Flat head syndrome is a condition in which part of a baby’s head develops a flat spot, either on one side or the back of the head, during the first months of life.
The syndrome — also called positional plagiocephaly — usually happens when a baby sleeps in the same position most of the time or because of problems with the neck muscles.
While it may seem alarming, the syndrome is common and is easily treated and prevented with a few simple practices. The condition has not been shown to harm brain development.
All babies need to be placed on their backs to sleep to reduce the risk of sudden infant death syndrome (SIDS). Back sleeping is the safest position even if your baby has flat head syndrome.
There are several other things you can do to help correct or prevent flat head syndrome, including:
“Make sure your baby is sleeping on his or her back as recommended by the American Academy of Pediatrics. It’s also important to make sure babies don’t spend too much time on their back with their head in any one position,” Dr. Chu says. ”You can gently reposition your baby’s head during naptime and bedtime, from right to left, left to right.”
Position your baby so that the more rounded side of the head is placed against the mattress. You can also change the position of the crib and place your infant so that the baby will look away from the flattened side of the head to see people or interesting objects in the room.
When awake, babies should spend supervised time on their tummies for at least 30 to 60 minutes a day, broken up into short segments. Routine awake tummy time can help a baby develop strong neck and shoulder muscles and help prevent flat spots. The best time to do this is following a diaper change or when the baby wakes up from a nap.
Reduce the time your baby spends with the head against a flat surface when awake, including car seats, swings, strollers and bouncy seats. These items put added pressure on the back of the baby’s head.
Many babies with flat head syndrome also have torticollis, tight neck muscles on one side of their neck that makes turning their heads difficult. Since it’s hard to turn their heads, these babies keep their heads in the same position when lying down, causing flattening.
Babies with severe flattening on one side of their head do not turn their heads and their necks become stiff from lack of use.
Torticollis is treated with neck stretches that should be performed with each diaper change. “Your pediatrician can teach you some specific exercises involving stretching techniques that are gradual and progressive,” Dr. Chu says.
Most moves will involve stretching your child’s neck to the side opposite the tilt so that in time the neck muscles will get longer, and the neck will straighten out.
Flat head syndrome usually happens in the first four to 12 weeks of life when babies are not able to sit up or move on their own. The condition improves with time and natural growth. As they grow, they begin to change position themselves during sleep.
If positioning and exercises are not helping, sometimes physical therapy is recommended.
If skull deformities are more significant and not improving, your pediatrician may refer your baby for a skull-molding helmet. Do not purchase or use any helmets without seeing your pediatrician.