Flat head syndrome

Lying baby on back

Flat head syndrome might look a little odd, but it's very common in young babies and nothing to worry about. It's usually caused by a baby sleeping in the same position for nights on end, so it goes away as they become more active. In the meantime, there are lots things you can do to give any slightly squashed heads a helping hand.

What is flat head syndrome?
What causes flat head syndrome?
Is flat head syndrome dangerous?
How can I prevent my baby from getting a flat head?
What are the symptoms of flat head syndrome?
How is flat head syndrome treated?
What Mumsnetters say about flat head syndrome

Babies’ heads are soft and pliable, especially in the first few months of their lives, so they can become flattened when continued pressure is placed on one spot. This usually happens after a few months of your baby sleeping on her back, although some moulding of the skull can take place in the womb (see below), depending on how she lies.

There are two types of flat head syndrome:

  • Plagiocephaly. The head becomes flattened on one side, giving it an asymmetrical appearance. This is the most common type.
  • Brachycephaly. Flattening happens at the back of the head. This can mean the head widens and the forehead might protrude (don’t worry – it doesn’t look as strange as it sounds). This is less common.
The main thing to do is keep pressure off the head as much as possible, so the more tummy time and sitting up the better. I bought my son a special mattress, called a “sleepcurve” for his cot, and a “goi goi” pillow. I also carried him in a sling as much as possible, rather than putting him in the buggy.

What causes flat head syndrome?

It’s been said that skull deformities in babies have been on the increase since paediatricians began advising parents to sleep their babies on their backs in order to reduce sudden infant death syndrome (SIDS). This is debatable, but more importantly, the “Back to Sleep” campaign has halved the number of infant deaths due to SIDS, so do continue to put your baby to sleep on her back.

Today, one in five babies suffers from flat head syndrome, usually in the first six months. If your baby is a sound sleeper, a flat spot can be the downside, but frankly it's a downside we'd take for a few solid hours' kip. A screamer who keeps you awake with her crying at night is less likely to develop flat head syndrome, which is a silver lining of sorts. There are lots of causes of flat head syndrome, though. Here are some of the main ones:

  • Sleeping on her back. It’s the best and safest way for babies to sleep, but it can flatten your baby’s head at the back or side in the early months.
  • Problems in the womb. If your baby gets into an awkward position in the womb then pressure might mould the shape of her head before she’s born. This can also happen if there’s a lack of amniotic fluid cushioning the head.
  • Premature birth. Premature babies are more prone to flat head syndrome because their heads are softer at birth.
  • Tight neck. This is called “torticollis” and occurs when a tightened neck muscle causes your baby’s head to tilt to one side. It needs to be treated by a physio.
  • Car seats. Sitting in a car seat means your baby leans back for prolonged periods. The same logic applies to baby swings and carriers, so avoid leaving her for a long time in either of them.
  • Craniosynostosis. This rare but serious condition occurs if the plates in the skull join together prematurely. It creates pressure within the head and can cause headaches, learning difficulties and eye problems.

Is flat head syndrome dangerous?

More often than not, it’s a brief phase in your baby’s development, with no long-term effects on her head shape or her brain. Many babies are born with an unevenly shaped head due to the pressure of passing through the birth canal. If the problem hasn’t corrected itself after six weeks, then your baby probably has plagiocephaly (caused by lying on the side or back of her head for long periods). This tends to go away once she becomes more mobile and starts enjoying tummy time, which reduces the time she spends on her back.

Monitor the shape of your baby’s head – taking photographs might help – and, if you notice changes, report them to your health visitor or take your baby to your doctor, especially if she’s older than five months. Alternatively, if you’re really concerned by the shape of your baby’s head, take her to your GP or health visitor for a chat to reassure you.

Tummy time

How can I prevent my baby from getting a flat head?

