You might have noticed that your baby’s head isn’t perfectly round.
Or perhaps you’ve heard the term ‘flat head syndrome.’
Don’t worry, this is more common than you think and usually isn’t a cause for alarm.
Flat head syndrome, or plagiocephaly, refers to an uneven or flattened shape of a baby’s head.
It often happens when a baby’s soft skull flattens in one area due to consistent pressure.
It is usually from lying in the same position for extended periods.
But what exactly does it mean?
Let’s explore this topic in detail to ensure that your little one’s head grows beautifully round.
How Common Is Flat Head Syndrome?
Flat head syndrome is surprisingly common.
According to studies, about 1 in 5 babies will develop some degree of plagiocephaly within the first few months of life.
It’s seen more in newborns because their skulls are soft and still forming.
Premature babies are even more likely to develop it since their skulls are even softer.
They also spend more time lying down in neonatal units.
Two Types of Flat Head Syndrome (Plagiocephaly)
Plagiocephaly, commonly known as flat head syndrome, is a condition that affects the shape of a baby’s head.
It can occur when one part of the skull flattens, often due to prolonged pressure in the same area.
While this condition may sound alarming, it’s quite common and generally treatable, especially when identified early.
There are two primary types of plagiocephaly that parents should be aware of.
Understanding the differences between these two types is key to knowing what steps can be taken to prevent them.
Positional Plagiocephaly
This is the most common form and is often caused by external pressures on the baby’s skull.
For example, if a baby sleeps in the same position every night, the area in contact with the mattress may flatten.
Since babies spend so much time lying down, especially in the first few months, their skulls are vulnerable to shaping.
This causes them to develop flat head syndrome (plagiocephaly).
Congenital Plagiocephaly
Unlike positional plagiocephaly, this type is present at birth and is often due to factors inside the womb.
It can result from limited space in the uterus, especially in the case of multiples (like twins or triplets).
Otherwise, it can happen if the baby’s head was pressed against the mother’s pelvis during pregnancy.
Congenital plagiocephaly is less common and often requires more specialised treatment.
How to Identify Flat Head Syndrome
Identifying flat head syndrome is relatively simple.
It’s all about noticing changes in your baby’s head shape.
If you observe that one side of your baby’s head is flatter than the other or that one ear appears more forward than the other, it could be a sign of plagiocephaly.
In some cases, you might also notice a bulging forehead or a difference in the height of the back of the head.
Symptoms to Look Out For
Identifying flat head syndrome early on is crucial for effective treatment.
The most obvious sign of flat head syndrome is a visible flat area on the back or side of the baby’s head.
This flattening often occurs on one side and may become more noticeable over time.
While the appearance of the head is the most obvious sign, there are other symptoms to watch out for:
- Head and Ears: Baby’s head and ears appears uneven or lopsided.
- Forehead Size: Forehead might appear more prominent or bulging.
- Torticollis: Baby has difficulty turning their head fully.
- Hair Loss: Bald patches on the flattened area.
- Facial Asymmetry: Differences in the eyes, cheeks, or jaw alignment.
How Does Flat Head Syndrome Happen?
Flat head syndrome, or plagiocephaly, can develop due to a variety of factors.
These factors range from a baby’s sleeping habits to conditions in the womb and even complications during delivery.
Below, we dive deeper into some of the most common causes.
Sleeping Position
Health experts strongly recommend placing babies on their backs to sleep as a preventive measure against Sudden Infant Death Syndrome (SIDS).
This ‘Back to Sleep‘ campaign has been highly successful in reducing SIDS rates, making back-sleeping the safest choice for infants.
However, when a baby sleeps with their head turned to the same side for a long time, the soft bones in their skull can flatten.
This is especially true if the baby favours one side, which can lead to a noticeable asymmetry in the head shape.
Since a baby’s skull is soft and still growing, staying in one position for too long can cause a flat spot to form.
This is why it’s essential to give babies time on their tummy during the day and to change the direction their head faces when they sleep.
Problems in the Womb
What happens before a baby is born can also affect their head shape.
If a baby shares the womb with a twin or triplet, space can get tight.
When there isn’t much room, a baby’s head might be pressed against each other or the uterine wall, causing their heads to flatten.
Additionally, if there isn’t enough amniotic fluid (the liquid that surrounds the baby in the womb), the baby’s head might not move around freely.
Amniotic fluid serves as a cushion that allows the baby to move and grow without undue pressure on any part of their body.
When this fluid is insufficient, the baby may experience increased pressure on their head, leading to flat spots.
Apart from that, even the position of the baby’s head against the mother’s pelvis or rib cage can create pressure that causes flattening.
Being Born Prematurely
Premature babies are at a higher risk of developing flat head syndrome for several reasons.
Firstly, their skull bones are even softer and more malleable than those of full-term infants, making them more prone to flattening from external pressure.
Premature infants often require extended stays in the NICU where they spend significant time lying on their backs in incubators.
Due to their fragile condition, premature babies typically have less muscle strength and control.
This can make it more challenging for them to adjust their head positions independently.
This long period of immobility can contribute to the development of flat spots.
Assisted Delivery
Sometimes, doctors need to use tools like forceps or a vacuum to help deliver a baby.
While these tools are important for a safe delivery, they can also apply significant pressure to the baby’s head.
The use of forceps, can compress the skull and lead to temporary or even long-term indentations.
Similarly, a vacuum extractor, which uses suction to assist with the delivery, can create a raised or flattened area on the baby’s head.
