Concerned...Questions

[ltzalewski]

Hi! Ok so I just typed this whole long post about every detail and then my internet hung up and it ended up not responding and knocked me offline. UGH!! Always something. So now I am going to give an abbreviated version.
I am a registered nurse and work in adult cardiac ICU. So, I really do not know much about baby medical conditions. My daughter is 9 months old and she is my first child. I am probably just being paranoid but I thought this was an awesome sight and I wanted yalls opinion.
About 3 months ago I started noticing that something about the middle of my daughters forehead did not look right. It is not a ridge like I have seen in some pictures on this site as well as some other websites. It looks more like a goose egg. It is not hard or anything. It is like a patch of skin that seems to stick out a little further than the other skin. This may be normal, I am not sure. I am attaching pictures and you can kind of tell in the second picture.
Last week, I was running my fingers through her hair as usual and I happened to notice a hump. It is not huge or stick up a lot but it is there. I can not see it because she has a lot of dark hair but I can feel it. The only way I can see it is when she is lying on my leg and I am feeding her. I can look down at her scalp and she that her skull is perfectly shaped except for right down the middle of the front of her head. It come up to a point from her fontanelle to her forehead. Like I said, it is not huge but it is there. I am thinking that it might be her sutures. I dont know if they closed already. I thought it was supposed to take longer for the front sutures to close....like when they are 2 or 3 years old. Her head is not mishapen so if anything she has a mild case of metopic cranio. Again, this may be normal. The other thing is her forehead is relatively small but it protrudes or buldges. I have seen this on other babies that have nothing wrong with them so I dont feel it is a big deal. I actually think it is cute. I also am attaching a picture of her profile so you can see what I am talking about. I can attach another picture tomorrow of the top of her head. Since I have been reading on here, that seems to help to see if there is anything abnormal looking. She is sleeping for the night so I do not want to waker her.
Some other things is she was 5 weeks early, c-section because she was breech, and stayed on one side of my abdomen the whole time I was pregnant. I read that these things are risk factors because of the position in utero. I dont know if that is true. She was in the NICU for a week and while she was in there they did an ultrasound of her head. I was told everything was fine with the results and did not think another thing about it. Once I started noticing these things on her head, I called my sister who works in the NICU and asked her about why the do ultrasounds on babies heads. I thought maybe it was routine. She said they only do them if they suspect something may be wrong with the fontanelle. The tech told me when she was doing the ultrasound that she was having a hard time because her fontanelle was so small. That may be another reason the sutures closed early if that is the case. If this is what it is, I dont think we would have to do anything about it because I am pretty sure it would just be a mild case.
Let me know what you all think even if you think she is perfectly normal. I am hoping that everything is ok. I just want to make sure. Also, she has her 9 month checkup with the pediatrician on Jan 30th. She has not been to the doctor since she was 5 months old. She will be 10 months when we go at the end of this month.

Thank you so much! I really appreciate you reading this and responding.

[mshanson]

I'm no expert like some of the other women on here with more experience. My son was diagnosed with having a metopic ridge, but no cranio. However, I do see the bulging on her forhead, it's quite plain to see. It would definately help to see a bird's eye view. My suggestion, would be to see a doctor about it - a pediatric neurosurgeon or cranio-facial surgeon who deals with this. Even if it turns out to be nothing, as it did in our case, it's best to go. Otherwise, you're always going to wonder.

[Jenny]

I see what you mean.. Have you had her checked out? She actually looks very similar to what I looked like as a baby, and I have bicoronal cranio. Typically with bicoronals, they forhead pushes forward. The bulge you see in the front could be from the tissue being pushed out from the metopic suture. It also could be nothing, but I think there is justification for having her looked at. My daughter was pretty severe with her bicoronal cranio, I was more normal in appearance. I would just suggest having her looked at.

[Janet]

My metopic child was a breeched baby for all of my 3rd trimester and I honestly believe this is why she was born metopic.
If you have any concerns I would bring it up with your pedi or family doctor, I had to push my doctor to do research on cranio because she never had a baby in her practise born with it, but once she did the research she put in a referral to a neuro-surgeon. Good Luck!! She is adorable BTW.

[ltzalewski]

Thank you so much for the responses. Here are some pictures I took this morning of the top of her head. Sorry about her bed hair! Let me know what you think.

[Lisa]

I agree with Jenni, I can see some slight coronal appearance. I would bring it up with your Dr. at her check up and if you are still worried, push to see a craniofacial surgeon, if anything they can reassure you nothing is wrong, or take action if there is. We're here to answer as many questions as we can.

Is the middle of her forehead where the lump is solid or is it open? Can you feel the coronal suture? It is located across the top of the head from ear to ear, a little in front of the ears. You would feel a solid bone ridge if it is fused.

[Monica]

It's always hard to tell exactly in pictures. I definitely see the ridge on her forehead, but it seems "wide" to be metopic. That, and her birdseye doesn't have that point at the top, though there are ranges, of course. Definitely bring it up to your doctor and you might even bring in your pictures.

Florence had a perfectly normal pregancy, but still came out metopic - there's just no way to know for sure.

[ltzalewski]

the lump feels like tissue. I would say it is closed. I can not feel anything along her coronal suture. I think it is fine. I can just feel the metopic suture well.
Thank you so much.

[Lisa]

I would definitely want her to be seen by a craniofacial surgeon. Where are you located? We have some great references from all over here.

[ltzalewski]

I am located in Monroe, La it is in the northeast corner of Louisiana. I think Dallas or New Orleans may be the closest locations. I am not sure though.

