How practical if you know your baby's head circumference - then you can always find the right bonnet or sun hat. However, the head circumference is even more important in another respect: above all, it shows how your child is developing!
If the head is clearly too small or too large in relation to the body, this may indicate a malformation or illness in the child. For this reason, the gynaecologist's practice will also carry out an examination during pregnancy by Ultrasound the size of the unborn child's head, among other things.
Once the baby has been born, the midwife or paediatrician will determine the following at the U1 examination immediately after the birth alongside Weight and height of the child also measures the newborn's head circumference. To do this, a flexible measuring tape is simply placed around the child's head over the ears so that the measurement result can be read off the front. For example, the average head circumference for newborn girls is between 32.2 and 37.2 centimetres, for boys between 32.9 and 37.9 centimetres.
Because the head circumference may still be altered by the displaced plates or bumps immediately after birth, the head circumference is checked again a few days after birth for the U2. By then, the head will have adjusted again and the bumps will have largely disappeared.
Measuring the circumference of the head is also part of the "compulsory programme" for the other U examinations in the first two years of a child's life. During this period, the child's head grows rapidly because the brain increases in size and needs space. The baby's head circumference increases by one to two centimetres per month until the first birthday. In the second year of life, it is still half a centimetre to one centimetre per month. Accordingly, by the age of 12 months, your child's brain has already reached 75 per cent of the size of an adult's brain - and by 24 months it is already 80 per cent!
According to the Robert Koch Institute's "Long-term Study on the Health of Children and Adolescents in Germany" (KiGGS), the average head circumference of a six-month-old girl is 40.3 to 44.8 centimetres, while that of a boy of the same age is 41.7 to 46 centimetres. At 12 months, the average for girls is 43.2 to 47.9 centimetres and for boys 44.5 to 49.2 centimetres.
I would like to emphasise once again that these are Average values is concerned. If a child is not exactly within these specified ranges, this is not automatically a cause for concern. As in all other areas, every baby develops at its own pace. It simply has "its own head" - in the truest sense of the word! This is why the general development of a child is always taken into account when making an assessment. Is it fit, agile and healthy, regardless of its head circumference? What about his parents - has mum or dad perhaps passed on a right "thick skull" to their offspring?
I still remember a pregnancy that I accompanied very well. The mother was very upset when she found out that her unborn child had such a large head circumference that the paediatrician feared a malformation. However, further examinations did not confirm this - and the boy was born healthy and happy. He simply had a large head circumference of a good 39 centimetres! No wonder, because large heads were also both Parents equipped.
In order to avoid any misconceptions here, I would like to add something right away: A large head (circumference) does not indicate a "large brain" and above-average intelligence, nor does a small head (circumference) lack intelligence!
After the second birthday, the child's brain continues to grow much more slowly. It is not until the child is seven years old that its brain has reached 90 per cent of its adult size.
By the age of two, the child's skull bone has also solidified and the fontanelles, which are still open, close. These are the connective tissue fissures that connect the skull plates together. Nature has cleverly designed the baby's skull to consist of five cranial plates at birth, which are not yet firmly connected but are flexible. This allows the baby to pass through the birth canal more easily.
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What do the percentile curves mean?
The measurements of your child's head circumference taken by a doctor are regularly recorded in the Yellow examination booklet at the very back in a corresponding diagram, separated by gender. In this diagram, you will find three curves that rise like arcs for girls (dashed line) and boys (solid line). With regard to head circumference, they represent the applicable age groups (up to 48 months). Normal range which is labelled with percentages: 3 % as the lower limit (3%), 50 % for the average and 97 % for the upper limit of the normal range. The percentages play an important role in categorising the values, as I will explain in a moment under "Examples of head circumference curves".
Before that, however, I would like to mention how this standard range for child development applies not only to head circumference, but also to Size and weight and the child's body mass index (BMI). This is also based on long-term studies in which all the important values were researched on a large number of children over a very long period of time. These then known average, standard and limit values are shown as growth curves (percentile curves) in the diagrams of the yellow child examination booklet. This also applies to head circumference.
