1. There are 3 different types of ‘flattened head shapes’. Plagiocephaly is the most common type of head shape change seen in babies; Brachycephaly and Scaphocephaly sometimes occur, but are less common.
  • Plagiocephaly occurs when there is flattening on the back of the head off to one side, towards the left or right side of the head.
  • Brachycephaly: Brachycephaly occurs when there is flattening in the very centre of the back of the head, right in the middle.
  • Scaphocephaly: Scaphocephaly occurs when there is flattening on the two sides of the baby’s head.  Scaphocephaly is sometimes seen in babies who have had to be in neonatal or special care units in hospital.
  1. It can be normal for newborn babies to have asymmetrical or flattened head shapes, but this should resolve by around 6 weeks of age. Lots of babies are born with slightly flattened or misshapen heads.  This is as a result of either (a) being squished in the birth canal in the weeks leading up to birth, or (b) being squished in some way during the delivery process, either being squished through the birth canal during delivery, or by being held by forceps or a suction machine to assist with delivery.  However, these variations in your baby’s head shape should resolve within the first 6 weeks of their life.
  1. Flattened head shapes in babies after the age of six weeks are most often due to the baby persistently having their head positioned one way. For example, a baby who consistently lies with their head turned to the right side might develop a flattening on the right side of their head.  Or a baby who spends a lot of time in ‘containers’ such as a baby bouncer, capsule or rocker might develop a flat spot from lying with their head resting against a part of the container.  Your baby’s soft skull puts your baby at risk of developing a flat spot on one side of their heads if they lie or have pressure on one part of their skull for too long.
  2. The head shape changes primarily affect the back of the head, but when severe it can impact the front of the head as well. For some babies, the flattening of their skull is mild, and it only affects the back of their head.  But for other babies that have moderate or severe flattening, the head shape changes can also include bulging of the forehead at the front, one ear coming forwards compared to the other, and asymmetry in their facial features such as one cheek appearing bigger.
  3. There has been an increase in the number of babies with flattened head shapes in the past two decades. The increase has coincided with the introduction of the ‘Back To Sleep’ safe sleeping recommendations to decrease the risk of Sudden Infant Death Syndrome (SIDS).  It is important that the ‘Back To Sleep’ recommendations are still followed for sleep time, but that your baby has opportunities to vary their head position and spend time in other positions when awake.
  4. There are things you can do to try and prevent your baby from developing a flat spot. Ideally we would like to prevent all babies from developing a flattened head shape. Parents can help to prevent their baby developing from a flat spot on their head by:
  • Ensuring baby has their head turned to a different side each sleep. This prevents them from spending too much time on one side of their head which can cause flattening.
  • Giving baby plenty of tummy time when they are awake. F or typically developing babies tummy time can start from the day they are born, and can either be on Mum or Dad’s body (eg: chest or lap)or on the floor.
  • Encouraging baby to do Facetime – this involves making eye contact and encouraging them actively turn their head to each side. This helps them to develop neck strength and awareness of both sides, so that they are more likely to turn their head to both sides and develop good control of their heads.
  • Varying the way the baby is carried and held carry to ensure the baby has opportunity to turn their head both ways when upright.
  1. If your baby does develop a flat spot, it is best to seek treatment early. If a parent notices that their baby prefers to turn their head to one side when asleep or awake, and that they are developing some flattening of their head, then it is best to seek help from a children’s physiotherapist early.  A children’s physiotherapist can help the baby learn to turn their head to the other side to remove the pressure off the flat spot, which helps the head shape to improve with time and growth.
  2. The use of helmets to treat flattened head shapes is reserved for the babies who have severe head shape changes. The helmets are made by an orthotist who measures, scans and custom makes each helmet for each individual baby. The helmet works to correct the head shape in two ways:
  • The helmet provides gentle counter pressure over the areas of the skull that are bulging excessively as result of the head shape changes. This helps to gradually remodel the head shape over time.
  • The helmet will be made to have a space or a gap over the area of flattening which means that there is no pressure on the spot the baby usually lies on, and the skull can grow out into that gap to create a more symmetrical shape.
  1. Flattened head shapes due to positioning are purely a cosmetic condition. Head shape changes are not thought to have any impact on the baby’s developing brain.
  2. You don’t need to see a doctor before getting help from a physiotherapist for your baby’s head shape changes. A physiotherapist can assess your baby’s head shape, assess your baby’s overall development, and help you get started on treatment for any head shape changes or head orientation preferences right away.

If you have concerns about your baby’s head shape or their ability to turn their head to both sides, please don’t hesitate to call us book an appointment with one of our experienced physiotherapists.  Early identification and treatment is key to ensuring optimal outcomes for your baby.