Did you know that your baby is born with soft bones? Your baby’s skull does not harden and fuse together until after they are several months old. Passing through the birth canal can be a tight and traumatic space for your baby to enter the world! To protect your baby’s brain during birth and to allow your baby’s brain to grow during their first year, your baby’s head is designed with soft bones that can be molded as needed during birth and to allow for brain growth that happens during the first year for baby.
A flat head in babies is quite common with almost 40 to 50% of babies six to 12 weeks old having flat head syndrome. Flat head syndrome is more properly known as plagiocephaly. There are two type of plagiocephaly: positional and congenital. Positional plagiocephaly is the most common type whereas congenital plagiocephaly is a rare birth defect in which the skull bones prematurely fuse together. Positional plagiocephaly causes cosmetic concern and does not pose risk to brain development.
You can identify plagiocephaly by:
- recognizing a bald spot or shortened hairs on one area of the head.
- seeing a flattened area of the head.
- noticing uneven ears.
- not feeling the fontanelle or soft spot of the head (for congenital plagiocephaly).
The most common causes of plagiocephaly are
- sleeping position. It is ALWAYS recommended that your baby lay on the back to lower risk of SIDS (sudden infant death syndrome). During the first four months of life, your baby has limited ability to move and spends much of the time on the back. This constant laying on the back leads to the constant positional pressure on the occiput (back of head), causing plagiocephaly.
- not enough tummy time. One of the best things you can do to prevent positional plagiocephaly is giving your baby plenty of tummy time when they are awake. Tummy time allows your baby to develop the strength in the neck muscles and will allow your baby to move the head more easily when laid on the back.
- Premature babies have even softer skulls and tend to spend more time on their backs. Premature babies may have to stay in the hospital longer and may not have the luxury of being picked up as often and as easily due to circumstances.
- This is a type of stiffening of the neck muscles causing baby’s head to favor one side over another. This can occur due to tight space in utero or due to baby being in the breech position.
- difficult delivery using forceps or other device.
- being a multiple. For example, plagiocephaly may even start in mother’s womb due to direct pressure from the other baby or from mother’s pelvis due to cramped space.
As your baby’s head is flexible during the first several months of life, you and your pediatrician may just routinely monitor your baby’s head to see if anything specifically needs to be done. Positional plagiocephaly may correct itself on its own.
How to treat flat head in babies:
- Always discuss treatment options with your pediatrician.
- Change the position. To help prevent SIDS, ALWAYS lay your baby on the back in the crib. You can change baby’s head position to the counter-position when your lay your baby down. For example, if your baby tends to turn to the right, then lay your baby down with the head turning to the left. DO NOT use wedge pillows or other positional devices as these could increase the risk of SIDS.
- Keep that tummy time going! Tummy time is needed to help get your baby’s muscles stronger to move around when needed.
- In torticollis, stretching exercises of the neck muscles can help after recommendation by your doctor.
- Molding helmet therapy may be considered when your baby is four to twelve months old if repositioning your baby’s head, stretching exercises and tummy time don’t do the trick. Discuss with your pediatrician first and they can refer you appropriately if needed.
Flat head syndrome or positional plagiocephaly tends to improve on its own. When babies begin to move their necks, roll around, and eventually sit up at six months old, they tend not to favor one spot and the flattened area slowly improves. Your baby’s head may end up not being perfect but you will notice the asymmetry less as your baby gets more hair and your baby grows into more cuteness!