In most cases, any flattening or shaping caused by assisted delivery methods will resolve on its own as the baby’s skull bones continue to grow and reshape.
However, in some instances, particularly if the baby is born prematurely, the flat spot may last longer.
Torticollis
Torticollis is a condition where the muscles on one side of a baby’s neck are tighter or shorter than those on the other side.
This muscle imbalance causes the baby’s head to tilt to one side.
It makes it difficult for them to turn their head in the opposite direction.
As a result, babies with torticollis often keep their heads in the same position for extended periods.
This can result in a flat spot forming on one side of their head.
In many cases, torticollis is often mild and can be treated with simple exercises that help the baby’s neck muscles stretch and strengthen.
Craniosynostosis
Craniosynostosis is a different and more serious condition than positional plagiocephaly, it’s congenital.
It happens when the bones in a baby’s skull fuse too early, before the brain has finished growing.
This early fusion can make the baby’s head may appear elongated, asymmetrical, or misshapen in other ways.
It can also lead to other health problems like increased pressure inside the skull and developmental delays.
Craniosynostosis is usually treated with surgery to allow the brain and skull to grow normally.
How to Prevent Flat Head Syndrome
Now that we know what flat head syndrome is, let’s discover how to prevent it.
The good news is that it’s relatively easy to take steps to avoid flat head syndrome.
Most of them include repositioning your baby to reduce the time they spend on lying down on their heads, while others use medical tools only if your baby’s condition is severe.
Parents should be aware of these differences and take action based on what fits their baby’s situation.
Tummy Time
Tummy time is essential for developing your baby’s neck, shoulder, and arm muscles, but it also helps prevent flat spots on the back of the head.
Aim for at least 30 minutes each day and gradually increasing it as your baby gets stronger.
To learn more on how to do tummy time, read our article: Tummy Time Fun: Why It’s Important and How to Do It Right.
Change Positions During Sleep Time
Alternate the direction your baby’s head faces during sleep.
If your baby usually looks to the right, try encouraging them to turn their head to the left.
According to study, this is an effective method to prevent the burden of your baby constantly sleeping on one side.
Limit Time in ‘Containers’
While car seats, bouncers, and strollers are handy, they can put pressure on the same areas of your baby’s head.
Since we want to avoid having your baby lying down in the same position for a long time, consider these other methods.
When possible, hold your baby upright or use a baby carrier to keep them in an upright position.
Alternative Methods: Helmets, Headbands and Curved Mattresses
If flat head syndrome is identified early, repositioning techniques and physical therapy are usually effective.
In more severe cases, your paediatrician might recommend other methods.
The helmet and headband help gently mould the baby’s skull into a rounder shape.
They are typically most effective when used between 4 to 12 months of age when the skull is still malleable.
However, the decision to use them should always be made with your healthcare provider, as they can be expensive and require regular adjustments.
Some parents even explore the use of curved mattresses designed to reduce pressure on the baby’s head.
While research is still ongoing, some studies suggest these may help in mild cases.
However, always consult with your doctor before making changes to your baby’s sleep environment.
If the Condition Is Severe: Seek Medical Advice
In rare cases where the flatness is significant or the baby struggles to turn their head, your doctor might recommend physical therapy.
This therapy helps stretch and strengthen the neck muscles, especially if torticollis is present.
For babies with congenital plagiocephaly or craniosynostosis, surgery may be required.
Surgery is usually recommended only when the condition is severe and other methods have not been successful.
It involves separating the fused bones and allowing the skull to grow normally.
This surgery is usually performed within the first year of life to minimise the risk of complications.
Doing so would also improve the chances of a normal head shape developing, allowing the brain to grow normally.
Unsafe Sleeping Techniques to Avoid
While repositioning your baby is important, there are some sleeping techniques to avoid.
These include:
- Sleeping on the tummy: This increases the risk of SIDS.
- Sleeping on the side: This is unstable and could lead to the baby rolling onto their tummy.
- Cribs filled with soft toys and blankets: These can pose a suffocation risk.
The safest sleep environment is a firm mattress with a fitted sheet, free from pillows, blankets, and toys.
Research shows that SIDS tend to happen due to suffocation from soft bedding and prone positioning.
How Long Do You Need to Reposition Your Baby?
Repositioning should be a regular part of your routine until your baby can consistently change positions on their own.
This typically happens around six months of age, but it can vary.
Once your baby is more mobile (rolling, sitting and crawling), they’re less likely to develop flat spots as they’re not staying in the same position for too long.
Will My Baby’s Head Return to Normal?
In most cases, yes! Flat head syndrome usually improves naturally with time.
As babies grow and start moving around more, they naturally change their sleeping positions, which helps round out their heads.
Flat head syndrome might sound worrying, but it’s often just a cosmetic issue that improves with time and simple interventions.
By being proactive with tummy time, repositioning, and avoiding pressure on the same spots, you can help ensure your baby’s head grows beautifully round.
Remember, every baby is unique. If you have concerns, don’t hesitate to reach out to your healthcare provider for guidance.
Ensure Your Baby’s Head Grows Beautifully Round
As you’ve learned, flat head syndrome, while common, is usually nothing to fear.
By staying vigilant and making small adjustments, you can help ensure your little one’s head grows beautifully round.
Take action with what works best based on your baby’s situation.
Remember, early intervention and consistent efforts can make a world of difference in your baby’s development.
Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner.
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