PSA for brand new moms and moms-to-be: Your Baby's Head

LucyPevensie

Many people here know I dealt with plagiocephaly when Jack was a younger baby (and am still dealing with its residual effects.) 

Plagiocephaly is the term for a flat spot on your baby's head - usually more pronounced on one side of the back part of your baby's head.  I had heard of it, vaguely, before I had a baby - but NEVER thought it would be something I'd have to worry about.  What I didn't know is that: it often starts in the womb (Jack was breech and stuck in the same position for several months toward the end) - and also - some babies are just more prone to it because their skulls are a little softer than others.

Plagiocephaly is caused by pressure on your infant's soft head - pressure from a firm crib mattress, pressure from infant carseat, pressure from infant swing, and pressure from infant bouncy seat.

This pressure literally flattens a part of of your baby's head.  It can also lead to a bulge on your baby's forehead as the brain grows forward on that side (because it can't grow backwards due to the pressure and flattening.)  This can in turn lead to facial asymmetry, and ear asymmetry.

 Here is a little drawing that illustrates the problem of plagiocephaly:

Notice the flattening out on right rear side, the bulging on left rear side, and the bulging on right front side.  A related problem, known as brachycephaly - happens when the flattening is uniform across the back of the head.  Brachycephaly causes the face to look very wide, and can make the eyes appear to bulge out.

Both are VERY common problems - brought about by the life saving Back to Sleep campaign.  When babies more commonly slept on their tummies, plagiocephaly was rare.

Many pediatricians will tell moms who notice it and are concerned "it will round out on its own ... it's normal ... it's only cosmetic."

However, unless your baby's flat spot is very, very mild -  it will often NOT round out on its own.  An orthotic device that looks like a little helmet is what is used to "fix" plagiocephaly.  The babies do not mind the helmets - it's the parents who have the biggest problem with these helmets.  Here is my baby in his helmet last summer:

Even better than seeking treatment though -- is prevention.  Here are some things you can try to prevent plagiocephaly or brachycephaly from affecting your baby:

- Turn baby's head to a different spot - every night, and every nap.  Start with your newborn as soon as you get home.  Notice if your baby is favoring one spot - that spot can quickly become flat because their heads are very soft. Rotate from tilted to the left for one sleep - back of the head for the next sleep - tilted right for the next sleep - etc. 

- LIMIT your baby's time in carseats - infant seats - swings - and bouncy seats.  All of these put flattening pressure on baby's heads.  Consider "wearing" your baby in a safe sling or wrap - and don't be afraid to just hold your baby - a lot!  It's fine, will NOT spoil them, and is actually very, very good for their development. 

- Tummy time - this is very important to strengthen baby's neck.  A tight neck (a condition known as torticollis) or a weak neck can contribute to plagiocephaly.  Notice if your baby seems to favor one side - always tilting his/her head to the same side or bending it toward one shoulder.  This is torticollis - it is very common - and often leads to plagiocephaly.  A physical therapy evaluation is important if your baby shows signs of torticollis.   NOTE: newborns and young babies hate tummy time.  Do it anyway - but follow the suggestions above too because a few minutes of tummy time every day is not enough to prevent plagiocephaly. 

- Finally - if you notice a flat spot developing - don't panic.  DO pay attention to it though - and if it is not getting better with aggressive repositioning efforts - seek help.  If your pediatrician blows off your concerns (like mine did) - seek help elsewhere.  Here are two links for the two biggest "helmet" providers:

www.cranialtech.com

https://www.orthomerica.com/products/cranial/starband.htm

I am posting this because of my experience, because we are still dealing with some residual effects, even after helmet treatment - and because NO ONE told me a) about plagiocephaly (and how common it really is) or b) how to even TRY to prevent it.  And I want to help YOU avoid the anxiety it's caused me. 

Don't let this PSA post upset you or scare you.  Just pay attention to your baby's head shape - "move" your baby's head position at night and for naps - and limit time in swings, carseats, and bouncy seats.   

