Positional Plagiocephaly (Baby “Flat Head”)
What Is It?
In the first few months of life, a newborn's skull is soft and flexible. Positional plagiocephaly, or "flat head syndrome," occurs when a baby consistently favors turning their head to one side, leading to a flat spot on the skull. This happens as pressure is repeatedly applied to the same area. While plagiocephaly doesn't affect brain development, it can change the shape of your baby’s head and face over time.
Why Does It Happen?
A baby’s neck muscles are weak, so when lying on their back, their head often turns to one side. Some babies develop a preference for looking either to the right or left, causing a flat spot on that side of their head. If this persists, a condition called torticollis can develop, where the neck muscles on the opposite side of the head-turning become tight or shortened. Premature babies are more prone to developing flat spots because their skull bones are softer.
How to Prevent or Address a Flat Head
The key to preventing or improving a flat spot is tummy time. This helps strengthen your baby’s neck, shoulder, and back muscles, encouraging them to hold their head in the center rather than favoring one side. Try to engage in tummy time multiple times a day, aiming for a total of 30 minutes. You can roll a small towel under their chest to support them if they have trouble lifting their head. Side-lying positions during playtime can also help.
If you’ve already noticed a flat spot, here are some tips to help improve it:
Limit Time in Car Seats: Avoid keeping your baby in car seats or swings for extended periods, as this can cause pressure on one side of the head. Car seats should be used for travel, not as a resting spot at home.
Change Carrying Positions: When bottle-feeding, switch arms regularly to encourage your baby to turn their head in both directions. Using a baby carrier helps keep your child upright and takes pressure off the back of their head.
Position Toys Strategically: Place toys and interesting objects on different sides to encourage your baby to turn their head equally in both directions during playtime.
Change the Head Position in Bed: Since babies are naturally drawn to look at interesting things like mobiles or doorways, alternate the direction of your baby's head in the crib each night. This encourages equal movement to both sides while they sleep. Always put your baby to sleep on their back.
If the flat spot persists or you notice your baby’s head tilting to one side, consult a paediatric physiotherapist or paediatrician to assess their eligibility for a helmet.