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What if my baby still has a flat head?

Flat spots on babies heads have been on the rise since 1992, when the American Academy of Pediatrics started recommending that parents put babies to sleep on their backs to reduce the risk of SIDS. While the recommendation has definitely been working – SIDS cases have decreased significantly as education about it has spread – it comes with its own set of challenges, not the least of which is a head that’s usually turned to a prefered side of his soft, still-forming skull.

The condition is called deformational plagiocephaly, and while it’s often benign, and only a concern visually, that doesn’t mean it can’t be a problem. No matter when you notice it or how severe it is (or isn’t), it’s always a good idea to check out head-flatness with the doctor. There are a variety of different things that can cause head-flatness, and depending on the cause and severity, a range of treatments, too, from wait-and-see, to the use of a corrective helmet, or even surgery.

  • The most common reason for a flat patch on a baby’s head is just that he tends to lie with his head in the same position, out of habit, or maybe because there’s something interesting to look at on that side of his bedroom or the living room, or he sleeps in a swing, rocker, or other device that holds his head in a certain position. Once this flat spot starts to form, it becomes even easier for Baby’s head to slip into this position, which makes it even flatter. If it’s caught before it’s too severe, this type of flatness can be combatted just by making sure your child spends as little time as possible lying on his back when he isn’t sleeping, increasing the amount of time he spends on his tummy or sitting upright in your arms or a carrier. Your pediatrician may also recommend repositioning Baby in his sleep so he sometimes lies facing the other direction. If the flatness is severe, your pediatrician may recommend using a corrective headband or helmet, though these can be a little expensive, since they’re not always covered by insurance.
  • Sometimes, if babies consistently turn their heads to one side or the other, it’s a sign that they have more mobility in the muscles on one side than on the other. This is called torticollis, and can be treated with physical therapy, as well as repositioning and giving Baby plenty of tummy time.
  • In some rare cases, head flatness can happen when the bones in a baby’s skull fuse together too soon. This can cause problems if it’s not corrected with surgery, and is one of the big reasons why even probably-normal, fairly minor flatness deserves a mention with your pediatrician so he or she can check it out.
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