You’re having a play date with your new mom’s group when someone asks you if you’ve noticed the flat spot on your baby’s head. Worse yet, they tell you they think he may have “plagiocephaly”. As you try not to panic and finish your latte, you wonder, “What is plagiocephaly and is it serious?!” Plagiocephaly is the medical term for a flat spot on the baby’s skull. Here are some tips and advice on how to prevent or manage this benign medical condition.
Why does my newborn’s head shape look odd?
Right after birth, you may have noticed that your baby’s head shape is “cone-shaped” or pointy – this is normal and is most often the result of the birthing process. Some babies’ head shapes can take up to six weeks after birth to correct or remold to a more normal head shape, however, most will improve within the first two weeks after delivery. Premature infants may have flat spots due to softer skulls. Twins or bigger babies may have flat spots caused by cramped space while in the womb.
My baby has a flat spot on his head, what is it?
If your baby had a normal head shape soon after birth but now you’re noticing a flat spot, it is likely due to the pressure placed on the back of your baby’s soft skull. This happens when babies spend a lot of time in one position, usually lying on their backs in the crib, bassinette, swing, bouncy chair, and/or infant car seat, and is called positional plagiocephaly. This is a preventable condition and most babies’ head shapes will improve with repositioning over time. In a few severe cases, a custom remolding helmet may be appropriate (photo shown).
Why should I put my baby on his back for sleeping if this can cause a flat head?
Back sleeping has been linked to reducing the incidence of Sudden Infant Death Syndrome (SIDS) or crib death by more than 50 per cent. It is very important that you always put your baby on his back for sleeping. This does not mean that while your baby is awake, he should continue to lie only on his back. When your baby is awake, place him in supervised tummy time or side lying positions frequently – the earlier you begin to do this the faster your baby will get stronger and more used to it! To reduce the risk of SIDS, never use any pillows, blankets, bumper pads, or wedges to reposition your baby while sleeping. In fact, these props often hinder your baby from naturally learning to roll over which is an important skill for normal growth and development.
What can I do to prevent a flat head shape?
As soon as your baby is born it is important to reposition his head frequently while he is lying on his back. A good suggestion when laying your baby on his back for sleeping is to turn your baby’s head to opposite sides with each nap/sleep-time. Be aware of how much time your baby is laying in any one position. It is not uncommon for some babies to spend up to 24 hours per day lying on their backs as they are moved from crib to swing to bouncy chair to cars eat . Encourage your baby to spend supervised time on his tummy or side lying while awake which will also encourage him to move around more. Remember, positional plagiocephaly is caused by prolonged, sustained pressure on your baby’s skull over time, so to prevent or improve a flattened head shape, reposition your baby’s head often.
My baby has never had a normal head shape, what should I do?
If you have noticed an odd head shape since birth that has not improved in the first couple of months, it is important that you contact your pediatrician or family doctor and have your baby’s head shape assessed to rule out craniosynostosis. Craniosynostosis is a rare condition with only .04 to 0.1 per cent chance of your baby having it, and occurs when the bones in the infant’s skull fuse too early. Craniosynostosis is corrected by a surgical procedure.
When should I see a health care professional?
Most pediatricians and family doctors have information and resources to help you with your baby’s head shape. Community health centers (where your baby gets his shots) are a great place to get any information about your baby’s health including tips and advice on positional plagiocephaly.
By: Tina Vogel, RN, BScN & Wendy Beaudoin, RN, MN
