Large head circumference - future health outlook?

[Greycushion]

I am due next month and my baby’s head circumference has been tracking above the 90th percentile all along the pregnancy. Other measurements are around the 20th-30th percentile so there is a significant difference.

I have searched plenty of threads on here and one reason seems to be familial benign macrocephaly (FBM) - in other words, big heads run in the family. But this is not the case in our family.

For other posters where FBM is also not the case, I have searched their posts in the years following their pregnancy and it seems there is an association between large head circumference and later learning difficulties, tics and autism. Published research also seems to bear this association out. So, I am trying to be prepared.

I would be grateful if anyone who has been in this position can share any advice. What sort of things do I need to keep an eye out for and at what age? Thank you.

My DS head was large, he was born on 99.6th centile but when he popped out he looked perfectly balanced as he was a right unit of a baby. Now as a small boy, everything is in proportion but he's still solid (and yes, he fits bigger hats). It was never raised as a concern and I was never concerned past how I was going to get that out of me. He's bright as a button, and developmentally he's always been ahead of his little friends (ie walking at 10 months, talking for bloody England from very early).

My DS had a massive head as a baby (had a C section for other reasons and the doctors took one look at him and said it was definitely the right decision…). He also didn’t have much hair until he was two. When I look back at baby photos now his head does look enormous and out of proportion but at the time I thought he was the most beautiful baby ever (of course!). He has grown into his head now (age 6) and the only issue I have is, as others have said, needing big hats - he was in age 10-12 at 4! No health problems whatsoever - doing well at school and very sporty. Easy to say I know but try not to worry OP!

My child with a big head is autistic. But she's a bright spark no learning differences and such a joy, well behaved kind and intelligent. My other child with a small head is autistic and has LD and is incredibly challenging.

You get what you get and while being prepared helps to feel better facing it you will love the child no matter how they are

My son ‘failed to thrive’ for his first year and was so small he dropped off the centile chart, but his head never went below the 91st centile and we were referred to another consultant about it. Prognosis was: difficulty finding hats and a lot of good joke material aimed at poor DH and his big head. DS is still tiny with a big head now aged nearly 3, but entirely healthy and looks completely normal (better than normal if you ask his mother). No developmental problems whatsoever.

My DS was born with a large head, the pediatrician commented on it at birth.
He looked really out of proportion as a toddler but better now.

He's very bright and no problems at all.

All my DC have heads that were much higher % than the rest of them at birth and through the first 3 years when the health visitors tracked it. They are all Autistic (not a bad thing) and all very smart too. The only bad thing was that they often grew out of clothes quicker because i couldn't get them on over their heads, but that's it. I don't think their heads are bigger in relation to their bodies anymore. Their bodies caught up.

I've just re-read your first post and you say 'tracking above the 90th centile'. How far above? 99, 99.5, off the scale altogether? The 90th centile itself doesn't seem anything to worry about. Maybe you just have a rather solid sort of a child.

I suppose the frustrating thing is you won't know until the baby arrives! It sounds as if it can indicate serious cleverness, or nothing, or potential disability. Do you know if you are having a c section because of the head size? That could be something to ask about, especially if you are petite at all. Otherwise if I were in your position I'd do what I always do with anything medical which is do the research, take notes, and get second opinions along the way.

What does your DP think? Hopefully they're being supportive

Oh, I would add (because my DD had a large head) - the health visitor did say a large head is usually a far more benign indicator than a small head. So there's that

When my first DS was born (30 years ago this week) the paediatrician who checked him out at birth remarked that he had a very big head and that I "would need to watch that". At the time I had visions of him not being able to sit up because his head would be too big to hold up ..... but he's been absolutely fine, no problems at school despite always being the youngest in his class and he has a maths degree. Sending best wishes for you and your baby.

My girl twin was born with a much higher head centile - it was only really noticeable in that she was much further behind her twin brother in sitting up - when she did her head tilted to the side for a long time and then she was very late crawling and then also walking - her doctors just said she had to "grow into her head" and her body had to be strong enough to support it to be able to get up on her feet. She was monitored for 3 years by a paediatrician and I notice sometimes if her growth spurts occur head first - then she can be a bit clumsy for a while but the rest of her body soon catches up

Update - to those posters who replied that their babies also had large heads - did they also have any frontal bossing?

DS is a couple of months old now and head is on the 98th percentile. Apparently he has ‘mild frontal bossing’ which is associated with a range of terrible things.

I've googled frontal bossing. The term wasn't one used of DD twenty years ago but the images look like her as a baby. Enormous forehead, especially obvious when still at the bald stage. I had one school parent quietly ask me what was wrong with her (and I'd blanked that from my mind, actually, but she was an odd looking baby).

DD is currently doing finals at a rather well known university. I wouldn't like to swear that she's entirely neurotypical but she's great.

Who called it 'mild frontal bossing'? Was your little boy being checked because of any developmental concerns, or just to keep a eye, or because you asked about his head specifically?

I do sympathise -- but what are your actual concerns, not your potential future ones?

The paediatrician called it that, at an appointment to discuss his head specifically. Thank you for letting me know.

My kid had a massive head in utero and when she was born. Now a healthy 14 year old who struggles to find hats to fit her big head but she doesn't look like a freak or anything 🤣

Two massive headed babies here - both off the charts. To be fair they were big otherwise but heads were not in proportion - DC1 was 75th centile with over 100th centile head; DC2 was 90th centile with other 100th centile head.

No difficulties whatsoever - they are 6 and 4 now and gorgeous. And their heads look normal size to me.

I know someone who had a huge head as a baby/ child honestly I used to wonder how they supported it as their body was small in comparison ... they are at least 6 foot 5 now so definitely grew into it and no other problems x

Purely anecdotal but my DB's head was off the charts when he was born. He was investigated for hydrocephalus (didn't have it) and our parents were warned that he could have learning difficulties etc. He still has an enormous and very strangely shaped head - I don't know if he was formally assessed as having frontal bossing but looking at pictures I would say so. Anyway, he's a university lecturer, married with two kids, very normal life.

Does the paediatrician have any concerns about your DS's development otherwise?

For those of you who had large headed babies, how were they in meeting their gross motor milestones such as lifting head at tummy time, crawling and so on? The HV said that they can be a little bit behind as the head is proportionately heavier, just wondered how common this was?

And an update - he was all signed off by the top cranio team, his head is 98-99th %ile large but they said it was all within the realms of normal thankfully! He is delightful and lovely and working really hard on learning to roll etc but what the HV said has stuck with me 😊

@Greycushion neither of my very large headed children rolled, though they both had very good head support at a young age. I wasn’t too worried!

They were on track/ahead with all other milestones (both sat unsupported at 5 months, DC1 crawled at 8 months, walked at 12, DC2 crawled at 7 months, walked at 11).

Glad to hear all is well with your little one!

My son had a large head when he was born, and to be fair the birth was a bit difficult and I blame the large head!
That aside he grew into it and is now 6,5 and he had no issues and got to Uni and is fine!

I posted previously.
My DC didn't crawl or particularly like tummy time, so I didn't really do it.
Totally fine now.

Hmm, milestones...

It's a bit dim and distant by now, but I don't think DD (she of the "fucking huge hats") crawled at all. Bad parenting alert -- I actually can't remember! She was slow to learn to jump, and only taught herself to cartwheel aged 18 during lockdown. Does that count?

I posted before about my DB. I don't think tummy time was a thing when we were kids! Obviously I wasn't tracking his milestones in the way that a parent would but our DM has mentioned he was slow to walk, about 18 months I think. Anyway, he runs marathons now