the top of his head.
I would like to know if I need to take him to see a doctor, or if I am overthinking this.
If I should see a doctor, which specialty should I take him to? I am really worried and stressed.
Last month, during his vaccination, the doctor mentioned that his language development is slightly delayed and suggested that I take him for an evaluation.
He still cannot say "mama."

Wei Kai Mama, 30~39 year old female. Ask Date: 2024/04/17

Dr. Xiao Kaiwen reply Pediatrics

Infants with abnormal head shapes and developmental delays, characterized by wide cranial sutures and a prominent forehead, may require an evaluation for potential brain abnormalities.
It is recommended to consult a pediatric neurologist at a major hospital for further assessment.

Reply Date: 2024/04/17

More Info

Dear Concerned Parent,
Thank you for reaching out with your concerns regarding your one-year-seven-month-old child. It’s completely understandable to feel anxious when it comes to your child's health and development, especially with the various issues you’ve mentioned. Let’s break down your concerns and discuss the best course of action.

1. Cranial Shape and Fontanelle: You mentioned that your child has a noticeable indentation in the fontanelle (the soft spot on the head) that is over 10 cm long and about one and a half fingers wide. It’s important to note that fontanelles can vary in shape and size, but significant changes or abnormalities should be evaluated by a healthcare professional. The protrusion of the forehead and the groove you described could indicate craniosynostosis, a condition where the bones in a baby’s skull join together too early. This can affect the shape of the head and potentially lead to increased intracranial pressure. I recommend consulting a pediatrician or a pediatric neurologist for a thorough evaluation.

2. Frequent Diarrhea and Nutritional Intake: You mentioned that your child often experiences diarrhea and has not consumed more than 150 ml of milk since birth. Diarrhea in infants can lead to dehydration and nutritional deficiencies, which are critical at this stage of development. It’s essential to ensure that your child is receiving adequate nutrition, including a balanced diet appropriate for their age. If your child is having persistent diarrhea, it’s crucial to see a pediatrician to rule out any underlying gastrointestinal issues and to discuss dietary adjustments.

3. Delayed Dental Development: The fact that your child has only eight teeth at this age is concerning, as most children typically have more teeth by this stage. While there can be variations in dental development, it’s advisable to consult a pediatric dentist to assess your child’s dental health and development.

4. Frequent Illnesses: You noted that your child frequently experiences fevers and colds. While it’s common for young children to get sick often, especially if they are in daycare or around other children, persistent or severe illnesses warrant further investigation. A pediatrician can assess your child’s immune system and overall health.

5. Kidney Issues: The history of hydronephrosis (kidney swelling due to urine buildup) is another critical concern. Since your child is under observation for this condition, it’s essential to follow up with a pediatric nephrologist or urologist as recommended. Regular monitoring is crucial to ensure that any potential issues are addressed promptly.

6. Speech Development: You mentioned that your child has been noted to have a slight delay in language development, as they are not yet saying "mama." Language development can vary significantly among children, but if there are concerns, it’s beneficial to consult a speech-language pathologist. Early intervention can be very effective in addressing developmental delays.

In summary, I strongly encourage you to take your child to see a pediatrician as soon as possible. Given the multiple concerns you’ve raised, a comprehensive evaluation is warranted. The pediatrician can then refer you to specialists such as a pediatric neurologist, dentist, nephrologist, or speech-language pathologist as needed.
It’s completely normal to feel overwhelmed and worried as a parent, especially when it comes to your child’s health. Seeking professional guidance is the best step you can take to ensure your child receives the care they need. Remember, early intervention can make a significant difference in addressing developmental and health issues.

Wishing you and your child all the best. Please take care and don’t hesitate to reach out for help.

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