Head shape - Flat head prevention
46% of infants have some form of head shape asymmetry (A. Mawki, 2013).
The term “plagiocephaly” is used to describe head shape asymmetry past 6 weeks of age.
There are 3 types of flat spots: plagiocephaly (flat more on one side), brachycephaly (flat across the back), scaphocephaly (head is long and narrow, most common in premature births).
What to look for:
Look at your baby’s head from the top (a bird’s-eye-view). Is there any asymmetry? Do you notice any flattening on either side of the back of the head? Do you notice any bulging on the forehead? Do the ears appear symmetric?
Look at your baby’s face. Does one eye appear larger than the other? Do the ears look balanced?
Look at the back of your baby’s head. Are the ears symmetrical? Is one ear higher or more forward than the other? Does their head tilt to one side?
If yes to any or all of the above your baby could be developing a flat spot also known as plagiocephaly.
What causes a baby’s head to be flat?
3 Major Causes of Plagiocephaly:
Torticollis - occurs when the muscles of your baby’s neck are shortened or weak and the baby will tilt their head to one side.
Pregnancy/Birth - overcrowding during pregnancy or the birth process.
Restricted Spinal Range of Motion and recurrent external pressure to the head from excessive time turned one way while sleeping or excessive time in baby-gear (swings, strollers, car seats etc.).
How do I prevent a flat spot on my baby’s head?
Tummy time: This position ensures your baby’s neck muscles are strengthening properly and rounding out the skull (see tummy time posts for tips!).
Carriers: Carry baby around with you during the day to keep her off the back of her head.
Alternate head positions: When baby is sleeping, on the ground or in baby gear, ensure to alternate which side your baby’s head is turning. If your baby is in a bassinet next to you, just switch the side of the bassinet where your baby’s head lays. For instance, if your baby’s head was at the top last sleep, switch to the bottom next sleep. Baby will naturally try to turn towards you!
Pro-Tip: If your baby is unable or refuses to turn his or her head in a certain direction, there may be some spinal restrictions present! Pop in for an assessment and we can determine the cause of the restriction. Remember, newborn adjustments are safe, incredibly gentle and effective.
Positioning protocol for Flat Head Prevention:
Change your newborn’s position frequently.
Alternate the end of the crib/bassinet where you place your baby to sleep.
Alternate the end of the changing table where you place your baby’s head.
Alternate the side you carry your baby on.
If bottle feeding, alternate which side you hold your baby when feeding.
Provide tummy time daily when your baby is awake. 60-90 minutes is the recommended time. This sounds like a daunting amount of time since most babies hate tummy time. However, there are alternatives to just placing your baby on the floor! See my tummy time tips for more info!
What to do if your baby is unable to turn her head both ways during these times?
Book in for an assessment. We will review ranges of motion, restrictions, musculature and discuss how to improve your baby’s range of motion, prevent flat spots and ensure your kiddo has the best start to symmetric movement and gross motor milestones!