Flat head syndrome — also called positional plagiocephaly — is a condition in which part of a baby’s head develops a lasting flat spot, either on one side or the back of the head.
The syndrome 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. In addition, the condition has not been shown to harm brain development.
Change your baby’s head position during sleep.
Make sure your baby is sleeping on his or her back as recommended by the American Academy of Pediatrics, but try to reposition your baby’s head during naptime and bedtime (from right to left, left to right).
Encourage your baby to actively turn his or her head.
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.
Practice tummy time.
When awake, babies should spend supervised time on their tummies for at least 30 to 60 minutes a day. Routine awake tummy time has been shown to enhance infant motor developmental scores during the first 15 months of life.
Limit time in car seats.
Reduce the time your baby spends with the head against a flat surface when awake, including car seats, swings, strollers and bouncy seats.
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.
In a catch-22, 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.
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.
The prevalence of positional skull deformities generally peaks at 4 months and will begin to show more improvement by 6 months as babies spend more time sitting and then crawling.
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.