Babies: 3 - 6 Months

will flat spot on head improve?

Vik9Vik9 member
edited February 2016 in Babies: 3 - 6 Months
My LO has always preferred to turn his head to the left when sleeping, as a newborn i never thought anything of it and did not want to wake him to re position him. My LO is now 4 months and i noticed that he has a flat spot on the left side. I have been re-positioning his head as much as i can, but he is constantly moving in his sleep. I mentioned it to his ped and she said that they no longer recommend helmets and to spend more time on his tummy. He hardly naps during the day so he is not laying down on his head and i try and have him on his tummy as much as possible. Has anyone had these flats spots improve without a helmet? I'm considering going to see a specialist. Although his spot is not extremely flat, it bothers me and i want to make sure that I do whatever is necessary. He has no problem moving his head and does sleep on both sides.

Re: will flat spot on head improve?

  • SmrBrd2012SmrBrd2012 member
    edited February 2016
    I would really push for a specialist. We had a similar issue and the ped wouldn't refer us until he was older and the issue obviously wasnt going away. You may want to try to call a specialist/orthotist and ask if they could do a free consultation if your ped refuses to refer you. Helmets are absolutely still recommended. My little guy is in one now and it's helped so much. He has moderate to severe plagiocephaly (flat spot on one side of the head).

    Also, if you have any particular questions and want to share photos to get other's advice, there is aan amazing FB group called: "Plagiocephaly-Support/Information/Advice". They've been sooo helpful to me.
  • We did. Our ped had us go buy one of these pillows for our LO to sleep on and it has helped. A LOT. In the beginning we moved it wherever she went (crib, swing, floor) now we just leave it in her crib. .. I'll add a pic (don't mind all the lost hair)
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  • Um, since when are helmets not recommended anymore?! That is insane to me. My first child had a flat spot that corrected itself, but my second child needed a helmet. Both of my kids have enormous heads and both had torticollis because they were big babies and crammed inside of me.

    My daughter wore a helmet for 2 months. She did exactly what you are describing and it wasn't just that she preferred sleeping on one side, come to find out she had torticollis just like my son did. Her neck muscle was so tight that she COULDN'T turn her neck the other way so she developed a pretty bad flat spot. She was in physical therapy to stretch out her neck and the specialist left the helmet decision up to us but I wasn't willing to take any chances with my kid's head. I would hate myself if it didn't correct itself over time and it was misshapen because I decided to skip the helmet.

    Go see a specialist. I'm serious. It's the easiest fix in the world if your LO needed a helmet. Might as well have someone else give you an opinion right? And besides, most kids don't even realize the helmet is on. It's easy.

  • Also, the earlier you intervene, the better. Their skull starts fusing at a certain age and isn't as "moldable". 
  • I didn't read the whole thing because I'm lazy. Ours improved immensely from 2 months to 4 months and at 4 months our ped told us she really didn't think our LO needed a helmet but she still gave me the name of a doctor to contact incase I felt I wanted to meet with a therapist and get more info. I told her I felt she was progressing enough as is and didn't need to take that route right now. I know around here, helmets are used pretty regularly. I would definitely definitely go see a specialist if you are concerned! In the meantime, that pillow I got was only like $15 and can't hurt :)

    good luck!
  • I would get a 2nd opinion before trying anything. In the meantime do lots of tummy time and keep baby upright in a bouncer if he can tolerate it.
  • any idea on what type of specialist i can go see? My pedi has said i can try physical therapy but he has no issues moving his head. What type of specialist would help me figure out the severity of his flat spot?
  • I would make an appointment with a different pedi for a 2nd opinion. 
  • Vik9 said:
    any idea on what type of specialist i can go see? My pedi has said i can try physical therapy but he has no issues moving his head. What type of specialist would help me figure out the severity of his flat spot?

    An orthotist or plastic surgery specialist. Most children's hospitals have them, if that helps.
  •  I did not read all of the other posts but just came here to say that my doctor said babies heads are flattest at four months and improve from there because they spend less time laying on them 
  • Bognes said:
     I did not read all of the other posts but just came here to say that my doctor said babies heads are flattest at four months and improve from there because they spend less time laying on them 
    It's important though to realize there is a difference between a normal flat spot and plagiocephaly or a REALLY flat head that needs correcting. Lots of babies have flat spots but they should always be evaluated by a Pedi first, then a specialist if needed.
  • Vik9 said:
    any idea on what type of specialist i can go see? My pedi has said i can try physical therapy but he has no issues moving his head. What type of specialist would help me figure out the severity of his flat spot?

    We started with physical therapy for the torticollis (tight neck) and she was the one to further evaluate my daughter then refer to Children's Hospital. They have cranial specialists.
  • Bognes said:
     I did not read all of the other posts but just came here to say that my doctor said babies heads are flattest at four months and improve from there because they spend less time laying on them 
    Our pediatrician said this too and would in fact not recommend a specialist until he was almost 6 months old. By the time that happened, my LO was in the moderate to severe category of plagio. I've seen this happen so many times on the FB group I mentioned above, too .I personally don't trust ped's recommendations on this since they are not specialists. At the very least, I'd get a second ped opinion.

  • My daughter got a helmet 2 weeks ago and it has helped tremendously already. I am not sure why your doctor would recommend against a helmet. As others have said, the earlier you intervene, the better. We only have about 5 weeks left, compared to a normal treatment time of several months for older babies
  • pupsicle23pupsicle23 member
    edited February 2016
    Popping in here because someone mentioned this thread on the 0-3 month board. My daughter is 11 weeks and has a flat spot on the back of her head,  and the right side of her head seems flatter than the left.  The pediatrician just says it will fix itself when she's more mobile. Is it too early to worry? At what age do people see specialists?
  • I've seen babies as young as 4 months with helmets but usually in my experience it seems like a lot of them get them around 6 months. It's def not too early to worry. I was worried and mentioned it at my LOs 2 month appointment and it just continued to get worse because he didn't start rolling until 4 months and didn't sleep on his belly until 5-6 months.
  • mhuber223 said:
    Popping in here because someone mentioned this thread on the 0-3 month board. My daughter is 11 weeks and has a flat spot on the back of her head,  and the right side of her head seems flatter than the left.  The pediatrician just says it will fix itself when she's more mobile. Is it too early to worry? At what age do people see specialists?


    Like PP said, it's NEVER too early to intervene, it can only be too late.

    My DD started PT for torticollis (tight neck) when she was 4 weeks old because I spoke up about something I had noticed that seemed "off" about her. She ended up needing a helmet from 7 months old to 9 months old. Your LO might not even need that but ask your Pedi about a second opinion.


  • @SmrBrd2012 @Bigboobsmcgee Thank you!  I'm keeping her out of baby gear unless I have to shower or something,  but I'll ask the pediatrician more about it. 
  • So i did go ahead and find a specialist here in Los Angeles that deals with plagio. He did state that our LO is in the 9mm range? so that is on the high mild to moderate range and that the back of his head is at 92%?  and that we could try re positioning but he did also say that a helmet might help. Although he is now rolling and has been sleeping on his belly i just don't see how his head will go back to normal without any type of help. I hate to have to put him in a helmet but i want to do whats best. I just hope its only for 2 months like the doctor mentioned. We are also taking him to physical therapy to help with his neck. I just wish his pediatrician said something, i hate that i had to ask her and research, i think i may need to find a new pediatrician.
  • Vik9 said:
    So i did go ahead and find a specialist here in Los Angeles that deals with plagio. He did state that our LO is in the 9mm range? so that is on the high mild to moderate range and that the back of his head is at 92%?  and that we could try re positioning but he did also say that a helmet might help. Although he is now rolling and has been sleeping on his belly i just don't see how his head will go back to normal without any type of help. I hate to have to put him in a helmet but i want to do whats best. I just hope its only for 2 months like the doctor mentioned. We are also taking him to physical therapy to help with his neck. I just wish his pediatrician said something, i hate that i had to ask her and research, i think i may need to find a new pediatrician.

    Don't even stress the helmet if it comes to that. It was so much easier than I thought it would be and babies look so cute in them. It sounds daunting now but it will be a piece of cake. I'm glad you went and saw someone. Good for you momma.
  • My 3 month old is being seen by an infant physical therapist for torticollis and plagiocephaly. She said recent studies show that by the age of 18 months there is no discernible difference between babies with a helmet and babies properly treated with physical therapy. At this point I am going with her course of treatment because she is the professional and the helmet is not covered under insurance (and costs upwards of $5,000). We'll see what kind of progress he makes over the next few months.
  • TwizBeansTwizBeans member
    edited March 2016
    LaceyH13 said:
    My 3 month old is being seen by an infant physical therapist for torticollis and plagiocephaly. She said recent studies show that by the age of 18 months there is no discernible difference between babies with a helmet and babies properly treated with physical therapy. At this point I am going with her course of treatment because she is the professional and the helmet is not covered under insurance (and costs upwards of $5,000). We'll see what kind of progress he makes over the next few months.


