Head circumference of a 4 year old child. What should be the size of the baby's head by months
At birth, and then every month during a routine examination, a pediatrician will certainly measure the head circumference of a newborn baby. Along with other parameters (height, weight, chest girth), this one plays an important role: it can be used to judge the pace and norms of an infant's development. A very large or very small baby's head often indicates the development of pathology - hydrocephalus or microcephaly. But, as a rule, the deviation from the norm of this indicator is a genetically determined physiological feature of the child.
So that parents do not have unnecessary worries about this, let's study this issue together today.
Child's head circumference: norms
The first measurements are taken immediately at the birth of the baby. This figure averages 34-35 cm. During the first year of life, the baby's head will grow rapidly, increasing by an average of 12 cm by the end of 12 months.
The most active period of growth of the baby's head is the first quarter: by 3-4 months, the circumference of the child's head will be 40-42 cm (1.5-2 cm is added in each of these months). Around this time, it will be equal to the circumference of the chest, which increases even more intensively. Then, gradually, the growth in the size of the head will slow down a little compared to the growth of the chest, and in the future, until the end of life, the normal chest in a person remains larger in volume than the head.
To assess the pace and norms of development of a newborn in terms of the volume of his head, there is a simple formula for calculating the “normal” head circumference of a one-year-old child. A 6-month-old age is taken as a guideline, at which the head circumference is on average 43 cm. To determine the norm in any of the previous months, it is necessary to subtract 1.5 cm for each of them.
- Example: in 4 months old baby's average head circumference is 40cm (43– 1,5– 1,5=40).
To determine what is the norm of this indicator for a child aged after six months, 0.5 cm should be added to 43 cm for each month after 6.
- Example: in 9 months old baby's average head circumference is 44.5cm (43+0,5+0,5+0,5=44,5).
The described method allows you to approximately calculate the head circumference of a one-year-old child. But, in addition, there are established norms for this indicator for children of different ages, and separate for boys and girls, since physiological parameters are slightly different in children of different sexes.
In premature newborns, the head size, as a rule, is less than the average, and begins to actively increase later than in full-term babies - during the period of intensive weight gain.
Head circumference of a newborn baby: deviations from the norm
It should be said that this indicator is always evaluated in conjunction with others, and together they determine the norms of growth and development of the newborn. In addition to the fact that such measurements do not carry diagnostic information, if considered separately, deviations from the established norms in some cases can also be a variant of the norm.
For example, if one of the parents in childhood (or even in adulthood) had a small or large head, then the child may also have such a physiological feature. The most important thing is that it does not exceed the circumference of the chest, except for the period when they are compared with each other.
Nevertheless, if the indicators of the circumference of the child's head differ significantly from the accepted average norms, then his appearance should be taken a closer look at. An excessively large head, along with other clinical signs (large convex fontanelles, divergent sutures, a large protruding forehead, the appearance of a venous network on the head, severe neurological disorders, etc.) may indicate the development of a serious pathology - hydrocephalus, in which fluid accumulates in the brain. A very small head, together with other characteristic symptoms (small or closed fontanelles, a small "sloping" forehead, neurological disorders, etc.), indicates the development of microcephaly. Both of these pathologies require mandatory treatment by a specialist. The diagnosis can be refuted or confirmed by ultrasound.
How to measure the circumference of a child's head?
In order not to get lost in false assumptions, the head circumference of a newborn baby must be measured correctly. To do this, the head is wrapped in a soft centimeter tape with divisions, passing in front along the line of the eyebrows, and behind - along the occiput. A prerequisite for obtaining reliable measurement results is the emotional calmness of the baby: if he cries or screams, then the data obtained will be inaccurate.
Don't be confused by the size of a newborn's head: it always looks disproportionate to the size of the body.
But as the child grows, the proportions will even out and take on the look familiar to the adult eye. If a child develops some kind of pathological condition, then the doctor (and attentive parents too) will be able to immediately determine this by his appearance and well-being: hydrocephalus and microcephaly are immediately noticeable, or if the hydrocephalus syndrome is just beginning to develop, the head circumference increases sharply along compared to previous figures.
Especially for - Ekaterina VLASENKO
All parents want to know if their child is developing correctly. Tables with norms for weight, height, chest and head circumference will help determine this. For this purpose, centile tables can be used, as well as the 2006 WHO standards. In the article, we will consider how to use these tables to assess the physical development of children, how to correctly measure the parameters of children, in particular infants, and also what deviations from the tabular norms may indicate.
