Getting a Flat Head from Sleeping on His Back

T., you do have to keep an eye on this. I see a lot of responses saying that it will resolve itself but that is not always the case. If there is concern at 4 months the proper thing to do is try repositioning. If at 6-7 months things have not improved (especially if the flatness in back is so severe that it causes a widening at the temples) please consider getting him a helmet. No, they're not pretty but they certainly help fix plagiocephaly and are well worth the effort for a perfect noggin!

Hi T., I had this concern too with my three children. The approach I took was to every night change which end of his crib was the "head". Very often, babies will automatically roll to the same side every time. If you switch which end of the bed is the head, they will still roll the same way, but it will actually be the opposite side because they are laying in a different direction. I have three kids with nice round heads...good luck! M.

I had my daughter sleeping on her side for the first 3-4 months and switching sides for naps and when she went down at night. This way she was equally sleeping on each side so her head did not get flat.

T., I recommend you Google Dr. Sprott, read the numbers, and about his research in New Zealand. Then buy a mattress wrap and sleep your baby on his belly. I have 4 who have all slept on their bellies this way. I hope this is helpful to you.
-T.

My son was born with a sub-dermal hematoma, not just a cone-head from pushing on delivery. I think he was stuck for awhile and presented ear first. The hematoma took a full month to abate. All the docs and nurses said "don't worry, his head will round out" but it didn't. I heard this at two weeks, 1 month, 2 months, 4 months, etc.. (Both my sons had skull x-rays at 2 wks because of abnormal skull shapes, maybe it had something to do with my pelvis), anyway...) I tried all sorts of repositioning, wedges, moving toys around. My regular pediatrician would have addressed his flat head at 4 months, but she was away and we were seen by another ped who just said, "don't worry, it'll round out". Finally at five months I felt more needed to be done. My ped ordered another skull x-ray. Based on that the radiologist recommended an MRI. All OK, but we were finally referred to the Craniofacial Team at CCMC. They just said, "we don't do the helmet thing". Too many side effects and his head would probably round out on it's own. They said Yale/New Haven's team would be much more likely to recommend the helmet. Just a different approach. My son went back to CCMC once a year until he was three, but there wasn't any action to take so they said we didn't need to come back. All his development was on track. At 4 and a half he is a beautiful child with great facial symmetry, but the back of his head is still quite obviously flat on one side. Unexpectedly, I find a very short haircut camouflages best. I'm sure it is true that most kids improve, but mine did not. When I see a child with a helmet I have a pang of regret that I didn't try to do more for my child.

My now seven-month old had plagiocephaly when he was about four months, and we were referred by our pediatrician to a pediatric plastic surgeon at Children's Hospital who specializes in this field. We ended up fitting him with a helmet that he wore for six weeks and now his head looks great. It took a few days for him to adjust to it, but after that he was fine. I highly recommend looking into it if you're concerned - insurance does pay. If you're worried, ask for a referral or second opinion. Better to feel like you're doing something than to sit around feeling helpless!

Hi T., I have exactly the same problem bothering me badly.

My daughter is now 4 months old and her head is really flattened. I reallly doubt my pediatrician that the flat head will correct itself if we do nothing. In fact, I force my daughter to do tummy time three times a day. And I wake her up to reposition her on her side. But she will just roll down on her back because her head is round on the side and so it will natually roll down on the flat back. And as you said how can a total 15 minutes of tummy time overweight 12 hours of sleep every day.

Many post below mentioned "repositioning". I am wondering as it is not recommended to sleep the baby on her back and not possible to let her stay still on the side, repositioning simply means still sleep on the back. What the use?

Get the wedge! rotate your son each night to sleep on a different side.
This happened to my son and at first the doc wasn't concerned but after a few months she did become a little worried that if he continued to sleep on one side the flat spot would get worse and harder to correct. My son is now four and he still has a slight flat spot. It was dramatically corrected from making sure I rotate his head or make sure he slept on his sides more. But had it got worse the doctor told me we would have to maybe think about getting a helmet to correct his head. Correct it now on your own by using a wedge.

