Plagiocephaly: Preventing Flat Heads in Babies


Over the last ten years there has been an increase in the number of babies with flat spots on their heads (plagiocephaly).  In 1992 the AAP recommended placing babies on their backs to sleep.  The Back to Sleep campaign was introduced to prevent SIDS deaths.  Since the program was launched the SIDS rate has dropped by 40%. However, one side effect of the campaign has been a significant increase in the cases of plagiocephaly.  This does not mean you should stop putting your baby to sleep on his back.  Plagiocephaly does not cause brain damage and it is treatable.

There are many things you can do to keep your child from getting a flat head.  Reducing the amount of time baby spends laying in the same position is the number one thing you can do to prevent plagiocephaly.  Many new moms misunderstand that back to sleep does not mean never put baby on their tummy.  Babies can spend time on their tummies while they are awake and supervised. The importance of tummy time is not always stressed to new moms.  The time frame for developing plagiocephaly is usually when babies are young and not able to move off of their back on their own.

Babies should get lots of tummy time when they are awake.  Some babies do not like tummy time.  They may get accustomed to being on their back and prefer it.  If you start doing tummy time right away this will help.  Babies may like to be on their backs more because they can look around easier.  If they haven't developed the physical strength to hold their head and neck up, they may not like to stay on their tummy.  If your baby does not like tummy time try putting them on their tummy for short periods of time at first.  Lay on the floor with baby and use toys or singing to distract them.  Each time you do tummy time, work on getting them to spend more time on their tummy. 

Another contributing factor is babies that spend a lot of time in car seats, swings or bouncy seats.  Babies spend so much time sleeping when they are young infants that any extra time with pressure on the back of their heads only adds to the flattening.  Try to avoid putting baby in the car seat or swing for long periods of time. 

Babywearing may help prevent plagiocephaly.  Babywearing is when you carry baby around in a sling during the day.  This will keep limit how much time baby spends with pressure on the back of his head.  Plus, there are many other benefits to baby.

Some babies also develop torticollis, which is a shortening or tightening of the neck muscle.  Baby spending too much time with his neck turned in one direction can cause it.  To prevent this try to alternate which way baby's head is turned when you put him to sleep.  If he is developing a preference to tilt his head in one direction try using toys to get him to turn his head the other direction.

Furthermore, there are treatments for plagiocephaly and torticollis.  If you notice a flat spot forming on your baby's head or that he is tilting his head in one direction consult your doctor for advice.  Some methods of treatment for plagiocephaly and torticollis include neck exercises to do with baby, physical therapy, and in extreme cases fitting baby with a helmet. 

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