How to use the tables of norms to assess the physical development of children up to a year and preschoolers?
Features of the compilation of WHO tables released in 2006:
- Initially, monitoring was carried out in different countries and clinics around the world. A. Based on such global studies, numerical indicators of the normal development of each child, regardless of where they live, were derived.
- The fundamental difference between the new physical development assessment system and the outdated one is such an important indicator as breastfeeding. It is this kind of food that is considered the norm for babies. Previous "reference" figures were inflated, as they were focused on formula-fed infants. The new WHO standards are applicable in any region, regardless of race and national characteristics of medicine in a particular country.
- For five years, scientists and physicians, nutritionists and immunologists, nutritionists and children's rights advocates have been conducting research , and the resulting graphics, tables became a breakthrough in the system of children's health care.
How to use the WHO tables to assess the development of a child?
WHO tables (used by Russian doctors) are divided into columns. Each contains numerical indicators by which it is determined how much the development of the child is in the generally recognized norm. To assess whether the child is developing correctly, you need to find in the first column in the WHO table a value that corresponds to the age of the child or close to it, and then in the same line in other columns find an indicator close to the value of the value measured in the child's body parameter.
- Normal indicators in the middle column are considered and in adjacent columns with values above and below the average . If the measurements taken by the parents are identical to those in the middle columns, there is nothing to worry about.
- The indicators of the child's physical development, which are in the extreme columns of the table with low / very low / high / very high values, should alert and encourage parents to contact the pediatrician.
How to use the domestic centile table to assess chest circumference in children?
The centile graph-table is elementary in use and understandable to ordinary average parents. Since centiles (or otherwise percentages) are indicated in average values, then you should not panic if the child's data is within the two middle columns. Below we consider a method for assessing the development of a child according to a centile table with norms for chest circumference.
- To determine whether the child is developing normally according to the size of the chest, in the leftmost column of the table, find the age corresponding to the age of the baby. If the baby is 3 months and 6 days old, then we are looking for a normal indicator for a three-month-old baby. If the real age of the baby is 3 months and 20 days, then we are looking for the corresponding indicators in the line “4 months”.
- The upper line is graduated by centiles (percentages) - 3, 10, 25, 75, 90, 97. After measuring the circumference of the chest, compare the obtained data with the average-normal indicator in the corresponding line.
- If the circumference of the child's chest falls between the 25th and 75th centiles, then this is fine, there is no cause for concern.
- If the circumference of the child's chest corresponds to the value in column 10 or 90, then this indicates a possible emerging imbalance in development.
- If the circumference of the child's chest corresponds to the values in the column with 3 or 97 centiles, then this is an occasion to consult a pediatrician or neurologist.
An important factor is the correspondence of the indicators of all tables to each other. For example, in a slender small child, even an indicator of 3 centiles can only indicate his asthenic constitution, and not the development of pathologies in the body. Be sure to check height for age, body weight for height, or head and chest measurements for age.
WHO tables: norms for weight, height, head circumference for boys and girls up to a year
Using the tables below, you can check how the head size, weight and height of babies should normally change in the first year of their life. The rates for boys and girls are different. To use the tables, you must first consistently measure the circumference of the head, chest, height of the baby with a centimeter tape, and also weigh the child. All the data obtained is recorded and the assessment of the development of the baby is carried out using tables.
How to measure the circumference of the head, chest, height, weight of the child? Correct measurements for assessing the physical development of a baby are not at all difficult to make. The main thing is to take into account a few nuances:
It is worth paying attention in infants to the parameters of the circumference of the chest and head in relation to each other. According to doctors working in the international organization WHO, the following changes in anthropometric data are considered normal for infants:
- The first 30 days of life - the circumference of the skull is more than the circumference of the sternum by a couple of centimeters.
- Closer to the 90-day milestone of life, the circumference of the head and chest of the baby are equalized in terms of indicators.
- Closer to the 180th day of life, the girth of the chest should be larger than the girth of the head.
Height, weight and circumference of the chest and head during the first year of life undergo the greatest changes in both boys and girls. Do not forget that newborns have "fontanelles" that completely disappear only by one and a half years. This affects the size of the baby's skull.
