Do you sometimes look at your baby’s head and wonder if their head is round? Does it seem flat on one side? Well, you could be right. This CAN occur. We pediatricians call this positional plagiocephaly or a positional skull deformity.

Babies can spend a lot of time within their first few months in one position, as they are not able to turn their heads, move, or sit up on their own. Because of this, the shape of their heads can change. Most commonly, they can be unevenly flat on one side of the back of their heads. This usually peaks at 4 months, but can vary as every baby is different.

What causes their head shape to change?

• Ever since the AAP started to recommend babies to sleep on their backs to reduce the risk of SIDS (Sudden Infant Death Syndrome), newborns spend even more time on their backs.

• Adding to that, babies have soft bony plates in their skulls that take time to fuse together, so are mobile. This delay in fusion allows room for brain growth in their first year.

• Like adults, babies can also have a preference as to how they keep their heads when they sleep. This can cause extra time spent in that position.

How can you check if your baby’s head is symmetric or not? The best way to check is when their hair is wet from bath time!

When you check, note these things:

• Is the back of their head round?

• Are the ears even?

• Is the width of the forehead and head even?

If you see something concerning, always talk to your pediatrician at the next well-visit check up.

What can you do to fix this? The best solution is prevention. Here are some tips to help you prevent your baby from getting a flat head:

1. Tummy Time: Spending time on the tummy when the baby is supervised and awake can help strengthen their neck, back, and shoulder muscles. This helps them move their heads easier so they don’t end up in one position.

2. Avoid extended periods of time in car seat: Any car seat, swing, or carrier can put pressure on the back of the baby’s head.

3. Simple neck exercises: This will help them strengthen their necks to be able to move/lift their head from side to side. We recommend doing this during diaper changes. Move their heads gently to the left and right gently each time you do a diaper change.

4. Rotate their position often. Try to make sure they don’t get used to looking in one direction. You can also alternate which end of the crib they sleep on.

Do positional skull deformities cause delays in brain or growth development? No! They are 100 percent cosmetic. In most cases, a flat head improves by itself and does not lead to developmental delays. In some severe cases, your pediatrician may refer you to physical therapy to strengthen your baby’s neck. If your baby has not responded to usual therapy by 5-6 months of age, a helmet can be considered. Though, these tend to be cumbersome. In most cases, surgery in not recommended to fix plagiocephaly.

In cases where you feel your baby’s development is delayed and they are not meeting their milestones as expected, discuss this concern with your pediatrician. They’ll be able to guide you. We hope this post alleviates some of your concerns of a flat head.

As always, follow us @thepedipals, tune into our podcast, and let us know how we’re doing! Here’s to happy, healthy, and well-balanced children!

Your PediPals