  • Stop her from sleeping in the same position. Of course, by doing this you risk waking her. Ugh. Parenting is full of catch-22s.
  • Carry her. Try carrying your baby around during the day, with her head supported, taking the pressure off the area on which she likes to rest at night.
  • Tummy time. Your baby spends her nights on her back, so it’s important to get her onto her front in the day. Tummy time is a vital way of helping your baby develop her muscles. It should start as soon as she comes home from the hospital, although it will be at least three months before she’s strong enough to hold her head up for long.
  • Special mattress. Sleepcurve mattresses are designed to stop your baby from putting too much pressure on one spot. Mumsnetters have mixed views about their effectiveness.

What are the symptoms of flat head syndrome?

  • Flat head. You’ll notice it, either by sight or by running your hand gently over the back of your baby’s head.
My daughter had severe flat head due to tight muscles, (so she always favoured one side for sleep) . We corrected it by exercising her muscles to loosen them and repositioning her while she slept.

How is flat head syndrome treated?

Most mild cases go away on their own and within weeks. However, a few need treatment from a doctor and, in all cases, there are things you can do to help:

  • Repositioning. Once a flat spot has developed on your baby’s head, she wants to rest on it and will turn onto it whenever she gets the chance. This perpetuates the problem, so help her break the habit by repositioning her gently. If she cries then she might have a problem with her neck, so take her to your GP.
  • Move the light in her bedroom. Babies are drawn to light, so if you move the light she might alter the position of her head.
  • Use a mobile. Hang a mobile above her cot or crib and, as with the light, move it from one night to the next.
  • Physical therapy. If your doctor thinks this is necessary to relax your baby’s neck muscles, they will recommend some gentle exercises.
  • Variation. In the daytime, try having her facing you in a sling, sitting in a sloping chair or having a cuddle. Which brings us to…
  • Alternate sides of holding. Changing sides when you're holding her will relieve some of the pressure on one side of her head and teach her that she shouldn’t be in the same position all the time.

Never use rolled up towels to elevate her head in the cot or Moses basket, as this is increases the risk of SIDS.

What about helmets and headbands?

You might have read that some parents put their babies in corrective helmets and headbands. These are for babies of around six months and are designed to reshape the head, following flat head syndrome, while it’s still soft. Some Mumsnetters say the helmet helped solve their baby’s flat head syndrome.

On the other hand, some clinicians claim that these products are marketed to exploit parents’ anxieties. There’s no official evidence that helmets or headbands are beneficial and, if you’re thinking of trying them, be warned: they’re not cheap (more than £2,000 in some cases). They can also cause side effects, including rashes and general discomfort.

What Mumsnetters say about flat head syndrome

“My advice for anyone whose baby has flat head syndrome? Pick her up. Carry her in a sling. Don't leave her in her car seat. Don't leave her for hours in her buggy. Hold her. Carry her around the house with you. Let her nap in your arms… It’s all about varying her positions.”

“My son had a torticollis, a neck stiffness, and developed a very pronounced flat side. It was most prominent at 8-12 weeks but the torticollis resolved with physiotherapy and we were fastidious about not letting him rest his head on that side.”

“Don't worry if your child has flat head syndrome as it’s pretty common. The skull flattens less as they start moving about more, instead of lying in the same place all the time.. Plus, hair covers it! Two of mine had a bit of a flat head and you can't notice it at all now…”

“My daughter had flat head syndrome from birth, due to her position in the womb. I was so paranoid about it that I bought a ridiculously priced pillow to try and correct it. But she just rolled straight off it!”

“As a baby, my son slept with his head tilted to the right, which gave him a flat head. We consulted a paediatrician. I was terrified he might have to wear something to correct it and obsessed about altering his head position when he was sleeping. But once he learned to sit up, and spent less time on his back, then crawled, walked etc, the problem sorted itself out.”

“My girl had a flat right side because of the way she slept. I couldn't reposition her because she would just roll back. The GP and health visitor were useless, but I asked the GP to refer us to a physio, who taught us exercises to loosen her neck muscles. I also used a special pillow to take the pressure off her skull, used the sling instead of the buggy where possible, and propped her up when she was playing on the floor.”