Norms of weight, height, head and chest circumference for girls and boys from 1-6 years old
The following 8 tables illustrate normal and extreme values for children of both sexes aged 1 to 6 years.
What can deviation from WHO standards indicate?
Naturally, in this case, only the maximum deviations are considered, the numerical indicators of which are indicated in the extreme columns of the tables.
Baby too big or too small
Weight is very important for newborns, and weight gain must occur continuously during the first year of life.
The problem of dystrophy and obesity forces the World Health Organization to monitor this indicator carefully, which served as its inclusion in generally recognized standards.
- Weight more than the allowable norm should encourage parents to change the frequency of feeding the baby.
- - this is an occasion to contact the pediatrician for advice and review the diet and diet of the child.
Head circumference over/under normal
Anthropometric indicators equal to the extreme columns, in this case, may indicate such serious diseases as hydrocephalus, microcephaly, rickets, intracranial hypertension.
- At hypertension The baby's head is growing too fast, as the extra fluid that has accumulated inside the skull presses on it. Such a diagnosis can be confirmed by a neuropathologist and an oculist who will examine the fundus and vessels inside the orbits. In case of hypertension, the “fontanelle” will not grow together for a long time, and all joints in the cranium will be mobile or simply soft.
- changes the very shape of the skull, but is accompanied by additional painful and unpleasant symptoms.
- A defect in the development of the bones of the skull is considered craniostenosis. The essence of the disease is the premature fusion of sutures and their ossification. The baby's brain will grow, but the skull will not expand, which will lead to excessive pressure on the walls.
- Microcephaly- this diagnosis is made if the brain does not increase in size. The lack of brain mass by more than 25 percent (of the accepted norm) leads to early closure of the "fontanelle".
Too big/small
This indicator is important, but it is influenced by many factors. First of all, it's genetics. In general, babies with tall parents grow quickly, but it is likely that a short great-grandmother or other distant relative may show up in the child's genes. In this case, it is important that the development of this indicator be in harmony with the rest.
Deviations from the average do not always indicate diseases or pathologies. Mass gain or growth in many babies occurs jerkily. So a shortfall in one month can be more than compensated for in the next. Therefore, it is important to record indicators constantly, without gaps. In most cases, this will help restore the peace of mind of the parents themselves, especially if the baby is the first in the family.
The indicators of the circumferences of body parts in infants differ from child to child, but there are general norms in which they must fit. It is especially important to monitor the size of the head in newborns in order to control and timely prevent a possible deviation, indicating a developmental pathology.
In contact with
Why measurements are needed
To begin with, it should be noted that for the first time they are measured in children at birth, in the delivery room. Too large or, conversely, a small head may indicate microcephaly or hydrocephalus. Such a baby needs additional attention from a neonatologist, neuropathologist, pediatrician and other specialists.
It is not enough to simply measure the circumference of the head and draw the appropriate conclusions. It is very important to correlate the indicators of the head in newborns with the sizes of others, especially the chest.
So, for a large child, the upper limits of the head circumference indicators or even a slight excess may turn out to be absolutely normal, and for a small baby, the small head size also fits into his own norm. The ratio of indicators is determined, and only after that, when the result obtained does not fit into the norm, it is possible to talk about a possible pathology.
It is also important to monitor these indicators up to the year of the baby. On average, the circumference of the head in children by the year reaches an increase of 12 cm from the original size.
Normal head size up to a year
What size is considered normal? At birth, this figure is about 34-35 cm. In the future, up to six months, the size will increase by 1.5 cm every month. After six months, the growth rate slows down, and the dynamics is no longer so active. The average monthly increase in head circumference in a child older than 6 months is 0.5 cm.
The specialist also monitors head to chest growth ratio. After 4 months, this level will increase in favor of the chest, and in the future this gap will only increase. Subsequently, as in adults, the baby's chest will be larger than the head.
Head volume in children, a table of which every pediatrician must have, should be measured every month at a doctor's appointment. The indicators are fixed and compared with the sizes of other parts of the body, and also look at the dynamics by months.
The norms of head circumference are not the same for boys and girls. Most often, boys are slightly larger than girls, and therefore there are special indicators for them, on average, 1 cm more. In premature babies, all indicators will be less than in those who were born on time.
