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Does your baby have a flat head? Tips for prevention and treatment

Baby with a flat spot on his head lying downMy baby was eight weeks old when a health nurse noticed his flat spot.

I felt like a failure—two months and I felt like I’d ruined his life already!

But now he’s a healthy, round-headed eight-year-old thanks to early detection, positioning exercises, a friendly physiotherapist and a remoulding helmet.

At the time it felt like forever—especially the eight weeks he spent wearing the helmet 23 hours a day. But now, apart from a few photos, we barely remember it!

Flat head syndrome—also called plagiocephaly—affects one in 10 babies but it’s easy to prevent and treat if you start early. Here are some tips.

What is flat head syndrome?

Flat head syndrome (or plagiocephaly) is when a baby’s head develops a flat spot as it grows. It can sometimes also create a bulge on the forehead and facial features can become asymmetrical (e.g. some babies might have one ear further forward than the other).

You may not notice the flat spot when you look at your baby front on. The asymmetry may be more noticeable if you compare your baby’s left and right profiles. If there is lopsidedness it is most obvious when viewed from above—looking down on the top of your baby’s head.

Why does flat head syndrome occur?

Newborn babies have a very soft skull and prolonged pressure on the one spot can cause a flattened area to develop as they grow. This means their head can become flat or misshapen if they are constantly lying on the same area of their skull.

The incidence of flat head syndrome has increased from 1 in 300 in the 1970s to 1 in 10 today. This is likely to be because more parents put babies to sleep on their backs as recommended by Red Nose Australia. It is important to continue to put small babies to sleep on their backs—the Safe Sleeping Campaign was introduced in 1990 and from 1989-2018 the rate of SUDI (Sudden Unexpected Death in Infancy) decreased by 85% [1]—but it is also important to give them plenty of ‘tummy time’ when they are awake.

4 ways you can help prevent flat head syndrome

1. Alternate your baby’s head position each time they sleep

You should always follow the Red Nose Australia Safe Sleeping Guidelines and place baby on their back to sleep. But when you put them down take note of which way their head is turned and then next time turn it to face the opposite way. A young baby spends a lot of time asleep and, if they are always lying on the same spot, their head will not grow symmetrically and a flat spot will develop.

2. Change your nursery layout

If your baby shows a preference for facing a certain direction take note of the way the nursery is laid out. Babies tend to look to the centre of a room or towards the doorway. You might have to change the way the cot faces or alternate ends of the cot each time you put baby to sleep.

3. Visit your GP or child health nurse

If the preference is unrelated to your nursery layout (ie baby looks to the left every time regardless of how often you reposition their head/move the furniture) see your GP or child health nurse. They can refer you to a physiotherapist to rule out a physical reason for the preference (eg. muscle tightness in the neck).

4. Give your baby tummy time when they’re awake

It is important that babies sleep on their backs. And it is also important to minimise the time spent on their backs when they are awake. This means cuddling them or carrying them in upright positions, using a baby carrier and giving them plenty of supervised tummy time. Tummy time will help develop your baby’s neck, shoulder, arm and back muscles. It will also help reduce the chance of your baby developing a flat spot as it gets them off the back of their head. Try to avoid prolonged use of rockers, swings, prams and car seats.

6 ways you can help correct flat head syndrome

A baby’s head grows a lot in those first few weeks and sometimes a flat spot can develop without the parents realising, or in spite of all repositioning efforts. Do not fret—if your baby is still growing it is possible to correct a flat spot.

1. A mild flat spot can correct itself

First of all talk to your GP or child health nurse and ask them to assess the flat spot or refer you to someone who can. They can measure your baby’s head and give you an idea as to whether the flattening is mild, moderate or severe. A mild flat spot can correct itself as the baby grows and spends less time on their back. You should still continue repositioning and tummy time though to ensure it doesn’t get worse.

2. A physiotherapist can help identify muscular issues

Consider seeing a physiotherapist if your baby has a preference for looking to one side. They can help identify muscular issues, can give you exercises to help improve your baby’s range of movement and show you some tips on making tummy time fun.

3. Reposition, reposition, reposition

If your baby has already developed a flat spot then it is important to keep them from lying on that spot as much as possible.

4. Alter their nursery and their sleeping position.

Try to make sure they aren’t sleeping on the flat spot—which is more difficult once it has started to go flat (imagine a ball with a flat spot, if you roll it down a hill it will always come to rest of the flat area). Change the nursery around so all the exciting stuff is on the non-preferred side. If they go to sleep lying on the flat spot turn their head the other way once they are asleep.

5. Don’t put baby on their back when awake.

Give baby plenty of tummy time in a variety of positions (in the bath, on your chest etc) and make tummy time fun by playing with baby in this position. Consider putting a mobile on the non-preferred side of the change table. Always talk and play with baby from the non-preferred side and encourage others to do so too (eg, when people poke their head into the pram to talk your baby guide them towards the non-preferred side). Put baby down for supervised play on their side and always put toys (or yourself) on the non-preferred side.

6. Adjust your feeding position

If you’re breastfeeding your baby try the football hold for the side that normally has them lying on the flat spot. If bottlefeeding, make sure you always feed so the baby is not resting on the flat spot.

Will your baby need to wear a helmet?

