Are you worried your baby has a flat head? Learn exactly how to assess your baby’s current head shape, plus specific positioning strategies to round it out. You can start rounding it out TODAY with proactive positioning recommendations! Plus, get a free positioning guide that breaks it all down. Wondering about a baby helmet? We cover that too!

There are several variations of flat head syndrome including plagiocephaly, scaphocephaly, and brachycephaly. 

Basically, it just means one of the sides or the back of your baby’s head has become flat. 

• Plagiocephaly— one of the back sides of the infant’s head is flattened
• Scaphocephaly— (also called dolicocephaly) the head shape is narrow with flattening on the sides of the head (most commonly seen in premature infants)
• Brachycephaly— flattening on the back, center of the head

Source: Pediatric Headshape Clinic

For the purpose of this post, I want to discuss the more common conditions seen among babies, which are plagiocephaly and brachycephaly.

WHY DO BABIES GET FLAT HEAD SYNDROME?

The bones in a newborn’s skull are very soft and moldable. They are separated by sutures that haven’t fused yet. Over time, the skull bones harden and those sutures close up. 

Flat spots develop early in life when a baby is resting in the same position for a long time.

Flat head syndrome is all about pressure!

When a baby rests in the same place for too long, the side of their head resting against the surface flattens, because the PRESSURE isn’t relieved from that spot.

The development of flat head syndrome among babies today relates to factors in your control AND factors outside of your control like:

• Too much time spent in infant equipment (like swings, bouncers, or car seats)
• Too little tummy time
• Prematurity
• Positioning in utero
• Vacuum or forceps extraction during delivery
• Initiation of ‘Back to Sleep’ (an initiative in 1992 when parents were encouraged to place their babies on their back for sleep to prevent harm)
• If baby was a twin or triplet

Today, I want to help you—

1. Know the basics of determining if your baby has (or is at risk for developing) flat head syndrome.
2. What to do about it.
3. How to track your progress.
4. When to seek additional help.

Maybe your pediatrician has identified it as an area of concern, or maybe you are just an observant mama. 

Regardless, please don’t follow the “wait and see” approach.

I am going to share with you what you can start doing today…and it’s easy!

HOW TO DETERMINE WHETHER YOUR BABY HAS HEAD FLATTENING

Wondering if your baby even has a flat head?

To accurately view your baby’s head shape, you need to look down on your baby’s head from above and behind them.

You should have the same perspective of your baby’s head as the image below.

This will give you the perspective of a “bird’s eye view”, so you can better distinguish the side and variability of any flattening that may have occurred.

What is the key thing to look for?

Is there a side of your baby’s head that appears flat?

You may just notice the shape is “off” or not symmetrical.

Or you may notice that your little one’s cheekbone, ear, or forehead may be more forward on one side.

If you do, it’s because extended pressure placed on that side of the skull has pushed those features forward.

If you do notice some flattening….is it the

• Back right,
• Back left,
• Center back, or
• Sides?

WHAT TO DO IF YOU NOTICE HEAD FLATTENING?

Here is the meat of this post…

And here’s the answer—proactive positioning!

That’s pretty much it. 

I’m going to share with you how to proactively position your baby, so you can round out that head shape.

Contrary to some opinions, it will not get better if you are not proactive.

Optimal timing for starting these strategies is between 6 weeks and 6 months old, but there are definitely benefits to starting at birth by being aware of how you position your newborn.

If your baby is older, get started with these tips for proactive positioning, but it is possible they may benefit from additional intervention.

1. TAKE NOTE OF WHICH SIDE OF YOUR BABY’S HEAD IS FLAT.

This will determine how you decide where your baby should be positioned most often during the day.

The goal is to take the PRESSURE off the side of the head that is flat and redistribute it somewhere else.

If the back right side of your baby’s head is flat, you don’t want them laying on their right side or looking to their right all day.

If they are, then the back right side of their head is going to be pressing against the surface and contributing to the flattening of their soft skull bones on that right side.

2. PUT YOUR BABY ON THEIR TUMMY.

This is KEY! 

You have to get your baby off their back and onto their belly. Just make sure they’re awake and you’re supervising them.

Your babe will be on their back for sleeping, diaper changes, clothing changes and for you to stare at their cute face and little movements.

Roll that babe over. 

When babies are on their tummy, it takes the pressure off the back of their head where it’s flattening, AND it is super great for their development by building head and neck control, bone density, and shoulder stability.

Need some great toys for tummy time? Check out:

THE ONLY 10 TOYS YOU NEED FOR YOUR BABY FROM BIRTH TO 6 MONTHS

3. KEEP YOUR BABY OUT OF INFANT EQUIPMENT.

We live in a ‘container baby’ society. 

‘Container baby’ society =  Babies always seem to be IN something! They’re placed in a swing, bouncer, and/or car seat (containers) for a large portion of the day. 

Babies are often moved from one container to the next throughout the day.

And baby “containers” limit movement opportunities. 

Sometimes this happens without even realizing how much the time adds up (I am definitely guilty!).

There is SO much baby equipment on the market these days—and mamas are led to believe their babies actually need it to boost development.

When your baby is positioned in an infant carrier, they have limited opportunities for turning their head fully side-to-side and decreased movement opportunities, and it places prolonged pressure on their soft skull bones. 

Head on back to the retro way of parenting, and place your babe on a blanket on the floor for some free play.

Plus, endless opportunities for kicking, rolling, and exploring their environment through movement.