T.,
You need to take action now! This has become an "epidemic." Start repositioning and YES get a postitioner to start sleeping him on his side. My son had the same thing happen to him and I started repositioning ASAP. However, it was still not perfect and I took him to a pediatric plastic surgeon at Children's Hospital and decided on a helmet, and was not happy it came to that after my pediatrician and neurologist both told me to continue sleeping him on his back. Well, 4 weeks later and he has graduated from his helmet with a perfect head, and we never have to worry about his flat head and broad forhead again! If you have ANY doubts..go to www.cappskids.org. There are NO statistics to prove it will correct on its own! My son wore the helmet 20 hours a day and adjusted to it just fine! Good luck, I wish these doctors talked at least about repositioning!

My daughter also had a flat spot, but once she started rolling around and sitting up, it went away. It took time, and I know in some extreme cases, the kid has to wear a special helmet to make the head round again, but it should just go away.

Hi T.,
I have a 12 week old who sleeps on her back and is also still swaddled. I'm contemplating when to try to get her out of her swaddle. I am also a nurse on the L&D unit. I would stick with back sleeping. It is safest. The wedges have mixed reviews and infants have suffocated with the use of them. I would do more tummy time during the day and if in a month you still feel like his head is too flat then bring him back to the pediatrician or switch pediatricians. The back to sleep campaign for SIDS has brought on many more cases of babies with flat heads. It is pretty common. It will work out! R.

My daughter's head was flat, too, but we always kept her on her back to sleep. You should thank your lucky stars your little boy sleeps so well and just continue your routine. Pretty soon, he'll be scooting/crawling and his head will round out. I was a little worried, too, but as long as he is sleeping safely you have nothing to worry about! Just enjoy tummy time during the day and take pictures to remember him this small!

The same thing happened to my nephew. He had a noticably flat head in the back when he was an infant from sleeping on his back. My dad is a pediatricain and told me sister the same thing. My nephew is five now and you would never know that he had that flat head now (it didn't take five years to round out!). My boys also slept on their backs, but didn't have as noticable a flat head. A little bit, but my nephew's was really prominent. I don't know why some kids are more prominent. I will tell you that with my twins they slept mostly in their swings due to really bad colic and that may have helped with their heads a bit. Tummy time is hard at four months. It will get easier as he gets older and wants to be more active.

Hi T.,

I have a friend who's son had this issue and now, as he is just turning 5, he still has a completely flat slope on one side of his head. My friend never pursued a helmet or any other corrective action and I fear he will have this for the rest of his life. If you have doubts about it correctly itself on its own, I suggest you take action. I know that with this friend, there was no "natural" correction."

Good luck!
~Liza

30 year old, FT working, single mom to almost 5 year old girl

I would get a second opinion anytime you have a nagging doubt about what a dr told you. My neighbor went through the same thing, and the dr said don't worry, but six months later, he had to wear a helmet nearly 24 hours a day to fix it. It did fix it, but he had to wear it for a long time, and it took quite a while to get used to sleeping in it for him. Something less intrusive now might be a better intervention. I would be proactive to avoid it if you can.
Good luck,
D.

Hi T., I had the same experience that you had in that I was concerned about the flatness of my sons head and my ped. was not. At about 8 months (his head did not "pop out" as my ped. had promised) so I took him to a plastic surgeon and we decided to put him in a helmet to correct the plagio. He wore it for 3 months 23 hours a day and adjusted to it very quickly. Sleeping was only an issue the first night and not even that bad. I highly recommend following your instincts. I still think Ethan would have ended up in a helmet, but it's easier to remedy when their rate of growth is still high.

There's a great yahoo group that I joined for Dr and helmet recommentations. The moms that run the group also let you post pictures to receive advice if you're interested.

Good luck!

Hi T.,
Completely normal!! My three boys all had this and my 4 month old daughter is no different. It is nothing to worry about because as the other posters have said, it will correct itself as he gets older. I was just reassured by my doctor for the fourth time at my daughters 4 month checkup. My boys are 3, 5, and 7 and their heads are perfectly normal!

Hi T.,

I have a unique perspective when it comes to this topic. Both of my children have a genetic disorder which can express itself in a variety of ways. The most severe expression involves premature (generally before birth) fusion of the plates of the skull--craniosynostosis. My first daughter did have the premature fusion, my second daughter, luckily, does not. Because of this, both girls see the craniofacial team at CCMC regularly. During their infancies, it was noted that they both had part of their head that was flattening (plagiocephaly). The team decided not to do anything, because they would soon be rolling over and sleeping in whatever would be their most comfortable position, and the skull would adjust accordingly. That being said, yes, there are cases where a helmet can be used to take the pressure off of one part of the head--I don't know how severe the flattening would need to be, and I don't know how severe your son's is, either. If you're concerned, I would certainly check with the pediatrician--which you have. If you are still concerned, which it seems you are, then ask for a referral to your local craniofacial team--they are the experts in this field.

