Does your baby have a flat head? Here are some reasons why Flat Head Syndrome happens and when to know your baby needs to see a professional! Kate’s children Finn and Roey had Flat Head Syndrome and Finn was in a helmet for 2 months. Keep reading to learn more.

What is Flat Head Syndrome?

“Flat head syndrome” is a condition in babies that affects the normal shape of their skull. This can be flattening on one side (plagiocephaly), a narrowing and elongating of the skull (scaphocephaly), or flattening of the back of the head (brachycephaly). 

*photo from www.cranialtech.com

What are the signs and symptoms of flat head syndrome? 

• Baby’s head is misshapen as shown in the photo above
• Baby may have less hair in the flattened area
• Asymmetrical facial features 
• Thickening of the neck muscles on one side

What causes Flat Head Syndrome?

The skull bones in babies are soft and malleable – which is important for childbirth and passage through the birth canal. Continued pressure on the skull bones cause the skull bones to take on the shape of the pressure, causing the bones to flatten.

• Safe To Sleep Campaign:

After babies are born, they are placed on their backs for most of the day to sleep (see the Safe to Sleep campaign), which puts pressure on the skull bones and causes flattening. Even when your baby has a flat skull, you should still place them on their back to sleep, as this is the safest position for baby to prevent SIDS (Sudden Infant Death Syndrome).

Flat heads can be fixed and it is not worth a sleep accident or accidental death, and potential SIDS. We can fix flat heads, we cannot fix sleep accidents! 

• Torticollis (turning head to one side):

Torticollis is a condition in which baby prefers to turn their head to one side. This can be from positioning in the womb (it’s common in larger babies) and causes neck muscles on one side to become tightened.

Sometimes, babies can even have a chin tilt preference along with the side preference. This can also happen in births of multiples. Turning the head to one side is often common in children with reflux. You can learn more about torticollis here.

*photo from www.correctivechiropractic.com

• Prematurity 

Babies who are born prematurely have an increased incidence with Flat Head Syndrome, specifically scaphocephaly. Typically these babies spend a lot of time in the Neonatal ICU (NICU) and develop this head shape from necessary positioning. 

• Craniosynostosis 

In rare cases, a condition called craniosynostosis can cause plagiocephaly. This is a condition where the skull bones are fused at birth. Typically, surgery is needed in this rare case.

Are there things I can do to prevent Flat Head Syndrome?

For the most part, flatness is seen in the first 6 weeks of life, especially with babies who have plagiocephaly. Since most of the time this is due to in-utero positioning, there isn’t much we can do to prevent it.

Babies also spend the majority of their day on their backs sleeping, which is safest for them, which also contributes to the flatness. Flat Head Syndrome is not your fault!

Head positioning items are NOT SAFE, especially for sleep and should not be used. 

There are some ways you can encourage your baby to turn their head to the other side during awake and supervised time:

• Tummy time
  • Baby will still prefer to turn their head the same way, try to encourage them with sounds and toys the opposite direction
• Encourage baby to turn their head the opposite way during awake time
  • Place toys and rattles in position to encourage them to turn to the opposite side
  • Sit on the opposite side that baby prefers to turn their head. Sing to them, read a book and encourage them to turn their head the other way
  • Place toys on the opposite side of car seat
• Side lying time
  • Placing baby on their side to relieve pressure on the flattened area 
• Naps in a baby wrap once or twice a day to offset pressure
• Avoiding unnecessary time in a car seat or other baby containers
• Gently reposition your baby’s head while sleeping if possible

When should I contact a provider with concerns regarding Flat Head Syndrome?

If you notice a flattening or that baby is preferring to turn their head to one side, you should talk with your provider at a well-check visit. 

It may also be a good idea to get a second opinion from a pediatric physical therapist and a cranial orthotics company who specializes in this area and cranial helmets. The earlier you can treat, the less time baby will spend in a helmet. A well known Cranial Technologies, who use the DocBand.

What are my treatment options for flat head syndrome?

• Physical Therapy

It’s always a good idea to get a referral to a physical therapist to have a second opinion on the severity of the flatness. PTs can work with you and your child as early as a few weeks old. This is especially important for babies with torticollis and can help reverse some of the flatness and prevent further intervention.

• Cranial Orthotic Band

A cranial band or helmet helps reshape baby’s head over the course of weeks to months. This is what Finn had and we had huge success with it!

The earlier you can get baby in a helmet, typically the less time they need to spend in it. This accompanies physical therapy as well.

• Wait and See

Sometimes, mild flatness can resolve on its own with time. Talk to your provider about the best options for your baby! 

Finn’s story:

Finn was a very large baby at birth – 10lbs, 1oz. Since he was such a large baby, it was hard for him to move in utero. He came out preferring to turn his head to one side from his position in utero.

With in 4-6 weeks, I noticed that he was developing a pretty significant flat head on one side. We started physical therapy at 8 weeks of age for torticollis with little improvement. Finn was evaluated for a cranial band and wore the band for 8+ weeks starting at 16 weeks of age.

The results were great! He outgrew his helmet (which was not covered by insurance), so we opted not to do a second helmet. His head is normally shaped now!

Other helpful blog posts:

• 4 ways a pediatric physical therapist can help your baby 
• 5 tips for preparing your child for the doctor
• Dental tips for babies, toddlers + kids 
• Hip dysplasia care and tips 

*Bumblebaby earns a small comission on some products included in this blog post. Information in this blog post is for educational purposes only and should not replace the advice of your care team.