ABSTRACT
All babies and young children should have their head circumference measured as part of child health surveillance and when medically examined. Head growth is rapid in the first year of life after which it plateaus. Serial measurements of head circumference should be recorded along with height and weight, on the appropriate centile chart and any deviation from the expected head size and shape should prompt a thorough assessment to determine the cause. In the newborn, the skull sutures are not fused to allow moulding of the head during delivery. They remain open to allow the brain to grow in the first few years. The anterior fontanelle is of variable size but is easily felt in the newborn and average time of closure is 18 months. The posterior fontanelle is much smaller and is usually closed by 6-8 weeks. Hydrocephalus and hypothyroidism may cause persistence beyond this age.