    Yikes. Not true unfortunately. I work in healthcare AND have seen multiple cranial specialists at Children's Hospital when my daughter had plagiocephaly. PT is definitely GREAT and I totally recommend it but unfortunately for some babies it cannot do anything for a seriously misshapen head. That requires a bit more intervention.

    And FWIW, I would sell my home or anything I own to pay for the helmet if I had to. Insurance only covered part of my daughter's helmet but I would have done anything to help fix her head so she didn't have issues later in life. It's just too important IMO.

  • TwizBeans said:
    LaceyH13 said:
    My 3 month old is being seen by an infant physical therapist for torticollis and plagiocephaly. She said recent studies show that by the age of 18 months there is no discernible difference between babies with a helmet and babies properly treated with physical therapy. At this point I am going with her course of treatment because she is the professional and the helmet is not covered under insurance (and costs upwards of $5,000). We'll see what kind of progress he makes over the next few months.


    Yikes. Not true unfortunately. I work in healthcare AND have seen multiple cranial specialists at Children's Hospital when my daughter had plagiocephaly. PT is definitely GREAT and I totally recommend it but unfortunately for some babies it cannot do anything for a seriously misshapen head. That requires a bit more intervention.

    And FWIW, I would sell my home or anything I own to pay for the helmet if I had to. Insurance only covered part of my daughter's helmet but I would have done anything to help fix her head so she didn't have issues later in life. It's just too important IMO.

    Agreed. She may be an expert in PT but not necessarily in plagio. That's not her specialty. Only a cranial specialist/orthotist/plastic surgeon can really make that call. I hope the PT is right.
  • Vik9Vik9 member
    So I finally got an appointment at cranio technology and had him measured. His Cephalic index measures 88.7 and CVA is 9.0mm, they said we should helmet him but his doctor is saying his measurements are ok and that when baby's graduate from their helmets there CI is normally within the 88-92 range anyway. This is a really hard decision and i just cant imagine having to make him wear a helmet for 23hours. Anyone remember their measurements?
  • https://pediatrics.aappublications.org/content/pediatrics/early/2011/11/22/peds.2011-2220.full.pdf

    That URL links to an article from the American Academy of Pediatrics that backs up what the PT said. Studies have shown helmets to be helpful only in very extreme circumstances of plagiocephaly, not in average cases.

    And I don't appreciate the insinuation that my choice to have my child go through PT rather than immediately paying for a helmet makes me a bad person. Good for you that you would immediately sell your home for a medical device that has been shown to have little effect on an average case. Fortunately that is your right. But don't ever make it sound like I wouldn't move Heaven and Earth for my child simply because I take my time, do my research and make the decision right for my family. Dont ever insinuate that about another mother. Ever.
  • Vik9 said:
    So I finally got an appointment at cranio technology and had him measured. His Cephalic index measures 88.7 and CVA is 9.0mm, they said we should helmet him but his doctor is saying his measurements are ok and that when baby's graduate from their helmets there CI is normally within the 88-92 range anyway. This is a really hard decision and i just cant imagine having to make him wear a helmet for 23hours. Anyone remember their measurements?
    I don't know the CI off the top my head but he was 12mm when we started which put him in moderate to severe range. He's at 6 now and I've heard lots of babies "graduate" around 2-3mm.
  • TwizBeansTwizBeans member
    edited March 2016
    LaceyH13 said:
    https://pediatrics.aappublications.org/content/pediatrics/early/2011/11/22/peds.2011-2220.full.pdf

    That URL links to an article from the American Academy of Pediatrics that backs up what the PT said. Studies have shown helmets to be helpful only in very extreme circumstances of plagiocephaly, not in average cases.

