It’s not a good day for parents when they hear the diagnosis “Flat Head Syndrome.” Some parents panic, others think that it will go away by itself. But will it really?
A symmetrical head is not just about esthetics, but is also tied to a symmetrical, well-developing body. Head deformation can indicate deeper problems with a baby’s body. Some problems can be worked out with simple exercises, while others need a visit to a specialist. What types of head deformations are out there? What to watch out for to avoid head flattening? Where and how does a flat head come from? Read on!
WHY DOES HEAD FLATTENING OCCUR?
A newborn’s head grows constantly, and the cranial sutures have not yet closed. If babies don’t alternate their head position between left and right — and seem to have a preferred side while sleeping — this could change the shape of their heads due to prolonged pressure on just one side.
WHAT TYPES OF DEFORMATIONS ARE THERE?
Plagiocephaly — the head is flatter on one side than the other. This is the most common type of flat head syndrome. This type of flattening is clearly noticeable from behind. The head is flat on the same side as the direction in which the baby prefers to look. It’s even more obvious if you view the baby from above. Normally the head is symmetrical and looks more or less like a sphere. In case of plagiocephaly the head resembles a parallelogram.
Brachycephaly — the back of the head is wide and evenly flattened. When viewed from above, it resembles a trapezoid.
Dolichocephaly — the baby’s head is narrow, flat on the sides, and elongated. When viewed from above, it resembles an egg.
Craniosynostosis — a condition in which one or more skull sutures close too early. The shape of the head depends on which sutures have actually closed. Although craniosynostosis is quite a rare condition (it is estimated that about 1 in every 2,500 babies are born with craniosynostosis in the United States), it is serious problem. As the bones in a baby’s skull join together too early, there is not enough room for the rapidly growing brain. This can lead to a build-up of pressure inside the skull which is life-threatening. Craniosynostosis requires surgical treatment.
WHAT CAUSES THESE DEFORMATIONS?
Flat head is caused by many factors. It can have its beginnings as early as during pregnancy (incorrect position of the baby in the mother’s belly, too much or too little amniotic fluid, a large baby, multiple babies simultaneously in utero, or abnormalities in the structure of the cervical spine). Complications during labor may become a factor as well (for example, damaged muscles in the neck can lead to torticollis). What happens after the birth has an impact, especially when babies tend to stay in one position. This happens because the babies have a favored side or, conversely, puts themselves in some forced position because of a disorder of the central nervous system or a problem with muscles or joints.
WHAT IS THE DIFFERENCE BETWEEN A FAVORED SIDE AND A FORCED POSITION?
We recognize a favored side when newborn babies noticeably prefer to turn their heads in one direction, but are able to rotate the head both ways. A forced position happens when babies cannot turn their heads to the other side, as if there is some sort of impediment. In such a case you should see a specialist.
DOES A FLAT HEAD ALWAYS REQUIRE PHYSIOTHERAPY?
Contrary to some beliefs, every deformation of the head should be checked out. This is because the problem may be much more involved than just the positioning or the shape of the skull. Very often, a flat head occurs together with other problems, such as: asymmetry of the torso or pelvis, hip joint or foot dysfunction, or even asymmetry of the face, which progresses quickly and can be seen within a few days with one side of the face being larger than the other.
WHAT IS MOST IMPORTANT?
– First and foremost, early intervention. This is why I strongly recommend seeing a specialist the moment you notice the slightest flattening of your baby’s head. Such a visit does not mean your baby will require extensive physiotherapy. Sometimes two or three sessions (and modifying certain care habits) are absolutely enough — and the problem goes away completely.
– A comprehensive approach. First of all, your physical therapist needs to evaluate whether the positioning of the body is in any way being forced by the position of the baby’s head. In newborns during first 6 weeks of life, coupling of the baby’s torso and head movements are absolutely normal. The older the child gets, the more we expect the head movements not to influence those of the rest of the body.
As I have mentioned earlier, plagiocephaly could be associated with many more symptoms that can be described as secondary deformations. It is best not to let them occur. If they do happen, a comprehensive approach is key.
HOW CAN YOU HELP YOUR CHILD?
If you notice your baby consistently favors one side, lay the child between your thighs placing their “rounded” bum higher than his or her head. The nose, chin, breastbone, navel, and pelvis should be in line. Do this 2-3 times a day for about 7-10 minutes.
This positioning will cause your little one to orient his or her head properly and get a feeling for body symmetry.
If, after a few days, you don’t see positive change (or you have any further doubts), it is best to consult a specialist.
Interesting Note:
The number of flat head syndrome cases has increased, while the percentage of babies who die of Sudden Infant Death Syndrome (SIDS) has decreased. The American Academy of Pediatrics recommend that babies sleep on their backs instead of on their tummies to prevent SIDS, as this is the safest sleeping position. As a result, babies are spending more time on their backs than before, thus increasing the occurrance of head flattening.
For every mother, the baby’s safety is a priority. That’s why I always laid my children on their backs to sleep, but I also paid attention to the shape of their heads. I did everything by the book for my children, however, it’s important to know that some babies still get a flat head.
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Playing with your baby is about so much more than rattles and flashy toys. Play should also help them develop correctly and avoid problems like flat head syndrome. Find out how to keep your baby moving with these ideas for playtime — from birth to first steps — in the following e-book:
