Positional Plagiocephaly, often referred to as baby flat head syndrome, is a condition that develops when a baby spends too much time lying on his or her back.
The term plagiocephaly is the medical term describing that a baby's skull is flattened on the side, the front or the back. There are 2 types of plagiocephaly, one congenital, and the other positional.
- Congenital Plagiocephaly is caused by craniosynostosis, and can lead to serious complications if left untreated.
- Positional Plagiocephaly develops during the first few months of a newborns life. It's most commonly caused when too much time is spent in one sleep position. This article's focus will be on positional plagiocephaly.
According to Healthychildren.org, flat head syndrome is a positional skull deformity. More specifically, the shape of the baby's head changes and develops a flat spot because the infant spends more time in one position than any other.
Most experts agree that during a baby's first 4-months there's a high risk of developing flat head syndrome. Mount Royal University found that nearly 50% of infants have a flat spot on their head.
However, as a baby approachs 6-months of age, they become more mobile and are capable of turning their heads on their own. In many cases, any flattening of the skull will correct itself over time and should not have any negative impact on the development of the brain.
When a baby is born, their skull is made up of several individual bone plates, which later come together at cranial sutures. A baby's skull is very soft and pliable at birth, and as the child ages it hardens to form a protective layer of bone and cartilage.
A newborn baby needs a soft skull for 2 primary reasons. First, to travel through the birth canal, and second, to allow space for the brain to grow.
However, when the baby spends large amounts of time lying on her back in the same position, it can cause the skull to look asymmetrical and develop a flat spot.
Once a baby reaches the age of 6-months they are usually able to reposition themselves while sleeping, and therefore, the risk of developing a flat head decreases dramatically.
Baby flat head syndrome doesn't appear overnight. In fact, it may take a few months before you're able to identify any signs. Still, it's a good idea to check for flat spots on a regular basis.
The best time to check is during bath time. Your baby's hair will be wet and her head shape will be easy to inspect. Here's what to look for:
- The back (or side) of the head is not round. It appears flat or slightly dented.
- A bald spot.
- Unable to locate the soft spot (fontanel).
- One ear appears slightly higher than the other.
- You can feel or see the ridge along the bones of the skull
Positional plagiocephaly, although relatively common, rarely develops into a medical condition that would affect the development or growth of the brain.
It's considered to be more of a cosmetic issue than a medical one. In fact, most cases improve as the child gets older and spends more time sitting, crawling, and standing.
In recent years there has been an increase in positional plagiocephaly. It's believed that the increase may be in response to the Back to Sleep campaign which began in 1994. Now known as Safe to Sleep, this public education campaign recommends that babies sleep on their backs to reduce the risk of Sudden Infant Death Syndrome (SIDS).
Since positional plagiocephaly is more of a cosmetic issue, surgery is rarely necessary. If there is any lasting flatness to the skull, the child's hair will usually conseal it from view. However, in some more severe cases, a helmet is recommended to realign the weight distribution to other parts of the baby's head which can correct the flatness.
As we stated earlier, in most cases the abnormality will correct itself once the baby grows a little older and stronger. But there are a few easy things that you can do to help the brain round out the skull. Let's take a look:
- Tummy Time - Start a routine of tummy time as soon as you bring your baby home from the hospital. Remember, tummy time should only be done when your baby is alert and awake, and it should always be supervised.
- Rotate Feeding Sides - When you feed your baby, hold her in your left arm first, then on the next feeding, switch to your right arm.
- Rotate Carrying Sides - Just as you change sides when feeding your baby, do the same when you're carrying her.
- Car Seat Time - Car seats have become multi-purpose carriers for infants. They should always be used when traveling, but look for alternative ways to carry your baby when you're shopping, visiting, or doing other activities. Check out this favorite.
- Alternate Sleeping Head Position - Your baby should always sleep on her back, however, you can reposition her head each time. One time turn her head to the left, the next, to the right.
- Change Crib Focal Point - Once your baby can turn her own head, move the focal point attractions from one side of the crib to the other. The focal point item could a mobile or other item she finds interesting. Just make sure that it's safely positioned.
Preventive Head Cushions
Beyond the above recommendations, many parents like to use a preventive head cushion for their baby.
Often referred to as a baby head shaping pillow, they are specifially designed to prevent a flat head, or help round out a head which is not severe enough for helmet therapy.
Preventative head cushions are often clinically tested for effectiveness, and they are designed to help distribute the pressure from the back of the child's skull when she is lying on her back.
