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Flat Spot on Baby's Head: Is it a Health Concern?

Alison Wood |11, July 2013


Approximately 20 years ago a new campaign started. Its goal was simple—lower the rates of Sudden Infant Death Syndrome and potentially save thousands of babies' lives.

Since then, the majority of parents have religiously placed their babies on their back during naps as well as at bedtime. The proponents of the Back to Sleep Campaign did succeed in drastically decreasing the amount of infant deaths associated with SIDS. A steep decline was reported and many researchers linked the success of lower SIDS rate to the Back to Sleep Campaign's industrious work to get the word out about safe-sleeping positions for infants.

However, in recent years the decline has not been very significant and parents have other concerns as a result of the popular back-sleeping position. Their picture-perfect infants are losing the nice, rounded shape of their heads and developing flat spots on areas where their head comes in constant contact with the bed.

These flat spots are known as "positional plagiocephaly". Are they of a major health concern or are they only cosmetic? Some experts say these spots pose no harm.

Dr. S. Anthony, head of plastic surgery at Miami Children's Hospital gives his educated opinion:
"There are no functional problems that I know of, except for a distorted head."

Other doctors say that possible mild developmental delays could result, but typically disappear at 18 months of age.

Recently a study in Canada was published in the journal Pediatrics. The research revealed that 46% of two to three month old babies may have some type of flat spots on their heads. The Canadian study analyzed 440 infants in four separate medical clinics. The researchers hypothesized that the results from a study in America would deliver a much higher rate of positional plagiocephaly, most likely from the popular Back to Sleep Campaign that began in the 1990s.

Many cases of babies with flat spots are hard to see, while others are quite evident. Treatment is available through specialized helmets made for babies aged six months and up. However, many pediatricians recommend that parents only consider these very expensive helmets in severe cases.

In recent years, parents have taken more notice of the shape of their baby's head. New campaigns have begun to encourage parents to avoid SIDS by focusing on other methods of prevention such as using a firm mattress and avoiding fluffy bedding and stuffed animals. Some parents are also trying only putting their babies to sleep on their backs half of the time, and the other half on their side. When a baby sleeps on his side, he should be carefully motored so he does not roll over onto his tummy and place his face in the bed.

The American Academy of Pediatrics is also encouraging parents to include lots of tummy time throughout the day so the baby spends time in different positions. Tummy time also has other benefits such as encouraging your baby to crawl and helping your little one explore his new world. The position on the tummy also cuts back on the amount of time that pressure is placed on the baby's head. The shoulders and neck muscles are also exercised when a baby is awake and enjoying tummy time.

How can I help my little one avoid flat spots?

Since flat spots are caused by constant pressure on the skull, it is possible to ensure your baby is sleeping safely while ensuring the pressure is not focused in one area. Here's how:

Change it up! For each nap, place your bambino in a different safe-sleeping position. For the first nap, place your infant on his left side. The next nap, place him on his other side. Keep switching throughout the day and save back-sleeping for the evening.

Hold, rock and play. Take your baby out of the bed, swing or carrier throughout the day and hold, rock and cuddle with him. Also, place him on his tummy for playtime throughout the day. Always supervise an infant closely when he is on his tummy for play and activity time.

Always ask your pediatrician about the most updated information on safe-sleeping positions for your little one. Safety is always the primary concern for your little one.

Alison Wood is a stay-at-home mom of six and freelance writer and blogger. She enjoys raising her six children and desires to share her experiences to help other mothers.

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