In this respect too, the measurements taken during the regular check-ups for your child create a very specific percentile curve for head circumference. Always assuming that you and your child attend all check-ups - and you absolutely should! Your baby's individual growth curve for head circumference can then be compared with the specified percentile curves, as they serve as a guideline and for comparison. The comparison in particular provides the doctor with meaningful information about your child's development. This makes it easy to recognise whether everything is in the "green zone".
Examples of baby head circumference curves
The three most important pre-drawn percentile curves are labelled with the letter P (for percentile) and a percentage. P3, P50 and P97 are decisive for the normal range:
The P3 curve marks the lowest limit of the standard range. If the head circumference were at the 3rd percentile (P3), this would mean that only 3 per cent of children of the same age (i.e. 3 out of 100 children) have an even smaller head circumference than your child - and 97 per cent have a larger one.
The P50 curve shows the exact mean value (median) in the normal range. If your child's head circumference is at the 50th percentile, you know: Exactly half (namely 50 per cent) of all children of the same age have a smaller head circumference than your baby - and the other half have a larger one. So with P50, your child is right in the middle of the normal range.
The P97 curve in turn shows the upper limit of the normal range. This curve is the opposite of P3. If your child's head circumference is at the 97th percentile, you can read this from the curve: The vast majority of all children of the same age - 97 per cent - have a smaller head circumference than your child, and only three per cent have a larger one.
The vast majority of children therefore have a head circumference somewhere between the 3 per cent and 97 per cent curve (P3 - P97). This can also be P60 (= 60 per cent of children have a smaller head circumference than the child and 40 per cent a larger one) or P25 (= 25 per cent of children have a smaller head circumference and 75 per cent a larger one) or P40 and so on.
As already mentioned, every child has its very "own" percentile curve, because its development also depends on its genetic make-up. If, for example, both parents of a child have a rather small head circumference, their baby may not "grow up to be thick-skulled" - unless it comes after one grandmother, whose head circumference is quite ample ...
As with the values of the percentile curves for Size and weight the longer-term curve of the head circumference is also important. It also shows whether a child's head is growing faster or slower and is larger or smaller than the average for children of the same age - or whether it is exactly average.
The most important thing is: The individual growth curve of a child's head circumference should always be between P3 and P97 and also run parallel to the marked P50 curve - regardless of whether it is below or above this. This comparison also makes it easy to determine fluctuations in the growth of the head.
Possible abnormalities in baby's head circumference
If a child's head circumference is below P3 or above P97, this is considered an abnormality.
The head of a newborn baby is too small compared to its peers: This may be an indication of microcephaly. In this - very rare - malformation, the child's brain has not developed sufficiently in the planned time. Depending on how severe this condition is, it is often accompanied by a mental disability in the baby. The cause can be inherited as a genetic defect or metabolic disorder. However, the condition can also be triggered by an infection during pregnancy (such as rubella, chickenpox or Toxoplasmosiswhich damages the unborn child's brain.
A child's head is too big compared to its peersIn medical terminology, this is called macrocephaly (large head). This can be completely normal, as described, "big heads" are also inherited.
However, the cause may also lie in genetic disorders or other diseases, which is why further examinations are usually carried out. For example, an enlarged brain (macrocephaly) or excessive growth of the skull bones (macrocephaly) can be detected. It is also possible that too much cerebrospinal fluid has formed in the child's brain. Then - also very rarely - there is hydrocephalus (colloquially: "hydrocephalus"). In this case, treatment, including surgery, may be necessary. The effects and associated impairments of a child with hydrocephalus are always very individual.
By regularly measuring the circumference of the head, the paediatrician can also make a diagnosis. Deformation of the baby's head more quickly. In this case, parents are given medical advice on whether and how they can counteract this. This can be done, for example, by positioning the child in a certain way (e.g. more frequent prone positions during the day or carrying in a sling) or by treating the child with a special helmet. However, you can also recognise a flattened skull yourself. As a preventative measure, a Positioning cushion from deformation of the skull after birth.
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