Why Does My Baby Have a Flat Head?by Dianna Graveman
Newborn babies often have unevenly-shaped heads, sometimes even an obvious flat spot. This is sometimes an after-effect of passing through the birth canal and resolves within about six weeks. But for doting new parents, the appearance of the flat spot on the backs of their babies' heads can be alarming and the cause for a trip or a phone call to the pediatrician's office with two questions in mind: "Is it serious?" and "What can we do about it?"
Many pediatricians report seeing an increase in the number of babies with flat spots since 1992, when the American Academy of Pediatrics began recommending that infants be put to sleep on their backs to reduce the risk of SIDS (Sudden Infant Death Syndrome).
Flat spots can develop when babies sleep repeatedly in one position, because their skulls are soft and pliable when they are born. Babies who have flat spots due to sleeping position are said to have positional molding or positional plagiocephaly. This condition usually resolves itself as the baby's head and neck become stronger.
Positional molding does not affect the brain or interfere with your baby's development, but the appearance of a flat spot can be a concern for cosmetic reasons. If you notice a flattening of your baby's head at any age, be sure to discuss it with your pediatrician to rule out the need for further evaluation. Also remember it is important to continue placing your baby on his back for sleep -- never on his stomach. There are a few things you can try to help redirect the shaping of your baby's head, however.
When you put your baby to sleep, try placing his head at the head of the crib one time and the foot of the crib the next. Gently position his head to face a different way each time you put him to sleep. (Don't worry if he keeps turning back the same direction.)
Occasionally reposition your baby's crib so that when he moves his head toward sound or movement, he will face a different direction. Consider hanging a colorful, musical mobile on the outside of the crib.
If you bottle feed your baby, switch arms with each feeding. (You will, of course, automatically do this while breastfeeding.)
When possible, limit the amount of time your baby spends in a carrier or infant seat while she is awake.
As your baby gets older and her neck control improves, place her on her tummy occasionally for play -- but only when you are with her and observing her closely to reduce the risk of SIDS. Make sure she is on a firm surface with no blankets or stuffed animals close by, as these can be hazardous while your baby is on her tummy.
If your baby's condition does not improve by the time he is about four months old, your pediatrician may recommend a special helmet that will apply gentle pressure to help shape the skull as it grows. This type of treatment is most effective when it is begun by four to six months. According to the American Academy of Pediatrics, helmet therapy is rarely needed, as most positional plagiocephaly cases can be corrected with physical therapy and other noninvasive measures.
Although flat spots due to positional molding are more common, occasionally a misshapen head can be caused by other more serious conditions. Torticollis, a muscular disorder, may cause your baby to hold her head to one side. Physical therapy is usually used to treat this condition. Craniosynostosis is a skull deformity that must be treated surgically during infancy. While these conditions are rare, if you notice a flat spot on your baby's head, be sure to consult your pediatrician. Most of the time, your baby's flat spot will resolve on its own with time.
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