To the Editor.—

Duc and Largo1 assert that assessment of the size of the anterior fontanel is a part of the routine examination of the infant. The reality is that the measurement is not used routinely and indeed is rarely noted in neonatal reports or records because it has not proved to be clinically reproducible.2 This hypothesis was tested and reported using landmarks and standards described by Popich and Smith3 and Davis and Anari.4 Two physicians independently examined 50 healthy term infants with normal head circumferences by the Nellhaus graph.

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