Q&A:
Why is the doctor concerned about my newborn's large head?

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Answered by Angela Rosas M.D.

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"The most enjoyable thing for me in practicing general pediatrics is to use my professional training and my experiences as a mother to help families to improve the health of their children," says Angela Rosas. "It is a wondrous feeling to watch children heal and develop into healthy young adults, knowing that you played a small role in the process."

Angela Rosas M.D., graduated from Stanford University with a degree in human biology. She attended medical school and completed her residency in pediatrics at the University of California at San Diego. She has been a fellow in the American Academy of Pediatrics since 1991. Dr. Rosas has practiced general pediatrics for eight years in community clinics, private practice, and university hospitals. She is currently Assistant Professor of Pediatrics at the University of California at Davis Medical Center in Sacramento, California. Her clinical and research interests are breastfeeding, asthma, adolescent care, children with disabilities, child abuse and neglect, and accident prevention. Dr. Rosas has published several articles in peer-reviewed journals and contributed to various pediatric textbooks. She frequently lectures on pediatrics issues at medical conferences and for community agencies. Dr. Rosas is married to another pediatrician and has three young daughters.

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Question

My son had his 2-month checkup yesterday. His doctor was concerned about his head circumference, which was 17 inches. He said he checked to see whether he had any fluid buildup. He said everything appeared normal. What would happen if he did have fluid buildup? What would that mean?

Answer

Your infant son does have quite a large head with a circumference of 17 inches at 2 months of age. The medical term is macrocephaly, meaning simply "large head." It is completely normal for some babies, and can have many causes. The most important factor to watch for in young infants with macrocephaly is a rapid increase in head circumference growth, so your medical provider has probably already mentioned to you that he will be following this closely.One condition associated with a rapid increase in head circumference in infancy is called hydrocephalus, or "water on the brain." That is the fluid buildup that your doctor mentioned. Hydrocephalus is caused by a blockage in the flow of the normal fluid that flows in and around the brain. Treatments are available for this condition. If on follow-up examination your doctor feels that your baby's head is growing too fast or he finds other changes, he may order a special study of the brain called a CT scan or an MRI.