Misshapen/Flat Head in My Baby. Tips to Prevent It

Flat head syndrome, also known as positional or deformational plagiocephaly, is a condition where a baby’s head has a flattened area on one side and may also have an asymmetrical appearance of the ears and face.

Key takeaways:
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    Flat head syndrome in babies is a common condition where the head becomes misshapen due to the baby lying in the same position repeatedly.
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    The three types of flat head syndrome include plagiocephaly, brachycephaly, and dolichocephaly.
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    Prevention methods to reduce a misshaped head include changing your baby’s sleeping position, holding your baby more often, increasing supervised tummy time, and changing their view by moving toys/items from one side to another.
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    Treatment options for flat head syndrome include positioning, corrective helmet therapy, and physical therapy.

Flat head syndrome occurs when a baby spends too much time lying in the same position, with their head turned to one side. It is a common, treatable, and usually preventable condition.

Why does flat head syndrome occur?

The occurrences of flat head syndrome have increased since 1994 when the Safe Sleep campaign, also known as the Back to Sleep campaign, was initiated. The campaign recommends that babies be placed on their backs to sleep until they are one year old to lower the risk of sudden infant death syndrome (SIDS).

When a baby’s head remains in the same position repeatedly for long periods, the skull will become flattened. It can be challenging for parents to prevent this flattening because babies must be placed on their backs to sleep. Babies spend a significant amount of time sleeping and also must be positioned on their backs while in a car seat.

The skull of a baby is naturally soft at first and begins to firm over time, so it can change shape with consistent pressure being placed in one area. Causes of flat head syndrome include the following:

Positioning

When a baby lays in the same position with the head turned to one side, the repeated pressure on the skull causes it to flatten.

Muscular Torticollis

The muscles in the neck contract, causing the head to naturally rotate to one side.

Prematurity

Babies born prematurely have soft skulls and are exposed to being positioned on their backs far sooner than babies that are born full-term.

Types of the flat head syndrome

Not all babies with flat head syndrome appear the same. The shape of the skull can vary depending on which area of the head is affected. The three different types of shapes that occur with the flat head syndrome include the following:

Plagiocephaly

One side of the back of the head is flattened, causing the appearance of slanting.

Brachycephaly

The entire back of the head is flattened, making the head appear wider than normal.

Dolichocephaly

Both sides of the head are flattened, causing the appearance of an elongated head.

Signs of the flat head syndrome

A misshapen head is not always obvious at first and can take several months to become apparent. Some of the signs of flat head syndrome may include:

  • A flattened area of the head.
  • A bald spot on one particular area of the head.
  • The forehead or cheek may appear to bulge outward.
  • Ears that appear unaligned.

Parents should monitor the appearance of their baby’s head, face, and neck positioning. If flat head syndrome or torticollis is suspected, parents can discuss their concerns with a pediatrician, who will perform a further assessment to determine if there is a problem.

Tips to prevent the flat head syndrome

The flat head syndrome can improve over time as a baby becomes stronger and starts to roll over and sit up. However, if it is severe enough, treatment options are available. It is best to try to prevent the condition early on before it becomes apparent that the head is misshapen. Parents can follow these recommendations to help prevent flat head syndrome:

Positioning

Change the position your baby sleeps as often as possible. If you notice your baby’s head is turned towards the right more often than the left, gently turn the head in the opposite direction to relieve the pressure of being repeatedly placed in the same spot.

Babies usually enjoy looking out of their cribs to view their room versus staring at the wall. One method of changing your baby’s position without changing their view is by alternating the position you lay them in their crib. One day, place your baby with their head facing the top of the crib, and the next day, place your baby with its feet towards the top of the bed. By doing this, they can still look out at their view, but their head and neck will change position.

Encourage your baby to change which way they look by placing toys or pictures to the left of them for a certain time and then moving the items to the right of them. This forces the baby to move their neck and head to the opposite side.

Tummy time

Babies should always be placed on their backs to sleep. Place your baby on their tummy while they are awake and only with supervision. Tummy time not only helps with development and muscle strengthening, but it also helps prevent the head from becoming misshapen.

Hold your baby

To lower the amount of time your baby is lying on their back, increase how often you hold them. If you need to use your arms, place your baby in a carrier. Alternate their neck position while in the baby carrier to help prevent tightening of the muscles on one side.

Treatment options available

If you notice that your baby has a flattened area on its head, take action immediately to prevent further misshaping. Speak with your pediatrician so they can perform further assessment and provide suggestions. Treatment options for flat head syndrome include:

Positioning

Increase supervised tummy time while your baby is awake, alternate the position you place your baby in the crib, hold your baby more, and encourage them to look in different directions by changing where you place toys/items in front of them.

Helmet therapy

If your pediatrician recommends treatment beyond positioning, a customized helmet can be worn to gradually correct and prevent further flattening of the skull.

Physical therapy

A physical therapist can help determine the cause of the misshapen head and will assist with strengthening and stretching exercises.

Flathead syndrome is a common condition that generally resolves on its own when the baby becomes older and starts to roll over and sit up. Prevention methods to reduce the risks of developing a misshaped head include frequent position changes to relieve the head from repeated pressure in the same spot.

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