Health professionals might recommend a helmet for your baby if the flat spot is severe or moderate and if attempts to reshape the head using repositioning techniques are not working—especially if the baby is approaching six months old.

Cranial remoulding helmets have been used to treat plagiocephaly since the late 1980s.

They are usually made out of a non-allergenic foam lining with a polypropylene outer layer. They work by leaving a gap where the flat spot is—this encourages growth into that gap while also ensuring the baby is not lying on the flat spot.

The helmets are most effective when fitted while a baby’s head is still growing quickly—usually between four and seven months old. Usually the quicker the head grows the less time is needed in the helmet.

A baby’s head will naturally grow into a more correct shape as they get older and become less likely to spend their days lying on their backs. But the amount of improvement will depend on how old the baby is when you start using repositioning techniques, the severity of the flat spot and how well repositioning techniques are implemented.

1.Australian Bureau of Statistics (2003). SIDS in Australia 1981-2000: A statistical overview. ABS, Canberra & Australian Bureau of Statistics (2001-).3303.0 – Causes of Death, Australia, 2001-. ABS, Canberra. Includes calculations prepared by Red Nose and confirmed by the ABS

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12 Comments so far -
  • Shen says:

    My son is already 6months old and has a flat head..is his head still soft? And can still be treated? Thank you in advance.

    • Hi Shen! Thanks for reading and thanks for your message. At six months your babies head will still be growing. If he has a mild flat spot it may fix itself as his head grows — especially as he is older and would spend less time lying on his head.

      However you will need to determined whether his flat spot is mild. Please visit a health care provider and ask them about it. They’ll refer you to someone who can check the severity of the flat spot and work out next steps for you if needed.

      The early the better so you can catch the next growth spurt if needed.

      Take care!

      — follow us on Facebook https://www.facebook.com/bubhub to stay in touch with all things pregnancy and parenting —

    • Eshita says:

      Hi i am eshita, my boy is 3 month. He has fhlat head. Now what i should do?

      • Hi Eshita, Thanks for reading and thanks for your question.

        First of all talk to your GP or pediatrician and ask them to assess the flat spot or refer you to someone who can. Obviously in the current circumstances this might not be possible.

        To check for severity they measure your baby’s head and give you an idea as to whether the flattening is mild, moderate or severe. A mild flat spot can correct itself as the baby grows and spends less time on their back.

        You should do lots of repositioning and tummy time to ensure it doesn’t get worse. There are heaps of repositioning tips in the article above. And there’s some tips for tummy time here: https://www.bubhub.com.au/tummy-time-making-it-fun-for-your-baby/

        I hope this helps. If you have further questions, don’t hesitate to ask.

        All the best!

        — follow us on Facebook https://www.facebook.com/bubhub to stay in touch with all things pregnancy and parenting —

  • Aparna says:

    My son is 2 n half yrs old . He is having flat head issue, is there anything i can do now to correct the problem…. Please help me….

    • Hi Aprarna. Thanks for reading and thanks for your question.

      I’m afraid though that the best advice I have is to talk to your GP or health care provider about your concerns and ask if there is a way your son’s flat spot could be assessed to determine its severity. They might also be able to determine whether there’s an underlying issue that may have caused the flat spot to appear. For example some babies do not have a large range of movement in their necks and may prefer to lie on one side of the head.

      I’m not sure what else can be done for a 2YO.

      I hope you find some answers. Take care!

      — follow us on Facebook https://www.facebook.com/bubhub to stay in touch with all things pregnancy and parenting —

  • irenellaneras says:

    t is very common among babies, it is because they always have a favorite side to sleep, you have to alternate them. When they crawl and sleep less, growth adjusts it

    • Hi! Yes – you’re quite right. It is very common and it is beneficial if you alternate baby’s head position for each sleep. The condition does adjust as the child grows and also as they become more mobile (so they’re not laying on the head all the time) but it can vary in severity so it is always a good idea for parents to talk to a health professional if they’re worried about their own child.

      Thanks for reading and commenting! All the best!

      — follow us on Facebook https://www.facebook.com/bubhub to stay in touch with all things pregnancy and parenting —

  • momma 2 says:

    This happened with my 1st child, and now I am dealing with it again with my last baby. I ended up buying a pillow which did wonders. My girl’s head is a bit rounder in about 7 days.

    Talk to your pediatrician asap about a pillow and depending on how flat it is, they can advise you.

  • Ola says:

    I have a daughter 15 month old and she has flat right side of the head, I am trying my best repositioning since we noticed it, and it is still flat, the helmet does not apply as they do correction with a helmet max up to 14 month old babies. I don’t know what to do how to correct her head. Kindly advise what should I do in this case.

    • HI Ola, hope you’re having a good week this week. I’m not sure on how to advise you in this case without really knowing what steps you’ve taken. My first step would be to see a GP or child and health nurse/midwife. Is there a local child health clinic near you – these are normally government-run and have different names depending on which state you live in. They should be able to refer you to a place where you can have your child’s head correctly measured to determine how severe the flat spot is. If it isn’t very severe they may suggest that the shape will correct itself as she grows.

      Sorry I couldn’t be of more assistance, hope you find some answers. All the best xx

  • marcus says:

    Our fist child had an extremely molded head at birth. We did everything we could to prevent him from favoring his flat side.

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