4. ALLEVIATE PRESSURE ON THE SIDE OF YOUR BABY’S HEAD THAT’S FLAT.

Basically, get your baby off that flat spot and distribute pressure somewhere else.

Diversity is the spice of life—you’ve got to mix up your baby’s position, if you want that head shape to round out.

For example, if your baby’s head is flat in the center on the back (brachycephaly), position them—

• On their right side
• On their left side
• On their tummy
• Upright in a carrying sling/wrap

If the back right side of their head is flat (right plagiocephaly, a majority of cases), then make sure you’re encouraging—

• Left head turning
• Time on their left side
• Lots of tummy time
• Time upright in a carrying sling/wrap

**Please know that ALL babies should ALWAYS be put to sleep on their back, so they are in the safest environment possible.

It is also important to give your baby time sitting up while you support their body, so they can use those neck muscles and learn head and neck control.

Want this information broken down based on your baby’s head shape?

Sign up to get my positioning cheat sheet below!

 ROUND OUT YOUR BABY’S HEAD WITH MY 

FREE POSITIONING GUIDE!

Need it broken down further? Don’t want to think about which side to lay your baby on?

Get my FREE positioning guide that tells you EXACTLY where to position your baby and promote head shaping!

i want the guide!

Enjoy your head shaping guide! 

5. HOLD YOUR BABY MORE.

Ah, yes, get that little cutie in your arms and cuddle them!

This one is easier to implement if you only have one babe at home. If there are older siblings running around, you may feel like a swing is the safest place for your baby.

But, try to minimize that time.

I want to encourage you to hold your baby more—especially if you are noticing a flat spot.

You can free carry, or you can use a soft baby wrap (like this one or this one!) to help support your baby close to your body.

This gets your baby up and off those soft head bones, allowing space for that head to round out.

Plus, mama gets lots of close cuddles.

If your baby has emerging head control, and you want to save your back during carrying…I recommend the Tush Baby! 

It’s a carrier that straps to your waist and alleviates the pressure from your arms and back as you carry your little one around. It helps you hold them upright so you can get the pressure off that head. 

I have one, and I love it. The grandmas love it too.

HOW TO TRACK THE PROGRESS OF YOUR BABY’S HEAD SHAPE

So…you’ve read this post and are hopefully committed to trying out some of these strategies with your baby.

How do you track any change?

This is one of the most important parts of the process, because it will tell you:

1. whether what you are doing is working,
2. when you can stop, and
3. whether you need to seek additional help.

To track progress, I recommend taking a photo of your baby’s head from the angle I described above.

A “bird’s eye view” while standing behind your baby. 

Here’s another example of the angle I’m talking about.

Take a photo 1x a week and save it to a new folder in the photos section of your phone.

Your pictures will be lined up next to one another, making it easier to notice improvements or whether progress has stalled.

WHEN TO SEEK ADDITIONAL HELP

Lastly, I want to talk about when to seek additional help. 

Sometimes, despite all of mama’s best efforts, additional support may be needed. 

And that’s okay—no mom guilt allowed here!

WHEN YOUR BABY WON’T TURN THEIR HEAD TO ONE SIDE

If your baby is at least 2 months old and can’t turn their head to one side and has a significant preference for looking to the right or left, then you may need additional support.

Your baby’s head may even look tilted to the side (one ear closer to their shoulder than the other) when you look at them.

This likely means your baby has a condition called  torticollis—which basically means a long neck muscle (called the sternocleidomastoid) on one side of your baby’s neck has gotten strong and tight. 

It will need to be addressed by a pediatric physical or occupational therapist with stretching and further intervention.

Not all babies with flat head syndrome will have torticollis.

But…most babies with torticollis will have some extent of head flattening.

Don’t be afraid to talk with your pediatrician about your concerns and ask for a referral to outpatient physical therapy or occupational therapy, so you can get some help.

CRANIAL SHAPING HELMETS

As I stated before, the best time to implement proactive positioning strategies is for babies younger than 6 months old. 

If your baby is older than 4 to 6 months, and has noticeable flattening, they may be a good candidate for a cranial shaping helmet. 

Cranial molding devices are worn 23 hours a day (after following a gradual wearing schedule), and can be incredibly effective in rounding out your baby’s head shape. 

Helmets are proven most effective when implemented between 4 and 6 months, but they can help even if your little one is older.

If your baby was premature, you want to use their corrected age (the age they would be if you counted out from their due date instead of their birthday).

Talk with your pediatrician about the best option for you. They may refer you to a plastic surgeon for further evaluation.

If your little one ends up needing a helmet, try your best not to feel mama anxiety over it (easier said than done, I know).

It is often much harder for the mama than it is for the baby. 

Most babies adjust to their helmet just fine without much trouble at all.

Whew!

I hope this overview helped some mamas out there who have been wondering about their baby’s head shape, but unsure if they’re looking at it the right way, or what can be done about it.

Remember “SEE and DO!”, don’t “wait and see”.

Once your baby is sitting by themselves and becoming mobile, it gets a bit harder to position them where you really need them to be. 

They’ll be ON THE MOVE.

If you want information ABOVE and BEYOND this post—because trust me, there’s a lot more to it…go ahead and get ‘The Flat Head Syndrome Fix’ by Rachel Coley. She’s a pediatric occupational therapist and educator over on Cando Kiddo.

It is an amazing book, written for parents.

It’s time to be proactive, mamas!

You got this!