I'll post this from time to time in the future - again - simply in an effort to help other moms and their babies. 

Best of luck with YOUR new baby! 

CardsfanSM

I think this is a great post. Sophie was born with hip dysplasia, which is associated with a higher rate of torticollis. We're still dealing with the tort, but I wish I had MADE her do tummy time more when she was younger, instead of backing down just b/c she didn't like it. She also had a mild flat spot, but we worked hard to keep her in positions to hopefully improve that, which it did. We significantly reduced her use of the swing and bouncy, and the amount of time she spent lying on her back. We're still in PT for the tort, but hopefully just for a few more months.

Mouseygail

Thanks!!  this is a great post!!

BRSaugust20

Thanks for posting and I love the vintage pic in his helmet - he looks so happy (even though I remember you weren't).

kjcullen

Thanks for the great post! I really appreciate hearing these little tidbits... There is so much to know! And it sounds like you can really prevent a lot of problems if you just know ahead of time and are proactive...

Aliki

This is going to sound really stupid but I honestly dont know the answer: how can you tell if your baby has a flat spot? I'm looking at LO's head from the top (looking down at her) and I can't tell-- she has a lot of hair and maybe I'm not good at visualizing a perfect circle? Is a flat spot very obvious (I'd want to spot it as early as possible, of course) or is this a question I can ask the pediatrician to point out if she has a flat spot??

 

....

 

I'm probably going to do something crazy like take a photo of the top of her head and post it for you ladies to evaluate, wont I...

LucyPevensie

Aliki:

This is going to sound really stupid but I honestly dont know the answer: how can you tell if your baby has a flat spot? I'm looking at LO's head from the top (looking down at her) and I can't tell-- she has a lot of hair and maybe I'm not good at visualizing a perfect circle? Is a flat spot very obvious (I'd want to spot it as early as possible, of course) or is this a question I can ask the pediatrician to point out if she has a flat spot??

Nah - if you're not seeing it - it's not there.  You'd see it.  It looks like a flattening on one side of the back of the head - or the entire back of the head looks very flat.  If it's only on one side - the other side appears to bulge out.  Usually baby's ears are "off" too.  Looking down at the top of your baby's head is the best way to see it.

And no baby's or adult's head is perfectly round.  This would be above and beyond normal non-roundness. 

piccolina09

Great post. There was some info on tv this week about plagiocephaly, the show Multiples: How do they do it? They had quints and 2 of them had to get sized for helmets.

LucyPevensie

piccolina09:

Great post. There was some info on tv this week about plagiocephaly, the show Multiples: How do they do it? They had quints and 2 of them had to get sized for helmets.

yep - multiples (and breech babies) are at higher risk, given that they are often a bit smooshed in the womb, flat spot can start there and once there is even a tiny spot - baby tends to lay on that spot.  Think of a ball with a slightly flat spot - when you roll it - it will always land (and stay) on that spot. 

igh0318

Tanner has a flat spot.  He definately favors one side and I wonder if it's torticollis. I have been repositioning him but he always seems to go back to that side. I'm not sure how to keep him from doing that.  We have a pedi appt soon so I will be getting a referral to see what we can do about this.  Thank you for the info.  I will read the links you sent later but I might have questions if you don't mind answering them.

leslies75

You've probably all seen my siggy pic of Jake in his helmet. He's made remarkable progress with his plagiocephaly and the reshaping of his flat head. As LucyP pointed out, the LO's have no problem wearing the helmet at all. Thanks for the post LucyP!

If anyone has questions, you can ask me about our experience too!

lnle

We noticed a flat spot on Abby's head since around 2 months old. We've been trying some of the strategies you listed, but I'm definitely guilty of not forcing the tummy time b/c she hates it. She's starting to go longer and longer before she freaks out about it though, so that's good. And she loves bumbo time.

JustaKidAtHeart

before:

During:

 

 

 

 After: