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My Baby’s Head is Flat

By Candy Campbell, DNPc, MSN-HCSM, RN, CNL

My Baby’s Head is Flat

It all started in 1994, when the CDC launched the Back to Sleep campaign to reduce rates of Sudden Infant Death syndrome (SIDS). By putting babies to sleep on their backs, the campaign helped cut SIDS rates by a whopping two-thirds! However, the ‘side-effect’ was a growing percentage of babies ages 3 months and older who now have a misshapen head. Flat head syndrome occurs when a child’s soft, moldable skull bones are pressed against a firm surface, such as a mattress or a car seat, for long periods.

Plagiocephaly vs. Brachycephaly

If your child has flatness on the sides of the head, it’s call plagiocephaly, and it most often occurs in preemies who have spent time in the NICU, where they’re frequently turned from side to side.
Premature babies have even more soft and malleable bones than term babies. Plagiocephaly can also be caused by some cranial-facial disorders, but that’s a discussion for another time.
If your baby’s head is flat in the back, brachycephaly is the culprit. It’s most often caused by putting babies to sleep on their backs. Experts are divided in their opinions as to whether this is just a cosmetic issue while some think it could put your child at risk for developmental delays.

Treating Flat Head

If you notice flat spots, bring them to your pediatrician’s attention. Starting treatment early—usually by age 6 months—is important. There are helmets and other head-positioning devices designed to help reshape the skull.
Helmets, for example, which must be worn 23 hours a day for many months, can be quite expensive, and usually won’t be covered by insurance. However, research is inconclusive as to whether these devices actually create a lasting change in the head’s shape.

Help Prevent Flat Head Syndrome

  • Tummy time is essential Limit baby’s time in seats where the head will rest against the back, like swings or car seats. Increase supervised tummy time each day. This is so important to build baby’s muscles in her neck, arms and upper chest. Tummy time also relieves pressure on the back of the cranium, which causes flat head syndrome.
  • Change baby’s view Babies tend to turn their head to the same side. By alternating the direction you put baby to sleep in her crib, she will naturally spend equal time turning to each side. Do the same when you hold baby to feed her. Baby’s muscles can shorten and cause stiffness in her neck if she tends to only ever turn to one side.

Candy Campbell, DNPc, MSN-HCSM, RN, CNL, is an expert advisor to Healthy Mom&Baby.

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