[dannlark]

Welcome to CK! You've come to the right place for information...this place is awesome!

Taking a look at your adorable daughter, I have to say that her forehead reminds me a lot of my son Ian's. He had that protruding, "bulbous" looking forehead and he was upper end mild metopic. He also had a very quickly closing fontanelle, that was on the smaller side of normal at birth and was completely closed by 6 months. That's definately a warning sign that all might not be normal... I agree, it's something that you want to look into. Ian's Dr. is located in Dallas, at Medical City, and he's wonderful!! You could set up a consoltation to meet with him and have him take a look at your daughter (let me know if you'd like contact info.). Bring it up with her ped. at the next appointment too. Have him/her feel the ridge and look at her head from all angles, top down, chin up to forehead, profile, etc... How is her head measurements? Ian was consistently in the 50%, and he STILL had metopic cranio with trig.. Don't let the Dr. tell you that it's only a concern if the head isn't growing or is off the charts... Metopic babies can have normal growing heads and STILL have cranio! You can take a look at Ian's pictures in my profile (click on my name off to the side and it'll give you the option to go to my profile). Tell us if you think she looks similiar. Do you think you're seeing a progression in the forehead? Ian's got bad pretty quickly.

Anyway, stay strong Mommy. You're being a great advocate for your daughter. Please keep us posted as to what you find out. I hope it isn't cranio, but if it is and needs to be addressed, know they do very well! And often, milder cases just need to be watched, and can "correct" themselves" over time...

[angeleka]

Andrew's metopic ridge was always hard. It seems odd to me that a protruding bone would be soft. It seems like soft tissue to my completely untrained ear and eye. I would want it checked out no matter what. It may be something very simple and completely nothing, but I would rather be safe than sorry. I think any time something 'appears' on a baby that wasn't there at birth it is worth looking into. If there were concerns at birth about the sutures, it can't hurt to follow up with them now.... even if they told you things were fine back then. My son's test results came back 'normal' but thank God for his persistent pedi who just felt like something was wrong and sent us to the specialist any way.
In the end, if there is nothing wrong, you will at least have peace of mind, otherwise I think you will always wonder about it.

[Tawnia]

It could also be a cyst or something. I would have it looked at to rule out cranio and figure out exactly what is going on.

[fitmomof2ae]

I would call the Pedi now or first thing in the morning and say you are concerned and would like for a Dr to see her asap. I called mine and told them I was having trouble sleeping and was concerned and they let me come in 2 hrs after I called. It doesn't hurt to call and see if you can come in now instead of later this month.

I'm a newbie with a son who has sagittal. Sagital can cause the forehead to protrude. It can also cause the back of the head to protrude. My son's forehead doesn't protrude much, but the back of his head is starting to protrude. He is 9 months also. You can see pics on my page.

Although, we have a fused suture on top of my son's head, you can't really feel the ridges that others have described. My pedi couldn't even feel the ridges. I would ask your pedi for a x ray. The cost is relatively small considering other alternatives. We just got the bill for over $200, but it is still pending ins and I expect ins to pay part of the cost. I know how horrible it is when you don't know what or if something is wrong. Good luck and keep us posted!

[Mindy]

I completely agree that if it is soft then it likely isn't bone. It can be a soft tissue or a cyst, but it is definately something to have checked out. Her forehead from the front on view looks wide, but due to the buldge, it does look narrow from birds-eye view. I say get it checked out just to be sure.

[ltzalewski]

Thank you all for the responses. I feel better.....like I am not crazy! I was under the impression that the metopic suture closes around 2 years old. I did not realize it could close this early and be normal. When it does close in a baby who's head is "normal", should it still cause a ridge on top of their head (not their forhead)? Or shoud their skull be smooth? Thanks for the help!

[Tawnia]

A ridge on the top of the head (front to back) is caused by the saggital suture closing early. Top of the head side to side or one side is cause by coronal closing early. Metopic suture is from the front soft spot down the forehead.

[ella's mommy]

If the metopic ridge closes within the "normal" time frame it can cause a ridge or be smooth. The ridge would be in the location mentioned above, but it would definately be hard, from what I know anyway (I'm definately not a doc). If her forehead is soft I would really question what this is. I don't mean to worry you but to put your mind at ease call your doc and see how soon you can get in, just so you don't have to worry anymore then necessary.
She does definately look pretty normal from the birds eye view, but in her profile I can see the "bulge" you are talking about.
She's darling though!

[zacharys_mommy0820]

I would take her into your pediatrician and request an xray to start with and then go from there. Being a nurse your doctor might actually respect your opinion. Always err on the side of caution. Talking to us might help but if there is something wrong we cant diagnos her...your best bet is to get some kind of xray or catscan. Because just because the doctor says something isnt wrong doesnt mean she is right as you can see from most of our stories...if we had had an xray done sooner then my concerns would of been validated right after his birth...and all i was going off of was a crooked nose and a slightly bulged forehead after birth....but I knew something was wrong and I was right. Go to the doctor and request some kind of test to prove that you are wrong...until then assume that you are right...mothers always know : )

[heatherific]

hi! looks like you already got lots of great advice. just to warn you, many of our babies were undiagnosed or misdiagnosed at first. many peds haven't heard of cranio. if you don't get a satisfying diagnosis or explanation, keep pushing 'till you do. it may not be cranio at all, but if they do test for it ask for a CT scan. many babies are undiagnosed or misdiagnosed with xrays. glad you found craniokids, it's been very helpful for me & i hope it will be for you too!