For such babies, the ratio of both indicators is also important. The dynamics of size growth may be slightly higher than in babies who were born on time. On average, by the year the values almost reach the level of children with a normal gestational age.
Why is it so important to keep track of these? The fact is that at this age it is much easier to cure many diseases than to endure their consequences later. The body of young children is very high compensatory capacity, that is, it can recover without any consequences. If treatment is started after a year, then these opportunities will already be missed. Therapy will need more serious, and it does not always give the desired effect.
Important! It is not possible to make a diagnosis based on measurements alone. Be sure to undergo additional studies, such as ultrasound, MRI or CT, to confirm or refute organic lesions of brain tissue.
What do deviations mean?
If they are, this is a signal to the doctor, who should take care of the development of the child and conduct additional observation of the crumbs. What will the head circumference in children, which does not fit into the norm, say:
- Large head. Usually these have other anatomical features - a protruding forehead, a convex fontanel, a noticeable venous network on the scalp, clinical signs of neurological disorders. All this may indicate hydrocephalus, that is, fluid retention in the head, intracranial pressure, and other problems. It is necessary to solve them only in consultation with the doctor.
- Small head. If, in addition to this, a small forehead and sluggish reflexes, then this is a symptom of microcephaly.
Hydrocephalus in children
Can there be deviations in size, but the child has no problems? Of course, this happens quite often. The specialist looks not only at the sizes and their ratios, but also in general at the development of the baby. If there are no clinical indications for diagnosis, then there is nothing to worry about. Perhaps the child's head is too small or large - hereditary feature. If parents in childhood had the same problems, then there is a high probability of repeating the picture in their child.
Before measuring head circumference in children, you need to familiarize yourself with the basic rules of this procedure. How to do it right?
The head size of a newborn is measured with a centimeter tape. In front, it passes through the eyebrows, and behind - through the occiput. How to measure chest? The measuring tape should go through the lower angle of the shoulder blade at the back, and cross the nipples in front.
Attention! It is very important that the baby at the same time behave calmly, do not cry. Otherwise, the indicators, especially the volume of the chest, will be incorrect.
Useful video: fontanel and head sizes in children from 0 to 12 months
Head circumference norms are an ambiguous concept, and for each baby they are different. The doctor must take into account the gestational age, the sex of the baby, and also look at other data - the size of the chest, the general condition and development of the child, and the dynamics of the growth of indicators. The doctor should only be concerned about situations where several signs testify to the pathology. A timely appeal to a specialist will allow you to start treatment on time and prevent formidable complications that can be detrimental to the health of the crumbs.
The sizes of hats and bonnets for children correspond to the circumference of the head in centimeters. We measure horizontally along the eyebrows, above the ears and further to the back of the head.
The size range of children's hats is very diverse. Some manufacturers sew products according to the size grid after 1 cm around the circumference of the child's head. Most manufacturers sew children's hats and bonnets on a grid every 2 cm at even values (for example, 36, 38, 40, 42, 44, 46, 48, etc.) or even after 4 cm (size 36, 40, 44, 48). Sometimes they sew on a double size (for example, some manufacturers like this: 36-38, 40-42, 44-46, 48-50, and other manufacturers like this: 38-40, 42-44, 46-48, 50-52). Sometimes on the tag, along with the size corresponding to the volume of the head, the height of the child or age is indicated (for example, 36/56, 40/62, 44/68, 48/74, 52/80). If only height or only age is indicated, then it is impossible to say exactly what head circumference is meant, sizes vary by manufacturer.
If you have met the letter designation of the size of the children's hat, then this table will help you determine the children's size:
Caps and hats should be exactly the size of the child. If the bonnet is large, then it can even be dangerous for the baby's life, because. a loose bonnet can slide over the face during sleep and interfere with the baby's breathing. Beanies should not be tight, it hurts, and loose beanies let the cold into the ear. Therefore, children's headgear should be just right.
When choosing a demi-season or winter hat for children, it is important to consider what you are going to wear under such a hat (bonnet or thin cap). Measure the child's head twice: without a headdress and in a cap that you will wear under a hat. It is difficult to measure the circumference of the head in a cap, so compare with the size without a cap. The girth of the head in the cap should be about a centimeter more. And already with this size, feel free to go buy a children's winter or demi-season hat.
