Is Your Baby’s Head Flat on One Side?

By Deirdre Wilson

Thousands of infant lives have been saved since the 1992 launch of a campaign urging parents to put their babies to sleep on their backs to prevent sudden infant death syndrome (SIDS). But neurologists say the effort has also led to a condition called “positional plagiocephaly,” where one side of a baby’s head is noticeably flatter than the other.
While this is easily treatable, it can be worrisome to new parents.

Is Your Baby's Head Flat on One Side? “I see many babies with flattened heads, and their parents are distressed that this is going to be a permanent condition and inevitably affect their child’s self-esteem,” says Monica Wehby, M.D., a pediatric neurosurgeon and spokesperson for the American Association of Neurological Surgeons (AANS).

Wehby advises parents who are concerned about their baby’s misshapen head to see their pediatrician first for a proper diagnosis. In a small number of cases, infants are born with a more serious form of plagiocephaly – a deformity caused by premature closure of the fibrous joints between the skull bones. A thorough examination is needed to rule this out, she says.

Because of SIDS awareness, many babies spend nearly all of their time on their backs and that increases the likelihood of positional plagiocephaly. To reduce this likelihood, the AANS offers these tips, which yield the best results if started before the baby is 4 months old:

• Place your baby with his head turned to the side that he usually does not sleep on. You can do this by placing a towel roll or rolled-up blanket beneath his back and hip on the flattened-head side, so that he’s positioned to 45 degrees. Put interesting objects on the opposite side of the crib to attract his attention. To prevent suffocation, never put a towel or blanket under the baby’s head. If you’re worried about the baby wriggling off the rolled towel during sleep, try using Velcro or tape to secure the roll to his body.

• Be sure there is no undue pressure on the flat side of the head when holding, feeding or carrying your baby. Change her position from side to side during feeding time.

• Provide plenty of supervised play time with your baby on his tummy, which helps build and strengthen neck, shoulder and arm muscles.

If these strategies don’t work, helmet or band therapy may be recommended. A baby would usually wear a doctor-recommended helmet or band for 23.5 hours a day, with a half hour set aside for bathing. If started between 3 months and 6 months of age, this treatment can be completed within 12 weeks.

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