If your doctor feels that the best course of action is helmet therapy, they'll refer you to a certified orthotist who'll make a custom helmet for your child. They'll take measurements are taken of your baby's head by either making a plaster mold or taking a laser light scan.
These custom-fitted helmets are designed to keep the round areas of the skull from expanding, while the flat area is allowed to expand and round out. The foam lining within the helmet makes it more comfortable, although, as the helmet is worn, it may be necessary to adjust the foam.
In most cases, the helmet should be worn at least 23 hours a day, and only removed when you're cleaning the helmet and/or bathing your baby. Although, this may initially seem shocking to a parent, your baby typically adjusts to the helmet rather easily. In fact, it may even act like a security blanket!
How Long Does it Take a Baby's Head to Round Out?
The eariler a baby begins using a helmet, the less time it'll take to correct the flatness. During the first few months of a baby's life, the brain grows at a very rapid pace and the use of a helmet can correct the flatness in a realitively short time.
Babies over 6-months old will most likely need to wear the helmet for a longer period of time for the correction to take place. By age 2, a child's brain growth is 3/4's complete, and once a child's brain has fully grown, a helmet is no longer effective.
Although, each case is different, some children only require 1 to 2 months of helmet therapy. Yet, in other situations, a second helmet may be required.
When shopping for a head cushion for your baby, it's critical to research and understand the various benefits and disadvantages of each style.
All flat head pillows should be used under parental supervision to ensure safety. Below are 3 different types and styles that we think are worth your time to research.
Mimos Baby Pillow
One of the more popular preventative head cushions is the Mimos Pillow because it was designed to allow your baby to both rest and sleep in the up-facing position. This pillow will ease the pressure on the back of your child's skull without the need to constantly adjust her sleep position.
The Mimos Pillow can either help prevent, or even correct, mild positional skull deficiciencies, because it's able to adapt to the shape and movement of your baby.
The recessed cavity in the center of the pillow is where you'll place your child's head. As shown in the video below, the cavity helps minimize the pressure and distributes the weight of the baby's skull over a much larger area.
The Mimos Pillow can be used with or without the optional Mimos Cover. Although, many parents enjoy using the cover since it can be removed to wash when you're cleaning the crib bedding. Both sides of the pillow have the recessed cavity, so you'll be able to flip it over and use both sides.
Determining the correct pillow size is as easy as measuring your baby's head with a tape measure. Although, Mimos states on their website that the pillow is safe to use while your baby is sleeping, we still feel it should be used with supervision.
This pillow is higher priced than many others on the market, but it has also been clinically tested for effectiveness and has multiple safety certifications.
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Another popular infant pillow is the Babymoon Pod. It's a great choice for home when your baby is awake and lying her back, yet it's small enough to tuck into a diaper bag when you're visiting friends or family.
The Babymoon Pod allows parents to comfortably place their child's head within the center of the pillow. The peak-a-boo cover and velcro will allow you to securely adjust the pillow's size as your baby grows.
In most cases, the Babymoon Pod will provide the necessry skull support for newborns to infants up to 6-months in age. It's available in a variety of patterns and colors, and can be machine washed and dried.
Babymoon Pod advertises this pillow with 2-in-1 functionality. Once your child reaches 6-months of age, the Babymoon Pod can be used as a neck support for strollers or car seats.
We, however, would advice against using the pillow in this manner, or at the very least, closely supervise this type of use. Without a strap to hold the pillow in place we worry there may be a risk of suffocation or injury.
We like this pillow and think that it'll become one of your favorite items. However, it's important to note that it is NOT designed to be used when your baby is sleeping, and should only be used under supervision.
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Boppy Noggin Nest Head
Perhaps the most versatile baby flat head pillow is the Boppy Noggin Nest Head Support. This cushion is designed to offer protection to a child’s skull when you are out and about.
Designed specifically to be used in strollers, bouncy chairs and swings, the Boppy Noggin is sure to become a favorite. And you won't need to worry if it gets dirty, because it's machine washable!
This pillow is an excellent tool to help prevent your baby from developing a flat head, however, it should never be used in a crib or when your baby is lying on the floor. But when you're on-the-go it's the pillow you'll want in your stroller.
We wouldn't recommend using the Boppy Noggin Pillow in a car seat. There likely isn't enough neck support to protect your baby from the movements of the car. However, it's an excellent choice for strollers, swings and bouncy chairs. In most cases, you should be able to use this pillow until your baby is 4-months old.
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Last update on 2024-03-02 / Affiliate links / Images from Amazon Product Advertising API