How to determine what size head a child will have
To determine the size of children's hats and bonnets according to the age of the child, we present tables of correspondence between the age and size of hats and bonnets below. The size of the headgear according to the circumference of the head is given based on the average for Russian children. Interestingly, for the first three months, the girth of a child's head increases by an average of 2 cm per month. Then, from three months to a year, the child's head increases by 0.5-1 cm per month. Later, the growth of the head slows down even more. By the age of two, the circumference of a child's head increases by an average of 2.5 cm. And from two to 10 years, a child's head grows by only 0.5 cm per year. Boys have bigger heads.
We give tables of sizes of hats and bonnets separately for boys and girls.
| Age of girls | 0 months | 1 month | 2 months | 3 months | 6 months | 9 months |
| The average size | 32-38 | 35-40 | 37-42 | 39-44 | 41-46 | 43-47 |
A newborn child constantly grows out of caps, because they are cotton knitted, almost do not stretch. If the cap is small or large, then the style of the cap itself forces the mother to put on the cap for the child in size and change it to a larger one in time.
Another thing is hats for winter, spring and autumn. A newborn will definitely grow out of his first cap, but the cap of the next season, perhaps, if it stretches a little, he will be able to wear it in a year. In the first three years of life, one winter hat will probably last a child for two winters, and a demi-season hat will definitely carry a child through spring and autumn, and maybe even the third season. From the age of three, a child will most likely be able to wear one hat for three years, but another question is: will a hat last that long?
Immediately after birth, the baby undergoes all sorts of procedures performed by nurses and neonatologists. They weigh, wash off the blood, mucus, and also measure the skull of the newborn. The last manipulation plays a huge role, as it can tell doctors a lot.
What do you need to know?
Almost all babies are born with swelling of the head, which is called birth trauma. Sometimes mothers themselves note that the newborn has changed for the better in appearance for 3-4 days. In fact, the swelling that occurs during childbirth simply subsided. Why is this happening?
When the time of birth comes, the child begins to gradually move along the birth canal. The baby has to push through soft tissues, and since he usually goes forward with his head, the main load lies on it.
Newborn head size
In a newborn baby, the head size is about 34 centimeters, depending on the sex of the baby. There is a slight difference between the volume of the head of boys and girls, it manifests itself in the fact that girls have a smaller circumference. In a month, the head grows by 2.5 cm. At the same time, the size of the chest of newborns is 2 centimeters less than the size of the skull.
In the period of 3-4 months, the size of the head is already equal to the volume of the chest, the head circumference is about 40 centimeters. That is, there is a rather intensive growth of the skull - 1.5-2 cm per month.
Then the growth of the head slows down, in contrast to the growth of the chest. By the end of the first half of the year, the volume is 43 centimeters, it grows by 1 cm per month. After six months, no more than 0.5 cm per month is added. Thus, at the age of one year, the volume of the head of a child is 47 centimeters.
The table below shows the indicators of normal growth:
However, you should be aware that premature babies usually have small deviations from the norm in the direction of decrease. Their active growth is observed somewhat later than in full-term children. Therefore, the above table is just an example of the classical growth of the head in an infant, but in reality everything happens individually for each child.
Alarms
Of course, the development of the body is a purely individual matter, each child grows in his own way. However, there are certain standards, well known to neonatologists and pediatricians, according to which symptoms of abnormal growth can be distinguished.
For example, if the baby's head rapidly increases shortly after birth, it indicates progressive hydrocephalus. This disease is characterized by the formation of a large amount of fluid in the spinal canals. With such symptoms, it is necessary to see a neurologist.
Too small a volume of the head may indicate microcephaly - a reduced brain. This disease can be seen even during a woman's pregnancy on ultrasound.
If the volume of the head is too small, you should immediately consult a neurologist, as this is also a serious disease that requires complex treatment.
How to measure the size of a newborn's head?
Parents can independently measure the volume of the child's head and record all measurements in a special notebook. For this procedure, you only need a soft tape divided into centimeters.
The baby should be laid on a couch, table or sofa. It is important that the child does not scream or cry during manipulation, as the results obtained when the infant is overexcited may not be true.
The measurement is taken on the eyebrow line. You just need to put a tape on your head to the indicated level and record the result.
Do not worry, because the symptoms of deviations in any case appear quickly and you can immediately see the violation. It is much more important to urgently and without delay turn to specialists.
