Preventing flat heads
As more parents put their babies to sleep on their backs, pediatricians have noticed an increase in positional plagiocephaly, or flattening of the head. The “Back to Sleep” campaign, first introduced in 1994 to prevent Sudden Infant Death Syndrome (SIDS), comes from research showing that back sleeping is safest for babies. Understandably, this makes many parents nervous about allowing their babies to spend any time on their tummies.
Most pediatricians now believe that the increase in head flattening is an unintended result of “Back to Sleep” recommendations. Because infant skulls are still somewhat soft and moldable, spending uninterrupted time on the back can cause a baby’s head to become flat due to the gentle-but-constant pressure on the back of the skull. While flattening of the head is generally not dangerous, many parents worry about their child’s head shape and wonder what they can do to prevent the flatness.
One of the best ways to avoid head flattening is by spending some time with your infant each day while she is on her tummy. Supervised tummy time is important for infants developmentally because it helps build neck muscles and prepares them for rolling and crawling. In addition, tummy time helps promote a more rounded head shape by decreasing pressure on the back of the head. Most pediatricians recommend 30 minutes of tummy time each day for healthy babies.
If you find that that your baby fusses during tummy time, start out with just a few minutes then try slowly increasing the time spent on the tummy; the 30 minutes doesn’t need to be all at once. Eventually, you want to get to the point that your baby is spending at least half of his awake time on his tummy. Be creative:
- Have your baby lay on your tummy, face to face.
- Lay your baby across your legs.
- Get down on her level so she can look at your face while on her tummy.
- Offer a mirror or other toys for your baby to look at.
- After a bath, dry her while she is on her tummy.
Additional ways to prevent flatness include:
- Alternate the direction she lies in the crib (while still on her back).
- Avoid prolonged time in the reclined position when awake.
- Take your baby out of the car seat as soon as you reach your destination.
If your baby already has some flattening, discuss any concerns with your pediatrician. In some instances, your pediatrician may recommend physical therapy.
Babies with more severe flattening may be referred to a specialist, such as a pediatric plastic surgeon, who may prescribe a custom molding helmet. Helmets work best if started between the ages of 4 and 6 months. They work by applying constant but gentle pressure on a baby’s growing skull and are generally worn at all times other than bathing.
Remember, the best option for avoiding the need for corrective measures is supervised tummy time. It not only prevents flattening of the head, it also promotes important developmental growth.