    And I don't appreciate the insinuation that my choice to have my child go through PT rather than immediately paying for a helmet makes me a bad person. Good for you that you would immediately sell your home for a medical device that has been shown to have little effect on an average case. Fortunately that is your right. But don't ever make it sound like I wouldn't move Heaven and Earth for my child simply because I take my time, do my research and make the decision right for my family. Dont ever insinuate that about another mother. Ever.
    It's your fault if you took offense to that comment. I was only speaking about myself. Plus, I trust the cranial specialists at Childrens hospital to have the most up
    to date research and advice over an article from 5 years ago. I really hope your PT is right and I was never criticizing you. 
  • Vik9 said:
    So I finally got an appointment at cranio technology and had him measured. His Cephalic index measures 88.7 and CVA is 9.0mm, they said we should helmet him but his doctor is saying his measurements are ok and that when baby's graduate from their helmets there CI is normally within the 88-92 range anyway. This is a really hard decision and i just cant imagine having to make him wear a helmet for 23hours. Anyone remember their measurements?
    Your LO will get used to it, I promise you. I'm not telling you to get the helmet but wearing it won't be a problem at all. They don't even notice it. 
  • Sorry if this sounds dumb but is there any reason for "correction" if it's simply from laying on the spot too much? It doesn't cause any brain damage, so I'm assuming a helmet would be just for cosmetic purposes? 
  • Sorry if this sounds dumb but is there any reason for "correction" if it's simply from laying on the spot too much? It doesn't cause any brain damage, so I'm assuming a helmet would be just for cosmetic purposes? 
    It is mostly for cosmetic reasons but there is some info out there that says it may be correlated with a slight developmental delay.
  • Sorry if this sounds dumb but is there any reason for "correction" if it's simply from laying on the spot too much? It doesn't cause any brain damage, so I'm assuming a helmet would be just for cosmetic purposes? 
    It is mostly for cosmetic reasons but there is some info out there that says it may be correlated with a slight developmental delay.

    And depending on the extent of the flat spot, it could cause facial features to be a little off.
  • TwizBeans said:
    Sorry if this sounds dumb but is there any reason for "correction" if it's simply from laying on the spot too much? It doesn't cause any brain damage, so I'm assuming a helmet would be just for cosmetic purposes? 
    It is mostly for cosmetic reasons but there is some info out there that says it may be correlated with a slight developmental delay.

    And depending on the extent of the flat spot, it could cause facial features to be a little off.
    Yes, most often eyes and ears.
  • Not just facial features. It can actually affect their depth perception. That's major!

    our pt said a new study has come out that babies need 1 hour tummy time (in increments) per day to combat the sleep on back. But it's just got to be done. 

    Our 1st had a helmet. Didn't correct much-put on too late. 

    Youngest-no mention of helmet. We have baby in pt. we knew of the torticollis from day 4 (hospital missed it). So we worked on positioning. This baby has less physical development problems & is already rolling over so pt said head shape is improving from this. 
  • We had same issue with that side. She was in nicu for 3 weeks on back most of time and hated being on tummy. Then in swing for first few months a lot and I didn't know that could be an issue. Started seeing the flatness around 3 months nNow 7 months it has been improving and ped said no helmet needed! You don't want one they are expensive and being pushed now! We have been seeing an OT for torticollis and she recommend the tortle hat. You can get at buy buy baby or Amazon.  I wish someone told me about it sooner. I have been using that if she is in her car seat for long or swing. Doing tummy time at least 3 times a day. And for a good month or two between 4 and 6 months was having her napping on me on her other side or baby wearing to keep off head. Now she is sleeping on side at night which is good. I still try not to put her on back during day for long. 
  • We had same issue with that side. She was in nicu for 3 weeks on back most of time and hated being on tummy. Then in swing for first few months a lot and I didn't know that could be an issue. Started seeing the flatness around 3 months nNow 7 months it has been improving and ped said no helmet needed! You don't want one they are expensive and being pushed now! We have been seeing an OT for torticollis and she recommend the tortle hat. You can get at buy buy baby or Amazon.  I wish someone told me about it sooner. I have been using that if she is in her car seat for long or swing. Doing tummy time at least 3 times a day. And for a good month or two between 4 and 6 months was having her napping on me on her other side or baby wearing to keep off head. Now she is sleeping on side at night which is good. I still try not to put her on back during day for long. 
    This is not good advice.
  • Vik9Vik9 member
    Well we went back to the specialist at cedars sinai. We wanted him to re evaluate our son before we decided to helmet. Our insurance approved the helmet and he just turned 6 months so it was basically up to the specialist ( he is one of the doctors who created the helmet). He was impressed how much our sons head had improved, mainly because he has been sleeping on his tummy. He said that the helmet would probably not help much and because his ears are aligned and his head has improved he no longer recommended a helmet.
  • Vik9 said:
    Well we went back to the specialist at cedars sinai. We wanted him to re evaluate our son before we decided to helmet. Our insurance approved the helmet and he just turned 6 months so it was basically up to the specialist ( he is one of the doctors who created the helmet). He was impressed how much our sons head had improved, mainly because he has been sleeping on his tummy. He said that the helmet would probably not help much and because his ears are aligned and his head has improved he no longer recommended a helmet.
    That's awesome!! Glad your little one doesn't need it.
  • I think the reason most babies are treated after 4 months is because they are more active and move more so some flat spots do correct themselves.
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