My son had a very flat, lopsided head as well from laying in the same position in the car seat, the swing and the crib. After seeing the dr about it and not getting a satisfying answer, I became hypervigilent at repositioning and repositioning his head every time it was on that side. Believe it or not, his head started to regain it's round shape and now, at 3 years old, it's totally normal. It only took a few weeks for the flat side to round itself out. You've got time before it's forever. So, try to be hypervigilent about it for a while.

Hi T.,

I can sympathize! My daughter was 10 weeks early and we had similar issues. We received a gel pillow from the NICU that helped tremdously (we put the pillow beneath the sheet). We also put her head in different positions when sleepin. In the NICU, I noticed my daughter would turn her head toward sounds, so we alternated her head at different ends of the crib to force her to look both ways.

Hope this helps!!!

It is common, however continue to give him tummy time & hold him in other positions so he is not on the back of his head as you are doing. It happend to my son just a little on the back of the head. But I have seen & heard about kids getting bad deformed (if that is the right word for it) heads & have to wear those helmets. So be consistent about keeping him off the back of his head & try turning his head to the sides when he is sleeping with him on his back still. That worked for my son! He is perfectly fine, normal head now & he is almost 2.

Hi T.,
My first daughter experienced this. My advice is not to wait to address this. The longer you wait the worse it can get and you don't want to have to deal with a helmet. If you are open to a non invasive way I would strongly recommend this wonderful chiropractor. I took my daughter there when she was 9 months old, I wish I hadn't waited as long as I did. The earlier you catch it the better. He fixed her flat spot. It took a few months of visits but it was well worth it. He just applies pressure to certain points that will help her body work against whatever is causing it. He is in Wellesley.

Good luck!

Dr. Martin G. Rosen
471 Washington St
Wellesley, MA 02482
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http://www.jvsr.com/authors/index.asp?ID=559

Hello,
My son had the same problem with his head being flat. I know the dr's answers are frustrating, but it does end up being true...as soon as your son begins to sit up on his own, around 6 months, you will start to see some difference. I took my son to a plastic surgeon..at the pediatrician's request, and he was diagnosed with Plagiocephaly...flat head. My options were to do nothing (which I chose) or put him in a helmet for a few months, for the cost of $1200, not covered by insurance or guaranteed to help. We left it alone, and at around 8 months started to laugh at how much we had stressed out, since his head was fine!! He is now 13 months old and you would NEVER tell that there was even an issue. He has a perfectly rounded little head. good luck!!

I feel the same way about my 3 month old and I worry about her getting a flat head. She still needs her swaddle at night but during the day I try to keep her in a sling, upright and do some tummy time. At her 2-month appt. I asked her pediatrician about her head and she said it was a little flat but she wasn't worried about it at all and didn't recommend anything. My husband tells me not to worry about it either and that her head it fine but it seems to be my obsession. I did go online to research what exactly a "flat head" looks like and my daughter's head does not resemble one at all. I've heard similar responses from other people about once babies start to sit up more it won't be an issue. I'm not going to do anything about it in terms of propping or a wedge. I'm just going to continue to be mindful of time on her back. Let me know if you hear otherwise.

I agree with most of the advice you have already received. I have a little different perspective because I worked in a children's physical therapy office with a lot of babies and kids with flat heads. It is more common these days due to the back to sleep campaign and things will get better as your baby starts sitting up and moving around more. But you do need to be pro-active. You can't do enough tummy time. There are lots of ways you can get your baby to extend his spine other than just on the floor. Mix it up so it is more interesting and even if he isn't a fan you have to do it a lot. Beware of bouncers, etc because the also contribute greatly to the flat heads. Pretty soon he might be able to be propped up in an exersaucer or something like that that keeps the back of his head off of the floor. You also want to make sure that he doesn't always have to look over to one side more than another. Look at how his toys, crib, carseat are all set up. Give it a couple of months of really working on it. If he is still flat you will need to get more creative. I unfortunately saw a lot of kids that needed to be put in a helmet because their heads weren't addressed until almost 12 months old. They are changing and growing so fast that you can make a huge difference through your day to day activities. Good luck:)

I too am a 33 year old first time Mom and went through the same thing not so long ago (my daughter is 13 months old). I went to my pedi with the same concern, and he told me the same thing as yours. He told me it would start rounding out around 6 months, and he was right. My daughter HATED tummy time, and I didn't use anything in her crib b/c I was petrified of SIDS. Her head started rounding when she became more active, but I do sometimes think it still looks a little flat in the back, but nothing like before. I would hang in there and listen to your pedi (unless they've misled you before).

