Fontanel Size from Birth to 24 Months of Age in Iranian Children




How to Cite This Article: Esmaeili Mo, Esmaeili Ma, Ghane Sharbaf F, Bokharaie Sh. Fontanel Size from Birth to 24 Months of Age in Iranian Children. Iran J Child Neurol. Autumn 2015;9(4):15-23.



Diagnosis of abnormal fontanel size, a potential clue to recognition of different disorders, requires an understanding of the wide variation of normal fontanel size. The anterior fontanel is the largest, prominent and most important for clinical evaluation. The aim of this study was to establish and define normal range of fontanel size from birth to 24 months of age in healthy Iranian children that might be generalized to other populations.

Materials & Methods

Totally, 550 subjects enrolled randomly in this cross sectional study. They were apparently normal healthy children, from birth to 24 months of age, including 208-term newborn and 342 infant from birth to 2 yr old. Fontanel size was measured and recorded as the mean of the length (anterior- posterior dimension) and width (transverse dimension). Mean anterior fontanel sizes in our samples were classified for periods of 3 months. Nomograms and statistical analyses were performed and depicted by Excel Microsoft Office 2007 and two-tailed t-test respectively.


The mean ±2SD of anterior fontanel size was 2.55±1.92 cm in newborns, 3.37±2.48 (largest size) in 3 months of age. It was closed in all cases in 15-18 months of age. The mean posterior fontanel size was 0.8 cm in newborns and closed in all infants in 2 months of age. There was no significant difference in anterior fontanel size between two genders except in newborn and 6-9 months old (P>0.05).


Abnormal fontanel can indicate a serious medical condition. Therefore, it is important to understand normal variations, to utilize standardized techniques for measurement and appropriate standards of normal range in different age groups and populations. This study provides a normal range of mean fontanel size in Iranian infants as a local reference. It might be generalized to other populations.



Fontanel; Infants; Children; Iran

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Kiesler J, Ricer R. The abnormal fontanel. Am Family Physician 2003; 67(12): 2547-2552.

D. Paladini, m. Vassallo, g. Sglavo, g. Pastore, c. Lapadula and c. Nappi. Normal and abnormal development of the fetal anterior fontanelle: a three-dimensional ultrasound study. Ultrasound Obstet Gynecol 2008; 32: 755–761.

Malas MA, Sulak O. Measurements of anterior fontanelle during the fetal period. J Obstet Gynaecol 2000;20(6):601-5.

Faix RG. Fontanelle size in black and white term newborn infants. J Pediatr. 1982; 100(2):304-6.

Popich GA, Smith DW. Fontanels: range of normal size. J Pediatr 1972; 80(5):749-52.

Perera PJ, Wickramasinghe AR, Ranathunga N, Fernanado MP, Warnakulasooriya D. Statistical characteristics of anterior fontanelle size at birth of term Sri Lankan new borns: a descriptive cross sectional study. Ceylon Med J 2013 Sep;58(3):96-100.

Shajari H, Rashidiranjbar N, Ashrafy M. Anterior fontanelle size in healthy Iranian neonates on the first day of life. Acta Med Iran. 2011; 49(8):543-6.

Srugo I, Berger A. Anterior fontanelle size in healthy Israeli newborn infants. Isr J Med Sci 1987 Nov; 23(11):1137-9.

Mir NA, Weislaw R.Anterior fontanelle size in Arab children: standards for appropriately grown full term neonates. Ann Trop Paediatr 1988 Sep; 8(3):184-6.

Adeyemo AA, Omotade OO. Variation in fontanelle size with gestational age. Early Hum Dev 1999 Apr;


Lyall H, Ogston SA, Paterson CR. Anterior fontanelle size in Scottish infants. Scott Med J 1991; 36(1):20-2.

Wu T, Li HQ. Changes of anterior fontanel size in children aged 0-2 years. Zhonghua Er Ke Za Zhi 2012

Jul; 50(7):493-7.

G Mathur S1, Kumar R, Mathur GP, Singh VK, Gupta V, Tripathi VN. Anterior fontanel size. Indian Pediatr 1994 Feb;31(2):161-4.

Lehman R, Schor NF. Neurologic evaluation, In: Keliegman RM, Stanton BF, St Geme JS, Schor NF,

Behrman RE, editors. Nelson Textbook of Pediatrics, 19th ed, USA. Elsevier-Saunders; 2011, p.1998.

Carlo WA. Physical Examination of the newborn In: Keliegman RM, Stanton BF, St Geme JS, Schor NF,

Behrman RE, editors. Nelson Textbook of Pediatrics, 19th ed, USA. Elsevier-Saunders; 2011, p. 532-534.

M. Uzura. Y. Furuya. K. Akashi, Sekino H. The persistence of an open anterior fontanel in a 4-year-old

girl. Childs Nerv Syst 2005 Jan; 21(1):83-5.

Gallagher Emily R, Hing Anne V, Cunningham Michael L. Evaluating fontanels in the newborn skull.

Contemporary Pediatrics 2013, 30 Issue 11, p12.

Usman D, Dilkash NA, Khan S, Hussein M, AV. Study of Relationship between Changes in Size of Posterior Fontanelle with Gestational Age. NJIRM 2011; 2(2): 53-55.

Lew S1, Sliva DD, Choe MS, Grant PE, Okada Y, Wolters CH, Hämäläinen MS. Effects of sutures and

fontanels on MEG and EEG source analysis in a realistic infant head model. Neuroimage 2013 Aug 1; 76:282-93.

Jackson GL1, Hoyer A, Longenecker L, Engle WD. Anterior fontanel size in term and late preterm Hispanic neonates: description of normative values and an alternative measurement method. Am J Perinatol 2010 Apr;27(4):307-12.

Moffett EA, Aldridge K. Size of the anterior fontanelle: Three-dimensional measurement of a key trait in human evolution. Anat Rec (Hoboken) 2014 Feb;297(2):234-9.

Duc G, Largo RH. Anterior fontanel: size and closure in term and preterm infants. Pediatrics 1986 Nov;78(5):904-8.

Pedroso FS, Rotta N, Quintal A, Giordani G. Evolution of anterior fontanel size in normal infants in the first year of life. J Child Neurol 2008 Dec; 23(12):19-23.

Omotade OO, Kayode CM, Adeyemo AA. Anterior fontanelle size in Nigerian children. Ann Trop Paediatr

; 15(1):89-91.

Zaki SA, Lad V, Abdagire N. Vitamin D deficiency rickets presenting as pseudotumor cerebri. J Neurosci Rural Pract 2013 Oct;4(4):464-6.

De Gaetano HM1, De Gaetano JS. Persistent open anterior fontanelle in a healthy 32-month-old boy. J Am Osteopath Assoc 2002 Sep; 102(9):500-1.

Aminul I, Rezaul A, Atikur R, B, Mafzal H. Fontanelle as an Indicator of Hydrocephalus in Early Childhood. Bangladesh J Neurosci 2011; Vol. 27 (2): 83-6.

McCarthy JG, Warren SM, Bernstein J, et al. Craniosynostosis Working Group. Parameters of care for craniosynostosis. Cleft Palate Craniofac J 2012; (49 suppl): 1S-24S.

Liptak GS, Serletti JM. Pediatric approach to craniosynostosis. Pediatr Rev 1998; 19(10):352.



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