Preventing and Treating Flat Head Syndrome in Babies

By Sarah A Davidson

Many newborn babies spend much of the time sleeping or laying in the same position. When the baby is born or within the first few months of life, you may notice a flat spot developing on the baby’s head. Particularly if this is your first baby, no doubt you will have received lots of advice from midwives, hospital staff, family members, friends and mothers and some of it will be relevant and useful. Other guidance will not be as suitable, or may be outdated. One area that is a relatively new condition and is difficult to find accurate information about is flat head syndrome in babies.

What is Flat Head Syndrome?

Flat head syndrome is a condition that can develop in a young baby, and it is often caused by repeatedly sleeping or resting in the same position. It can also be a congenital condition, which means it can develop before a child is born. The medical terms for flat head syndrome that occurs in babies are plagiocephaly and brachycephaly, depending on whether the flattening is primarily on one side or across the entire back of the head.

Older children and adults automatically adjust their positions during sleep, however, a young baby cannot do this for themselves initially. Some babies also have conditions such as torticollis, or a shortening in the muscles on one side of the neck, that make them more prone to laying in the same position, with their head usually turned to the same side.

Why is Flat Head Syndrome so Prevalent in Babies Now?

Since more information regarding sudden infant death syndrome (SIDS) became available, mothers are advised not to lay a baby on their tummy to sleep, but to place them on their backs instead. However, although this has led to a reduction in the number of SIDS cases, which is wonderful news, it has also led to a rise in the number of infants with flat head syndrome. Up to a third of all babies who sleep on their backs will develop this to some extent.

Luckily, if this does occur there are treatments that are simple and effective, with no risk to your baby. As babies can sleep for long periods of time, lying on their backs without much movement will affect the part of the head that touches the crib mattress. Because the baby’s head is so soft, the shape of the head can be affected by becoming flattened. Some babies seem to be particularly prone to this condition, and it is also more common in premature infants. This flattening can be rectified or prevented by just following a few basic principles. The main thing to remember is that the earlier that you can start implementing these strategies, the better the results.

How can Flat Head Syndrome be Prevented or Treated?

Use of Slings and Baby Carriers

As babies can’t move around by themselves very much initially, they spend a lot of time either in your arms, car seats, baby bouncers, etc. Time spent in seats of any kind can add to the effect of a flat head, but if you place your baby in a sling or carrier and carry it with you, you will be automatically reducing the amount of time spent with the back of the head against a flat surface.

If you do need to put your baby in a stroller, car seat, bouncer, or swing for some time, you can use special pillows to keep the pressure off the back of the head. These should always be used with supervision.

Tummy Time

Babies need to experience a variety of positions and tummy time is very helpful to prevent flat head syndrome in your baby. Therefore, allow them time to lie on the tummy while you are supervising. Their heads can be placed to one side if they are very young and unable to lift their heads themselves. It is important that you still always lay the baby on their back to sleep. The earlier and more often you can do tummy time with your baby, the more comfortable the baby will get with being on its tummy. If your baby does not like the position in the beginning, just try to do more very short sessions, even a few moments until the baby fusses will help if you do it often. Over time, the baby will be happier in this position. Tummy time is important for other areas of development as well, so don’t neglect it.

Change Baby’s Sleep Positioning

Making sure to vary a baby’s sleep positioning can go a long way to help prevent your baby from getting a flat head, and to even help to resolve a flat spot which is already developing. One thing you can do is to alternate the direction that the baby is sleeping in the crib. A baby will tend to look out of the crib towards the room or door, and will then always be turning the head the same way and putting pressure in the same spot on the back of the head. Each time you put the baby down, put her head at a different end of the crib. You can also alternate the direction the baby is laying on the changing table. If the baby continues to turn the head in the same direction no matter the position, there may be other factors such as torticollis at work. It’s important to speak with your health care practitioner because special exercises or physical therapy may be recommended. It is also good to alternate the position that you carry and hold the baby, for instance on alternating shoulders.

These are also special infant sleep positioners that are designed to keep your baby in one position and these are adjustable, which means you can slightly change the sleeping position for your baby each time you lie them down.

What if all of these methods are not enough?

Putting these methods into practice will minimize the possibility of developing flat head syndrome in your baby. However, please know that despite your best efforts, sometimes it is impossible to prevent flat spots from developing. There is no need to feel guilty about this! If the condition is severe and the child is young enough, ideally starting under a year old, a special orthotic baby helmet can be made to correct the issue. The baby wears the helmet for 23 hours a day for usually 3-6 months, and it is normally very comfortable for the infant. It is important to seek advice early from your health care practitioner if you suspect a flat spot is developing, as this kind of treatment is best done as early as possible, sometimes even as young as four months if the flatness is severe enough.

Sarah A. Davidson invites you to learn more about how to treat and prevent baby flat head syndrome on her website, babyflathead.org. There you can find more articles, practical tips, videos, and information about the latest research on baby flat head syndrome. You are welcome to share your own experiences there, in order to help other parents dealing with this issue.

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