Since the introduction of the “back to sleep” campaign where parents are encouraged to always place babies on their backs for sleeping, we have seen an increasing amount of flat head syndrome or positional plagiocephaly.
As adults, we have one fused, round skull bone. Babies are born with eight softer skull bones that all approximate one another. This is what creates your baby’s soft spot (four skull bones coming together to create a diamond shape). This soft skull allows for your infant’s brain to grow, which it does a lot in the first year of life! The skull typically fully fuses together by age 12 to 18 months. Until that time, these bones remain soft and malleable. Meaning if babies have a preference of laying on a certain side of their head or just always flat on the back of the head, that part of the skull can become flattened.
This is why tummy time for your baby is so important! Tummy time helps babies develop their chest, back and neck muscles. It also allows babies to see their environments from different perspectives, which is important for development. If you notice your child prefers to always look one direction or consistently resists turning the neck to one side, inform your doctor.
There are other, more rare, reasons that infants can have flattened head such as craniosynostosis. Your doctor should be able to tell when further evaluation is needed. The vast majority of positional plagiocephaly can be improved with positioning and changes in the infant’s environment (placing toys/stimuli on a certain side for example). Helmets and/or physical therapy are rarely necessary. If a flatten head seems to be worsening or more severe by 6 months of age, this is when a referral to a specialist would occur.
Ways to prevent a flat head
- Always place your baby on their back to sleep on a firm flat surface with no soft blankets, toys or bumpers around the face.
- Try to change arms when holding and feeding your baby.
- You can alternate the way you place your baby in the crib to sleep. Try putting them at opposite ends each time.
- Move the mobile or other stimulating toys to different sides of the crib.
- Tummy time! Always awake and supervised.
- Limit the amount of time your baby spends in swings or carriers.