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Many babies develop a flattened head when they are a few months old, usually from sleeping on their back. It often corrects itself over time and is nothing to worry about.
It happens because a baby's skull is still soft enough to be moulded and to change shape if there is constant pressure on a particular area of their head. The skull is made of plates of bone, which only start to strengthen and fuse together as the child grows older.
Flattening of the head is just a cosmetic problem. It doesn't cause any symptoms and doesn't affect the baby's brain, so their development is unaffected.
This page explains:
Brachycephaly vs plagiocephaly
There are two main ways a baby's head can become flattened:
Why some babies are affected
The main cause of brachycephaly or plagiocephaly is the baby's sleeping position, although other factors play a part too. These are discussed below.
Brachycephaly and plagiocephaly are commonly caused by the baby sleeping on their back every night. The back or one side of the baby's head (if their head naturally rolls to the side) is squashed against a firm mattress for a long period of time, which eventually forces the soft bone of the skull to flatten.
Once flattened, the baby's head will automatically stay on or roll towards this side and it becomes the preferred side for sleeping and for resting their head during the day.
The solution, however, is not to change your baby's sleeping position from lying on their back at night. It's important for babies to sleep on their back, as this reduces the risk of sudden infant death syndrome (SIDS).
Insetad, you should aim to change your baby's position during the day to take some pressure of the flattened area - see the section on 'What you can do', below.
Factors in the womb
Flattening of the skull can sometimes occur in the mother's womb.
There may not be enough amniotic fluid inside the womb to cushion the baby (known as oligohydramnios), which means the baby's head can become temporarily deformed as they travel down the birth canal.
Also, it tends to happen more often when there is a multiple birth - for example, when twins squash against each other in the womb.
Giving birth prematurely
Premature babies are more likely to have a deformed skull because they are squeezed through the birth canal when their skulls have not fully developed (the skull becomes stronger in the last few weeks of pregnancy).
Sometimes, a baby will have tightened muscles in their neck, which prevents them from turning their head one way and means they will always rest their head on the other side, causing this side to flatten. Physiotherapy can help correct this problem (see What you can do, below).
A flattened head may sometimes be caused by the bony plates of a baby's skull joining together abnormally early - known as craniosynostosis. This can pull the baby's head out of shape, and will need to be corrected with surgery (see below).
What you can do
In mild cases of brachycephaly and plagiocephaly, no treatment is necessary. Your baby's skull should naturally correct itself over time, if you take some simple measures to take pressure off the flattened part of their head and encourage them to try different positions. You may find the following advice helpful:
It may take 6-8 weeks of doing the above measures before you notice any improvement in your baby's head shape.
In cases of craniosynostosis, where the plates of your baby's skull have fused too early, surgery will be needed to unlock and move the bones. Read more about the treatment of craniosynostosis.
Should I try a helmet or skull band?
You may have heard about helmets or headbands, known as cranial orthoses, that aim to improve symmetry of a baby's skull. These custom-made devices are designed to be used in infants aged 6-12 months (during the period of greatest skull growth), to apply pressure to 'bulgy' parts of the skull and relieve pressure from other parts, enabling growth in the flatter areas of the skull. The device may also prevent your baby from lying on the flattened part of their head.
However, their use is controversial. There is currently not enough evidence to say for sure whether a helmet or headband will make any additional improvement to your baby's head shape if the above measures are taken early on.
Also, you should consider the following:
Mild flattening of the head usually corrects itself with simple measures to take pressure off the affected area of the skull.
More severe cases of brachycephaly or plagiocephaly can still be improved over time, but some flattening usually remains. However, the hair may cover this so it is not noticeable, and it's unlikely to result in teasing or bullying at school.
A helmet or headband may help to correct your baby's skull shape, but this is not certain. You should weigh up the inconvenience, expense and possible discomfort to your child before trying this.^^ Back to top
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