Help! My Baby's Head is Flat!
By Rachael Towle

Contrary to popular belief, not all babies have perfectly round heads. We especially see this at birth because many children's soft craniums are still formed in a coned shape to help make passage through the birth canal an easier journey. However, even after birth, we still see many babies with misshapen heads. Flat spots can cause an infant's head to appear lop sided or unbalanced.

What causes flat spots?

There are many answers to this question. But the first answer is that it isn't your fault! First and foremost, your baby's position in utero can set the stage for a misshapen head. Premature babies also have a higher chance of suffering from flat spots. Flattening can also be caused by a child's predisposition to sleep on one spot of their head more regularly than on other spots or in different positions. In my son's case, torticollis (a wry neck) caused him to position his head in such a way that something as simple as gravity caused a flattening of one side of his head.

The "Back to Sleep" Campaign to help prevent Sudden Infant Death Syndrome (SIDS) may also contribute to flattening of the back of the head. This doesn't mean that the campaign isn't an important part of SIDS prevention; it simply means that it can contribute to flat spots. Prolonged time in infant swings and bouncy seats can also attribute to a flattened head.

Prevent flat spots from forming.

From the moment you bring your baby home, tummy time is an essential part of communication, bonding and play time. Tummy time doesn't necessarily mean lying on the floor! You can put your baby on its tummy while laying on your belly or chest. This not only allows your baby's head time to be exposed to different positions, but it also gives you more bonding time with your infant.

Positioning your baby during nap time can play a big role in correcting flat spots, or even prevent them from forming. Children tend to be attracted to light, so if you position your baby in different areas of the same sleeping space, they will change the way they face while sleeping. Once again, this gives your baby's head more evenly distributed pressure over a length of time.

How to correct a misshapen head.

Sometimes no matter what you do, your baby's head will still end up having a flat spot. If this happens, the next step is to try to correct it without medical intervention. First, be sure you talk to your child's pediatrician because there is always a slight chance that there is something more severe than a simple misshapen head.

Small and less severe flat spots may be treated by simple repositioning of your baby while during nap and bedtime. Ideally, the best way to try to make a correction is to have the infant lay in a way the puts pressure on the head where the head isn't flat. If the flat spot is more to the left of the head, positioning would occur on the right side, etc. Repositioning along with plenty of tummy time will aid in the prevention and correction of slightly misshapen heads.

More severe cases may need helmet therapy.

Plagiocephaly, Brachycephaly and Scaphocephaly (Dolichocephaly) are the medical terms used for different kinds of cranial flattening. Each of these medical terms refers to the flattening of the cranium in different areas, causing different deformities. However, each one can be successfully treated using helmet therapy. In the case of our son, he was fitted with an orthotic that gradually reshaped his head over a period of four months. It was worn for 23 hours a day and successfully reshaped his head to be more round, making his face and ears more symmetrical. There are many different medical groups and companies that specialize in cranial orthotics. Your pediatrician should be able to refer you to one near where you live.

Possible problems caused by untreated cranial flattening.

Children with untreated flattening may have life-long medical issues. Studies have shown that moderate to severe cases of untreated Plagiocephaly, Brachycephaly and Scaphocephaly can cause issues with vision and hearing. More severe issues like migraines, Temporomandibular Joint (TMJ) and facial muscle disorders can cause serious pain that may be untreatable in adults. All of these issues could be mild or severe.

Early prevention and treatment of your infant's misshapen head can prevent costly medical intervention. Active play, including tummy time, is more important than ever. Simply spending more time with your child and taking the extra time to reposition your infant can benefit them as much as it benefits you.

If you have a concern about your child's flat spot(s) and your pediatrician isn't able to provide you with the information necessary to correct the flat spots, it is recommended you seek a second opinion. Early intervention can make a huge difference in whether or not your child will need medical assistance in the correction of a misshapen head.

Rachael Towle is a mom and owner of several family friendly websites, including Parenting Resources, Parenting Message Boards and Work at Home Resources. You can read more about her and her websites at http://www.TowleCreations.com. During the first year of her son's life, she spent a lot of time learning about and treating her son's Plagiocephaly and Torticollis, including helmet therapy. You can read a more personalized account of their journey on TJ's DOC Band Jouney.