Question
An 18-month-old child has not yet closed their fontanelle, which is about the size of a small finger and shows a jumping motion. Although the parents have been giving calcium supplementation, they are still worried about the possibility of other health issues. How should one deal with an 18-month-old child’s unclosed fontanelle?
Answer
The anterior fontanelle is approximately 1.5 to 2 centimeters at birth and increases in size as the skull develops, beginning to ossify and shrink around 6 months of age, usually closing between 1 to 1.5 years. The posterior fontanelle is smaller at birth and closes by 6 to 8 weeks postpartum. Delayed closure of the anterior fontanelle is commonly seen in rickets. It is recommended to continue calcium supplements and consider using medications to promote calcium absorption.