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Your Baby's Head Shape: 5 Tips to Prevent a Flat Head

Baby developmental head shape

Many infants and young children develop a flat spot on their head, often due to favouring turning their head one way more than the other. This flat spot is known as plagiocephaly. Plagiocephaly develops in infancy because newborns have very soft skulls and prolonged pressure on one spot causes flatten to that area. Over a period of time, this makes the head look misshapen, including the forehead protruding more on one side or mild facial asymmetries.

The incidence of plagiocephaly has increased from 1 in 300 in the 1970s to 1 in 10 today. Many believe that this increase can be attributed to more infants sleeping on their backs since the Safe Sleeping Guidelines were introduced in the 1990s. Plagiocephaly, though often a concern for parents, is mostly innocuous. The appearance of a flat spot can be worrying to parents, however in most cases it does not affect a child's development or the growth of their brain. A child's head continues to grow and mould significantly in the first year of life, and continues to change shape until 3 to 4 years old. In many cases, children can also have a tight muscle in their neck and favour looking to one side. This is known as torticollis. If this persists, the flat spot may continue to progress and your child may be slower to develop their motor skills on the non-preferred side. It is important to encourage your infant to turn their head to both sides and spend as much time off their back when awake.

5 Tips to Prevent a Flat Head

1. Alternate your baby’s head position with each sleep

Babies spend a lot of time sleeping, and if they are always lying with their head to one side, this places pressure on the same area and a flat spot will develop. Always follow Safe Sleeping Guidelines and place your baby sleeping on their back. However, when putting your baby to sleep, take note of which way their head turns, and for their next sleep turn it to the other side.

2. Change the set-up of your nursery

If your baby prefers to turn their head one direction, take note of your nursery set-up and what stimulus is on their preferred side. Simple things such as which side of the cot you approach your baby or which side of the cot faces the door or a window are enough to encourage a preference to look one way. You might have to change the way your cot faces or when you change the linen of your baby’s cot, change the end your baby’s head goes. These are simple ways to alternate which side your baby has to turn their head to look around the nursery or to look up at you.

3. Reduce how much time your baby spends on their back when awake

It is important to minimise the time your baby spends on their back when they’re awake. This means carrying them in upright positions, such as using a baby carrier or supervising time in a bouncer or supportive chair for short periods. Try to talk and play with your baby from their non-preferred side more eg. place yourself and toys on the non-preferred side when playing.

4. Tummy time, tummy time, tummy time...when your baby is awake!

Tummy time is not only an important gross motor activity but also reduces the time your baby spends on their back when they’re awake. Tummy time helps to develop your baby’s neck and back muscles which helps with their ability to turn their head from side to side and hold their head up when supported in carrying positions.

5. Visit your maternal child health nurse or family doctor

If you are concerned about the amount of flattening of your child’s head or if your child persists with a preferred side to turn their head, speak to your maternal child health nurse or family doctor. They can refer you to a paediatric physiotherapist who can assess your child to rule out any physical reasons for the preference and provide you with more advice on exercises and activities to address your child’s plagiocephaly. Thank you for reading. If you need, I'm only an email or phone call away. Wishing you the best, Francyne Finlayson Paediatric Physiotherapist Physiotherapy of Children

0413 588 414

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