Prevent Infant Flat Head

Infant flat head (plagiocephaly) usually only has minor cosmetic effects, but you can always visit a doctor if these measures do not help.

Steps

Giving Baby Time Off Her Back

  1. Make “Back Is Best” your sleeping priority. The possibility of a flat spot on the back of your baby’s skull is insignificant compared to your opportunity to greatly reduce the threat of Sudden Infant Death Syndrome (SIDS), a terrifying condition in which a child under age one dies in his or her sleep for no determinable reason.[1]
    • Always place your infant to sleep on her back, on a firm mattress in an unoccupied, approved crib, with no pillows, blankets, toys, or loose clothing on or near the baby. Pacifiers are acceptable and may even be helpful in preventing SIDS.
    • The American Academy of Pediatrics’ “Back Is Best” campaign helped reduce SIDS deaths by 40%, but unintentionally caused rates of infant flat head to grow as well.[2]
  2. Give your baby regular “tummy time.” Place your infant on his belly on a firm surface for periods of ten to fifteen minutes (if possible) at least three times per day. Supervise the baby closely at all times. Never leave the room.[1]
    • "Tummy time" not only helps prevent flat head, it aids in motor development. It helps babies to strengthen their neck, arm and shoulder muscles.
    • The AAP has in fact changed its slogan from “Back Is Best” to “Stomach to Play and Back to Sleep” to indicate the importance of “tummy time” to infant development.[2]
  3. Hold your newborn often, especially in an upright position. The more time a baby spends out of the crib, infant seat, and swing, the less pressure is applied to the baby's head.[3]
    • The goal is not only to prevent pressure on the back of the skull, but to give the baby a range of movement that permits development of the neck and shoulder muscles as well.
    • Infant carriers that strap onto your chest and hold the baby upright while permitting range of motion can be a good choice.[2]
    • Holding your baby often also offers important bonding opportunities.
  4. Vary your baby's activities throughout the day. Don't leave your baby in the same position or location for long stretches of time. Overuse of swings, infant seats, and bouncers can result in flat spots.[3]
    • Though a tempting option, car carriers, swings, and the like should not be used as long-term holding areas nor sleeping quarters for your infant, because they limit range of motion of the head and neck.[2]
    • Moving your baby around to new locations and new positions frequently also engages her senses, which is essential to infant development.

Adding Variety to Baby’s Back Time

  1. Avoid pillows, cushions, wedges, and the like. It can be tempting to think that adding cushioning behind baby’s head will prevent a flat spot, but the risks outweigh any potential benefits.
    • Items like pillows introduce a smothering hazard and can increase the possibility of SIDS.[3]
    • Additionally, pillows, cushions, wedges, etc., make head movement more difficult, thereby limiting muscle development in the head and neck area.[2]
    • Babies should always sleep flat on their backs on a fairly firm surface, and if they are being temporarily propped up on a pillow or similar item while awake, must be constantly supervised.
  2. Alternate your baby's orientation within the crib. Have your baby's head face the foot of the bed one day, and reverse position the next. This encourages your baby to look in different directions.
    • This can help if your baby tends to tilt his head to one side or the other while sleeping to look toward a window, for instance. Some babies develop flat spots on one side or the other because they stare out in the same direction all the time.[1]
    • Changing the view by repositioning within the crib also increases visual stimulation.
  3. Rearrange your baby's sleeping quarters occasionally. In addition to moving baby around within the crib, you can change up the surrounding view from time to time. Anything that helps keep her interested in looking around will help prevent flat spots and promote eye and muscle development.
    • Try putting the crib in another area of the room to give the baby a new viewpoint. This can keep the infant from regularly looking in the same direction.[3]
    • Relocate mobiles or other sources of visual stimulation as well. Make sure they are always properly installed and not in danger of falling or being pulled down into the crib, however.[1]
  4. Switch arms every time you feed your baby. This will occur naturally if you are breastfeeding, but do the same if you use a bottle as well.
    • Switching sides regularly keeps pressure on the back of the head from occurring in the same spot all the time.[4]
    • Switching sides also aids in the equal visual development of both eyes, as each eye will have a turn with the dominant view of the surrounding area.
  5. Check with your pediatrician if your newborn develops flat head, or if his ears, eyes, or forehead look uneven. While in most cases this is plagiocephaly, some head shape deformities are caused by craniosynostosis, which is a serious condition that requires surgery.[4]
    • If your child is diagnosed with positional plagiocephaly, your doctor may advise taking the above steps and waiting to see if the condition improves. Most flat spots do become rounded in time.
    • Regular physical therapy is also an option.
    • More serious cases may require remolding of the skull using a custom-made corrective helmet or band.



Warnings

  • Avoid using unapproved sleep positioners; these include mats, wedges, and bolsters. Please check the U.S. Consumer Product Safety Commission (CPSC) official page for details.
  • Never place a newborn to sleep on her belly, even if she has developed a flat spot. Allowing your baby to sleep on her belly increases her risk of SIDS (Sudden Infant Death Syndrome).
  • Early intervention is the key to avoid the possibility of costly and painful helmet treatment.

Sources and Citations

  1. ↑ 1.0 1.1 1.2 1.3 http://www.caringforkids.cps.ca/handouts/preventing_flat_heads
  2. ↑ 2.0 2.1 2.2 2.3 2.4 http://www.charlotteobserver.com/living/article9097502.html
  3. ↑ 3.0 3.1 3.2 3.3 http://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/healthy-baby/art-20045964
  4. ↑ 4.0 4.1 http://www.babycenter.com/0_plagiocephaly-flat-head-syndrome_1187981.bc
  • "Misshapened Heads." Pediatrics for Parents 25.2 (2009): 3.
  • Ohman, Anna (2014). "A specially designed pillow Can Decrease Developmental Plagiocephaly in Young Infants". Health (6): 1092–1098. doi:10.4236/health.2014.611135.
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