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Flat Spots and the Shape of Your Baby’s Head

sleeping babyWhen a baby is born, the birth process often causes his or her head to have an irregular shape. Rest assured that a normal shape usually returns within a few weeks. In the first few months of life, however, some babies develop a lasting flat spot on one side of the head or the back of the head.

CAUSES OF FLAT SPOTS
The skull flattens when a baby’s head stays in one position for long periods of time. Factors that may increase this risk include muscular torticollis, early birth (prematurity) and back sleeping. Babies who sleep on their back or in a car seat without changing positions for long periods of time can develop flat heads, a condition called plagiocephaly. It is important to note that the American Academy of Pediatrics recommends that babies sleep on their back to reduce the risk for SIDS. Young babies who can’t roll over or move on their own should not be placed on their belly to sleep.

PREVENTION AND TREATMENT
“To help prevent plagiocephaly, let your baby have some tummy time while you are watching them,” says Dr. Michael Muhonen, CHOC Children’s neurosurgeon. “You can also lessen the time your baby spends in one position in car seats and baby carriers. Hold your baby often, giving them time to be upright.”

Your doctor will check your baby’s head regularly. If you or your doctor notices any problems with the shape, the doctor will feel your child’s head, particularly along the suture lines, and take measurements. A pediatric orthotic specialist can also perform a laser analysis of the head shape. Treatment of plagiocephaly will depend on your baby’s symptoms and on how severe the condition is. In most cases, frequent repositioning away from the flat side of the head will quickly correct plagiocephaly.

Your baby may need to wear a cranial molding helmet if the problem is moderate to severe and if repositioning the baby’s head has not helped. Helmets are usually made of an outer hard shell with a foam lining. Gentle pressure helps to reform the head. As the head grows, adjustments are made. The average treatment with a helmet is usually three to six months. This will depend on the age of the baby and the severity of the condition.

CRANIOSYNOSTOSIS
It is important to make sure that an irregularly shaped head is not a less common condition known as craniosynostosis. In this condition, the skull plates close prematurely, and the infant typically requires surgery to repair the fused bones. A pediatric neurosurgeon will be able to distinguish craniosynostosis from plagiocephaly.

Healthy, Safe Sleep for Baby

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Sudden infant death syndrome (SIDS) is a very real sleep-related risk for babies under age 1. Here are recommendations from the American Academy of Pediatrics (AAP) on how to reduce the risk for SIDS, as well as tips for helping your baby sleep easily.

Babies Should Sleep Alone and on their Backs

In this CHOC Radio podcast, CHOC Children’s community educator Amy Frias outlines tips for parents to ensure their child stays safe while sleeping, including how to create a safe sleeping environment and what to do if the baby rolls onto their tummy.

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CHOC Children's is affiliated with the UC Irvine School of Medicine