What is a flat head (plagiocephaly)?
Plagiocephaly, also known as "flat head syndrome," is a common and treatable condition where a baby's soft skull becomes flattened in one area due to consistent pressure. Since an infant's skull bones are pliable and not yet fused, they can easily be molded by external forces. There are two main types of flat head syndrome:
- Positional Plagiocephaly: This is the most common form, caused by external pressure on a baby's head, such as sleeping on the back or spending too much time in car seats and swings.
- Craniosynostosis: A rare condition where the joints between the skull bones fuse prematurely. Unlike positional plagiocephaly, this can impact brain growth and usually requires surgery. A medical professional can accurately distinguish between the two.
Natural methods to undo a flat head
For most cases of positional plagiocephaly, conservative, non-invasive treatments are highly effective, especially when started early.
Maximize supervised tummy time
Tummy time is a crucial activity for strengthening a baby's neck, shoulder, and upper body muscles, which are all vital for developing head control. It also serves to alleviate pressure from the back of the head. Aim for several short sessions throughout the day, gradually increasing the duration as your baby grows stronger and more comfortable.
- Begin early: Start tummy time shortly after birth with just a minute or two at a time.
- Engage your baby: Use colorful toys, mirrors, or get down to your baby's eye level to make it an engaging and fun activity.
- Vary the position: Place your baby tummy-to-tummy on your chest or on your lap to offer a different perspective and relieve pressure.
Master repositioning techniques
Actively changing your baby's head position is one of the most effective ways to encourage a rounder head shape. Think of it as counteracting the pressure on the flat spot throughout the day and night.
- Switch sleep positions: Place your baby to sleep with their head at one end of the crib one night and the other end the next. This encourages them to turn their head in different directions to look out into the room.
- Adjust feeding positions: If bottle-feeding, alternate the arm you hold your baby with. If breastfeeding, ensure you offer both breasts equally.
- Change how you hold your baby: Make a conscious effort to hold your baby in different positions, such as carrying them upright against your shoulder.
Limit "container" time
Reducing the amount of time your baby spends in devices like car seats, swings, and bouncy seats is essential for correcting a flat head. These devices can put constant pressure on the back of the baby's head.
- Opt for a baby wrap or carrier when practical to keep your baby upright and off their head.
- Take your baby out of the car seat as soon as you arrive home, even if they have fallen asleep.
When professional help is needed
While many cases respond well to conservative methods, some infants may require professional intervention, especially if repositioning isn't enough or a neck muscle issue is present.
Physical therapy for torticollis
Many babies with plagiocephaly also have torticollis, a condition where tight neck muscles cause a head tilt and limit neck movement. A pediatric physical therapist can provide stretches and exercises to improve your baby's range of motion, which in turn helps with head shape.
Cranial remolding helmet therapy
For moderate to severe cases, particularly if conservative methods aren't showing improvement by around 4-6 months of age, a doctor might recommend a cranial remolding helmet.
- How it works: A custom-made helmet applies gentle pressure to the rounder parts of the skull, redirecting growth to the flattened areas as the baby's head grows.
- Duration: The helmet is typically worn for about 23 hours a day for several months, with regular adjustments by an orthotist.
Comparative table of treatment options
| Feature | Repositioning & Tummy Time | Physical Therapy | Cranial Remolding Helmet |
|---|---|---|---|
| Effectiveness | Highly effective for mild cases, especially if started early. | Addresses underlying neck muscle issues (torticollis) that contribute to flattening. | Very effective for moderate to severe cases, can show quicker results. |
| Cost | Free. | Varies by provider and insurance coverage. | Often expensive and may not be covered by insurance. |
| Age Range | Most effective in newborns and young infants up to 4 months. | Can be started as soon as torticollis is identified, early intervention is key. | Generally for babies between 4 and 18 months, during a period of rapid head growth. |
| Level of Effort | Requires consistent parental effort throughout the day and night. | Requires parental commitment to a home exercise program taught by a therapist. | Requires wearing the helmet almost full-time for several months, with regular clinic visits. |
| Potential Issues | No known side effects, can be challenging to remember to reposition. | No known side effects, exercises can be uncomfortable for baby initially. | Potential for skin irritation and rashes, can be uncomfortable for some babies. |
Conclusion: take a proactive approach
While a flat head can be alarming for new parents, positional plagiocephaly is a common and treatable condition. The most important takeaway is that early, consistent, and proactive measures are key to correcting a flat head. By maximizing tummy time, frequently repositioning your baby, and limiting time in carriers, you can significantly help their head round out naturally. If these conservative measures aren't showing results, or if you suspect a neck muscle issue, consult your pediatrician, who may refer you to a specialist for further evaluation and a tailored treatment plan. It's important to remember that these cosmetic issues rarely affect a baby's brain development, and early intervention is crucial for the best cosmetic outcome.
For more in-depth information and resources on plagiocephaly, consider exploring the resources provided by the American Academy of Pediatrics.