It is very common for that too happen...Eventually when he starts to sit up and do other things, his head will round out. I really wouldnt worry to much.

We worried about the 'flat spot on the head' with our daughter (who is 2 now). She would lie on her back but always, always, turned her head to the right and her flat spot was on the right side of her head! Relatives and the doctor said not to worry and after a long time (several months at least) her head rounded out again :)
It sounds like you are doing a lot to help your baby's head grow normally; as he becomes more mobile he will change positions on his own and should 'round out' nicely :)

Hi T.,
My little girl (6.5 months now) had the exact same issue - including the love of the swaddle at night. I did all you are doing now and it worked! Really, once she started sitting up and doing more (exersaucer play helped) upright activities, all was good. I was super paranoid about it and even prepared myself for the helmet, but no need! keep doing what you are doing. Be aware of too much back time during the day and simply mix it up. I never used the positioners. I'm thinking that 4 months is now too old for those now anyways - your boy must be beginning to roll and toss/turn at night anyways, right? My girl finally went unswaddled @ 3.5 months b/c she was rolling over and started sleeping on her belly. It was weird b/c she hated awake tummy time, but loved sleeping on her belly when she rolled over on her own at night. GOod luck.

Hi,
I did not have experience with flat head but I did use the wedge for my daughter. I was very worried about SIDS so using the wedge made it so she didn't wiggle or roll into a compromising position. I say it can't hurt but the decision is up to you.

Your child skull bones are not fully formed untill about 2 years old. You have time to prevent and change flat head NOW. Tummy time is all important for the development of neck, back and arm muscles. Lay him on your bed so he can't bang his face (as opposed to on a blanket on the floor). Teach him to roll onto his side then his back. Use toys for him to "track". back to front comes next. Do this several times a day increasing the time he will tolerate. Try not to use a swing or bouncy chair for more than 15-20 minutes at a time

As for sids... Place him on his back but don't swaddle. If you think he's cold add an extra layer or heavier layer of clothing to sleep in. There should not be anything in his crib, no toys, blankets, bumper pads or anything tied to the rails. If he can roll he can position himself. He doesn't need to stay on his back all night.
hope this helped

I wouldn't worry. I'd be more concerned with a wedge in the bed since babies can move (you won't be swaddling forever). This can cause a risk of suffocation if they get there face up against the wedge. Also, you are then running the risk of having a baby with a flattened SIDE of the head, instead of in the back. That would be worse, as far as I'm concerned.

If you're really worried, talk to your doc again. Remember, though, that once you stop swaddling, your baby is going to move around a bit in his crib so he won't always have his head flat against the mattress in the back. Good luck.

Hi T.,
I had the same problem as you. My son is now almost 7 months but when he was around 4 months his head was really flat on one side. I was really nervous about it to. Our pedi told us that if it didn't get better on it's own then we would have to take him to physical therapy for it. She also suggested making a donut out of a receiving blanket to lay his head on. When he started rolling over I couldn't get him to sleep on his back anymore, which was scary but it really helped his head. It's still a little bit flat but looks a lot better:) Once your baby starts sitting up and spending more time on his tummy his head will round out. Also, the ultra saucer is a good, fun way to get them off their backs. Try not to worry to much about it.
Good luck!

Hi T.! I had this problem with my oldest (she's now 3) because she was a great sleeper and was down for so long at night, not that that was a problem! But she was also slow to roll over and sit up, so I felt like she spent so much of her time on her back. I did the tummy time with her too, though she didn't like it! Anyway, the issue did resolve itself once she was a little older and started sitting up and staying awake for longer stretches. By the time she was 6-7 months, it was totally fine, and we joke now that her head is perfectly round! I did not use a wedge with her - my pediatrician also said what yours did, and I just trusted her and went with it. I was so overwhelmed being a first time mom and making sure she was sleeping on her back that I just wasn't ready to take anything else on at the time. I also asked a lot of other moms (like you're doing now!) and they all agreed that it would be okay when she was a little older. We have had no problems at all through the years. I hope this helps! Enjoy your baby - they grow WAY too fast!

but what the pedi says about them outgrowing the flat spot when they are more mobile is true. My youngest son had it till he started sitting up more. So they do outgrow it.

