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In most cases it’s perfectly normal and safe because flat head syndrome is a natural result of the newborns’ thin and soft skull bones. Their heads are easily “moulded” because of yet incomplete development and to better accommodate further physical and brain growth.
The flat spot is also the result of the newborns’ extended sleeping time and lack of mobility. The back of the head takes all the pressure and because of the long hours with the head on roughly the same position, the flat spot develops.
Usually the flat spot developed fixes itself within two to three months with the help of repositioning and as the baby gets more active. With the decreased pressure to the back of the head, the flat spot will gradually disappear and the baby’s head will look more normal.
However, the baby’s life and safety is more important because babies sleeping on their backs have a lower risk for sudden infant death syndrome (SIDS). During the 1990s parents were told about lowering the risk of SIDS by putting their babies to sleep on their backs. This advice alone probably saved countless lives but a little and harmless consequence appeared (flattened head). After all, within a reasonable time the flat spot will disappear and the temporarily flattened head doesn’t harm brain development or won’t cause any long-lasting appearance issues.
Important: Putting your baby to sleep on his/her back lowers the risk of SIDS.
What should you do then about that flat spot? Keep in mind that the goal here is to take the pressure off and you can easily do this by holding your baby more often. If you pick up and hold your baby often, there will be less contact time between the baby’s head and the flat surface (e.g. mattress, strollers, car seats). This small and consistent action will do a lot for your baby’s head to normalise in shape.
Another easy thing you could do is to allow your baby to lie on his/her stomach while awake during the day. Aside from promoting the normal shaping of the back of the head (i.e. less contact time between the head and a flat surface), this activity also helps the child’s physical and mental development (e.g. the child will start to explore and gain a new perspective, muscles also develop because of the playtime and movement). Your supervision during this “tummy time” is important here for safety reasons.
Repositioning the baby’s head (from right to left, left to right) while he/she is sleeping also helps. Again, the goal here is to take off the pressure from the flat spot by somehow distributing the pressure on different sides of the head. But as mentioned earlier, babies should still be put down to sleep on their backs to prevent SIDS.
Over the months and years the flattening will become less apparent as the skull grows and develops. This is one of the many cases where things get resolved by themselves. That’s because as our children grow, they get more active and spend less time lying on their backs. In addition, as babies grow they tend to naturally reposition themselves during sleep thereby distributing the pressure. Throughout the night the baby’s head will be in different positions.
By the time your child begins primary school, the flat spot will become less apparent or virtually unnoticeable. After all, there’s no perfect symmetry when it comes to physical development and the back of the head also grows more hair as months and years go by. There’s also no cause for worry because the flat spot during the child’s early years won’t cause brain damage or developmental delays.
If you’re concerned about your baby’s head shape, you should see the GP or nurse (who might then refer you to a paediatric physiotherapist, paediatrician or a plastic surgeon). The surgeon’s help might be needed to treat craniosynostosis wherein the skull bones fuse together way before they’re supposed to. As a result, the premature fusion causes skull deformities and even affects brain growth. Treatment and surgery might be needed to correct the problem early on.
Although the flat spot disappears by itself as children grow, it’s still important to visit the doctor as soon as you notice the flattening. This way, the doctor can do the monitoring for a few visits and check for any issues especially when it comes to how the baby moves his/her head and neck. Regularly taking photos of your baby for comparison through the weeks could also help in better noticing the flattening. It also helps to allow family and colleagues to see the baby because we parents may not readily notice the gradual flattening. After all, we’re with our babies all the time and small changes might be hard to pick up.
A flat spot on the baby’s head is normal given the newborn’s soft and thin skull. But in most cases it corrects itself as the baby gets more tummy time and by holding the baby more often. If you have any worries and concerns, it’s best to visit the doctor to identify and correct any possible issues early on.