My baby suffered from flat head syndrome, or plagiocephaly, during his first year. While the flattening scared me, his pediatrician told me he would grow out of it on his own without the use of a baby helmet or corrective surgery. After he turned one, his head did take on a normal shape, and my worrying had been for nothing.
In the last decade, there has been a marked increase in infants with flat head syndrome. This is mainly due to the Back to Sleep campaign by the American Pediatric Association, which greatly reduces the chance of sudden infant death syndrome (SIDS). While placing baby on his back is best, it does increase the chance that he will have flattening of the back or side of the head.
A new study published in Pediatrics found that up to 47 percent of infants experience flattening of the head (Castillo). The issue has become more common, so don’t feel bad if your infant has some flattening of the head. My grandmother asked loudly at a family party why my baby’s head was so flat, which was embarrassing to say the least. While older generations aren’t up to date on safe sleeping positions, don’t let them make you feel bad about your baby experiencing some flattening.
If you are worried about the flat spots on your baby’s head, talk to your pediatrician. Unless it’s an extreme case, the doctor will probably assure you that your baby will grow out of it once he has more control over his neck muscles and can roll over.
What is Plagiocephaly?
Flat head syndrome, also called positional plagiocephaly, can occur for reasons other than your baby sleeping on his back. Babies delivered vaginally may be born with a flattened head from going through the birth canal. Premature babies have softer heads than full term babies so they are more likely to be born with or develop flattened skulls (Castillo). Twins or other multiple births may fight for space in the womb and can also be born with flat spots on their head.
Since an infant lacks muscle control, his neck can become stiff easily if he is laid on his back with his head to one side for a long period of time. This is called torticollis and sometimes occurs when the child has plagiocephaly on one side of the head.
The baby’s head may be flattened on one side or the back of the baby’s head may flatten from lying on his back to sleep, which is called brachycephaly. Instead of flat spots on the side of the head, a baby with this type of plagiocephaly will have a uniformly flat head (“What is Plagiocephaly?”). My son had this type of flattening and it made his head look shorter and wider than normal. Luckily he always had a lot of hair so it wasn’t as noticeable. My pediatrician routinely checked the back of his head during well visits and helped to ease my fears about his head shape.
How to Check for Plagiocephaly
An easy way to check for plagiocephaly is to hold your baby in an upright position and to look directly down on his head from above. From this angle, you should be able to see if the head is flattened on the back or side of the head. The head may also appear slanted or there may be less or no hair on the flattened area. Depending on how severe the flattening is, your baby may have uneven ears or slightly skewed facial features (“Plagiocephaly”).
Even if you aren’t worried about or don’t notice any flattening of your baby’s head, your pediatrician should screen for plagiocephaly during your baby’s 2-3 month well visit. The American Academy of Pediatrics recommends this to all pediatricians. Normally your baby’s doctor will only need to look at your baby’s head to make a diagnosis, though further testing may be required or your infant may be referred to a specialist in extreme cases (“What is Plagiocephaly?”).
How to Reduce Plagiocephaly
If your newborn or infant sleeps for the majority of the day, then some flattening will occur and is unavoidable. When you lay your baby down to sleep in his bassinet or crib, alternate his head position. Some nights have his head facing to the right side and other nights to the left so flattening won’t occur on one side of the head. Also change his orientation in the crib by sometimes placing his head where his feet normally are so he can look at his room from another angle instead of always facing the same direction (“Flat Head Syndrome”).
When your baby is awake, there are several things you can do so your baby isn’t lying on his back all the time. If you breastfeed, alternate which breast he feeds from so one side of his face doesn’t flatten from being pressed against you for extended periods. Also switch sides if you bottle feed so his neck doesn’t get stiff (torticollis).
Tummy time is the best way to reduce plagiocephaly. It is also a great way to strengthen your baby’s muscles and get him ready for crawling and sitting up. With a newborn, start out with a few minutes of tummy time and work your way up to a half hour at a time. Chances are your infant may hate tummy time, but keep it up to help his head from flattening further.
My son absolutely hated tummy time when he was first born. I would lay him on a comfortable blanket and he would cry and cry. I bought a pillow to make breastfeeding easier and decide to use it for tummy time. It made all the difference. My son’s head and arms rested on the pillow and he could see more around him and touch his toys. I would lie across from him so our heads were at the same level and he loved being able to look at me while I made funny faces. Tummy time helped to keep him off his back and ended up being a great bonding experience for us.
Use a Harness
When you have tasks to do around the house, instead of laying your baby down in his play pen, hold him in a harness. This will help your baby feel safe and cared for and will also give him some time in an upright position with proper head support. Avoid keeping your baby in his car seat, carrier, swing, or bouncer for extended periods of time as well (Castillo).
Most baby’s heads with naturally take on the correct shape if you take these simple steps. It is rare that a baby would need to see a specialist or wear a helmet to correct his plagiocephaly. So while his head may look strange right now, there aren’t any developmental effects or lasting flatness as your baby grows.
Castillo, Michelle. “Study: ‘Flat head syndrome’ found in 47 percent of infants.” CBS News, 8
July 2013. www.cbsnews.com/news/study-flat-head-syndrome-found-in-47-percent-of-infants/. Accessed 2 Nov 2017.
“Flat Head Syndrome (Positional Plagiocephaly).” KidsHealth, kidshealth.org/en/parents/positional-plagiocephaly.html#. Accessed 2 Nov 2017.
“Plagiocephaly.” Family Doctor, familydoctor.org/condition/plagiocephaly/. Accessed 2 Nov2017.
“What is Plagiocephaly?” The National Association for Plagiocephaly, plagiobaby.org/what-is-plagiocephaly. Accessed 2 Nov 2017.
Mawji, Aliyah et al. “The Incidence of Positional Plagiocephaly: A Cohort Study.” Pediatrics, pediatrics.aappublications.org/content/early/2013/07/02/peds.2012-3438. Accessed 3 Nov 2017.