Hi T.,

My daughter was born with a football shaped head due to being wedged under my rib for over 10 weeks. The docs were concerned about her head becoming flat so they had us go to NOPCO at Boston Childrens hospital. They fit her for a head cup positioner which she slept in for about 2 months. She did not mind, did not even notice. I think it was like $150 bucks, insurance did not cover it 2 yrs ago because it was new. But it worked like a charm and we avoided having to do a helmet later. She has the most perfectly shaped head and she is 2. Hope this helps.

My daughter had the same issue--she is 5 months and her head is starting to reshape "normally" as she is able to spend more awake time on her belly or other positions (she is starting to sit and likes spending time in an exersaucer). When I talked to her pediatrician during the 4 month checkup, she said that since she had good neck control, not to worry. Is he able to support his neck & turn his head in both directions? Someone I know has a child who needs a helmet because of the flatness, but he didn't have good neck control and could only turn his head in one direction. I hope this helps.

Both of my son's had the same problem. When my oldest son began to show signs of this the pediatrician said not to worry just like the other responses however it did not correct itself and he has a flat spot on the back of his head. Poor kid hope he never asks me to get a whiffle. I changed pediatricians for my second son and what a difference. My younger son started to show signs and they recommended early intervention. They said helmets are mostly used when the flattening starts to shift the features like the eyes and ears. Look for symetry. The early intervention specialist gave me great tips to work with my son who hated traditional tummy time. lay baby on stomach with arms over a boppy which helps neck development and provides time off the back of the head, and the baby does not get as mad with his/her face in the floor. Doing airplanes with your arms or baby lying on your legs. Carry baby face out rather than snuggled in your arms. If you bottle feed make sure you switch which hand you use. This was a big one. My husband and I are both right handed so we were both holding him the same way putting pressure on the same spot every time he ate. An when you put your baby in the crib alternate every night which end you put his head. He will want to look out when he is awake so switching sides usually works to make him look a different way which is also true for changing the diaper if you use a changing table. Hope it helps. Have to say my second son's head looks much better than my oldest.

Okay, I have a 10 month old who's head is flat in the back. He is currently being treated at Cranial Tech in Clinton CT with a Doc Band to make it round again. They suggested repositioning him when he was younger in the crib so he's looking a different way before we went this route. I've heard that you can put fun toys to get him to turn his head and anything that would turn his head to a different side because they do start to favor one side. Also when you are holding him try switching the way you hold him. They told me once he starts rolling that would help round out his head. None of that worked now. Once he's sitting up though all the repositioning isn't going to work because you won't be able to get him to stay in the new position.

Let me explain the DOC band to you now. Our son will have to be in it for 12-14 weeks. He wears it 23 hours a day. We drive down to Clinton every 2 weeks to get it resized. They'll do it more often if you get it on at a younger age though. They do a free consultation so you can see if he would need a band or not. You can check out their website to get more info about it at www.cranialtech.com. It has been very helpful for us. He's been in it since the end of July and we already notice a difference. I almost wish we had seen them sooner. Good luck.

M.

Not sure if he likes to lie on his side but that's what I would do since he is getting older. Switch off each night. It drives me nuts because the Dr.'s have us so worried about SIDS that we tend to pay attention and forget that our babies can suffer from long term affects. I have seen children with those helmets to fix stuff like that. I know my son is almost 6 and his head is flatter on on-side than the other and when his hair is really short I notice it. It does bother me because I wish I made him move his head but that is the way he slept. Anything to keep him upright and not laying down will help, that's if he is ready for the "jumpa-roo" or exesauser, etc.

I agree that you shouldn't worry too much. I thought my daughters head was getting a little flat but she started moving around at night and eventually started sleeping with at least her head to one side of the other so she wasn't sleeping all night in the same position. And once your son starts rolling over, you don't need to worry about making sure he sleeps on his back. If he is already rolling over, I wouldn't keep him swaddled because that will force him to stay on his back and he won't get the chance to give the back of his head a rest. At 4 months, he's probably starting to show signs of rolling over if he's not already doing it. So don't worry, it should fix itself!!