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How to Avoid Flat Spots on Your Baby's Head

Wednesday, June 01, 2011

In this article I'm taking a look at flat spots, torticolis and abnormally shaped heads.

Flat spots on a babies head are on the rise. How do they become so misshapen and what can we do to avoid or reverse the damage once it has occurred?  These are some of the questions I would like to look at in brief in this article.

When a baby is born it has a very soft, pliable skull which enables them to pass through the birth canal.  This soft skull can and is easily moulded by its surroundings as with a baby who was constricted within the womb such as a breech baby whose head is wedged under the mother’s ribs.   These babies are often born with a very abnormally shaped head.

Some of these babies may also have torticollis, a tight muscle on one side of their neck causing a pulling to one side. These babies tend to favour looking and lying with their head on one side. Other babies may just choose to favour one side or lie with their head straight, looking up. All these babies, due to their still developing soft skills, are at risk of developing a flat spot on their heads.

These days a flat head may be a combination of one or more of the above mentioned problems and not enough time off their backs. Many babies sleep, play, sit and travel on their backs this can causes or exacerbate the problem.  When a baby continues to lie in the same position over several weeks’ even months the pressure on the soft skull causes it to flatten out.

Prevention and assistance in correcting the problem:

Encourage Tummy Time
To help prevent a baby from developing a flat spot. Alternate which side his head rests when sleeping but more importantly give your baby lots of supervised time on his tummy. When he is awake and after the feed time put him on his tummy not on his back. If this is done from birth you will find baby will not resist. If your child is older and complains about the length of time he spends on his tummy then start with small sessions and work up to longer sessions so that eventually he will have from 60-80% of his awake time, when not feeding, no his tummy.

If your baby has a flat spot or is showing signs of torticollis, encourage baby to turn away from the direction they favour by attracting their attention to the other side with toys, sounds, movement or by sitting on the opposite side which will encourage them try to turn to look at you. (see Articles on play and learning - How Important is Tummy Time for Your Baby?)

During Sleep Time

To prevent a baby favouring holding his head on one side, alternate which side his head rests. To help him, turn his head either to the left or right. With an older baby who is aware of their surroundings you can assist baby by alternating which end of the cot your baby sleeps. Babies tend to look towards the direction from which their caregiver comes. They will look towards the door where you enter. Therefore changing his cot position from one end of the cot to the other will help him to turn his head from one side to the other.

Things to avoid
Avoid tea-tree mattresses as they form a hollow into which baby's head rest this may cause flatness on one side.
Avoid putting baby into a rocker, bouncinette or Frazer chair where they are lying on their backs. It is also advisable no to leave your child, for long periods, in the car capsule or pram for the same reason.

Although sitting upright will keep your baby off their backs it is not wise to leave a child sitting for long periods of time as it is not beneficial for their development and may cause stress on their developing backs. Limit unsupported sitting until baby is able to put himself into and out of a sitting position himself.  This includes equipment such as jumping or sitting rings where baby needs to sit. A child who has limited tummy time often doesn't learn to crawl. Tummy time is the best exercise to develop all the muscles for rolling, crawling, sitting, standing and walking. It also helps develop special awareness and coordination.

Signs to look for are:

  • Baby is holding his head tilted to one side.
  • A flat spot on the back or side of baby's head.
  • Baby is unable to turn their head or favours looking in one direction.
  • Very round face with flattened back of the head.
  • Non-symmetrical head, eyes or ears differing in size. 
  • If you notice any of these signs I suggest you contact your Early Childhood Nurse or Doctor.

If you are concerned

If there is no improvement or if you child has had this problem for some time you will need to see a physiotherapist who will be able to show you some exercises to help stretch tightened neck muscles.

Also read our article on Flat Spots on Baby's Head by Alti Vogel, who is an Orthotist at the Children's Hospital Sydney.

If you would like more information on this and other similar topics our E-books are packed full of practical parenting tips. Down load an E-Book specifically related to your child's age group through Publications at Our Shop.

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