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Health Information For Parents
Flat head syndrome usually happens when a baby sleeps with the head turned to the same side during first months of life. This causes a flat spot, either on one side or the back of the head.
Flat head syndrome is also called positional plagiocephaly (pu-ZI-shu-nul play-jee-oh-SEF-uh-lee).
The most common cause of a flattened head is a baby’s sleep position. Infants are on their backs for many hours every day, so the head sometimes flattens in one spot. This happens not only while they sleep, but also from being in infant car seats, carriers, strollers, swings, and bouncy seats.
Premature babies are more likely to have a flattened head. Their skulls are softer than those of full-term babies. They also spend a lot of time on their backs without being moved or picked up because of their medical needs, such as a stay in the neonatal intensive care unit (NICU).
Flat head syndrome can even start before birth if there’s pressure on the baby’s skull from the mother’s pelvis or a twin. In fact, many babies from multiple births are born with heads that have some flat spots.
Flat head syndrome is caused by tight neck muscles that make it hard for babies to turn their heads. This neck condition is called torticollis. Because it’s hard to turn their head, babies tend to keep their heads in the same position when lying down. This can cause flattening. Then, once the head has a flat spot, the torticollis (tor-ti-KOLL-iss) can get worse.
It takes a lot of energy for babies to turn their heads. So those with severe flattening on one side tend to stay on that side, and their necks become stiff from lack of use.
Flattened head syndrome usually is easy for parents to notice:
In severe cases, the forehead might bulge on the side opposite from the flattening, and may look uneven. If torticollis is the cause, the neck, jaw, and face also might be uneven.
Doctors often can diagnose flat head syndrome by looking at the baby’s head. To check for torticollis, the doctor may watch how a baby moves the head and neck. Medical tests usually are not needed.
Caregivers should always place babies on their back to sleep to help prevent sudden infant death syndrome (SIDS), even with possibility of flat head syndrome. Avoiding swings, car seats, bouncy chairs, and other devices is safest for sleep and also helps to make sure that babies can move their head freely.
So what can parents do when flat head syndrome is due to a sleeping or lying position? Simple practices like changing a baby’s sleep position, holding your baby, and providing lots of “tummy time” can help it go away.Try these tips:
Most babies with flat head syndrome also have some degree of torticollis. So physical therapy and a home exercise program usually are part of treatment. A physical therapist can teach you exercises to do with your baby involving stretching. Most moves involve stretching the neck to the side opposite the tilt. In time, the neck muscles will get longer and the neck will straighten itself out. The exercises are simple, but must be done correctly.
A doctor can prescribe a helmet for flat head syndrome. The helmet is designed to fit a baby loosely where the head is flat and tightly where it is round. In the helmet, the head can’t grow where it is already round. So it grows where it’s flatter.
Helmets make the head rounder quicker than time and normal growth. On average, though, babies who get helmets and those who don’t have the same results after a couple years. Talk to your doctor about whether a helmet could help your baby.
Flat head syndrome improves with time and natural growth. As babies grow, they begin to change position themselves during sleep, so their heads aren’t in the same position.
When babies can sit on their own, a flat spot usually won’t get any worse. Then, over months and years, as the skull grows, the flattening will improve, even in severe cases. As hair grows in over the first few years, the flat spot often becomes less noticeable as well.
Flat head syndrome doesn’t affect a baby’s brain growth. But having a stiff neck can slow early development. Physical therapy for torticollis should include a check of the baby’s progress and extra exercises to treat any delays.
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Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
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