The Ultimate Guide to Flat Heads in Infants

Introduction to Plagiocephaly (Infant Flat Head Syndrome)

Plagiocephaly, or flat head syndrome, is a condition where a baby’s head develops flat spots, often due to the restricted neck movement caused by torticollis as well as many other factors. Torticollis is a condition where a baby has tight or shortened neck muscles that limits their ability to turn their head freely. While there is ongoing debate about whether torticollis develops in utero or after birth, studies suggest a higher incidence of pre-birth onset. This leads to prolonged pressure on one side of the skull. Skull flattening can develop in the first few months of life, particularly in babies who spend a lot of time lying on their backs, such as nighttime sleeping and daytime positioning. While it’s relatively common and usually not a cause for major concern, it’s important to recognize the signs early so that you can take steps to prevent or treat it.

In this guide, we’ll walk you through the causes, signs, and treatment options for plagiocephaly. You’ll also find advice on what to expect during treatment, tips for supporting your baby’s development, and resources to help you along the way.

The good news is that with early intervention, head flattening can be treated effectively, and most children respond well to treatment without any long-term issues. However, when left untreated, it may lead to complications such as facial asymmetry or developmental delays in rare cases. That’s why paying attention to your baby’s head shape and seeking advice from healthcare professionals is so important.

2. Understanding Infant Flat Head: Causes and Risk Factors

Infant Flat Head Syndrome or Plagiocephaly can develop for a variety of reasons, and understanding the causes and risk factors is key to preventing it or addressing it early on.

Common Causes:

●  Sleeping Positions:

Babies have soft skulls, and when they spend a lot of time lying on their backs in one position, pressure on one side of the head can cause flattening. This is especially common during the first few months when babies are still developing neck control. The American Academy of Pediatrics recommends tummy time and when babies are awake and supervised to help reduce this risk.

●  Premature Birth:

Babies who are born prematurely are more likely to develop flat head syndrome. Their skulls are softer and more vulnerable, and they may spend more time lying on their backs in a neonatal intensive care unit (NICU), which can increase the likelihood of flat spots developing.

●  Torticollis (Neck Muscle Tightness):

Some babies are born with a condition called torticollis, where the muscles on one side of the neck are tighter, causing them to favor turning their heads in one direction. This uneven positioning can lead to flat spots forming on the side of the head that is consistently resting on a firm surface (e.g., mattress).

Risk Factors:

●  Daytime Positioning Habits:

Babies who spend a lot of time lying in car seats, swings, or bouncers where they can’t move their heads freely are more at risk for developing flat head syndrome.

●  Multiple Births:

Twins or higher-order multiples are more likely to experience head flattening due to limited space in the womb, which can cause prenatal head molding.

●  Male Infants:

Studies have shown that male infants are slightly more likely to develop flat head syndrome compared to females, although the reason for this is still unclear.

Encouraging Early Observation:

If you notice that your baby prefers turning their head to one side or is always lying with their head resting on a particular spot, it’s important to act early. Simple habits, like adjusting their sleeping position or offering more tummy time, can help prevent or reduce the severity of the head flattening.

By being aware of the common causes and risk factors, you can take steps to minimize the chances of your baby developing flat head syndrome or address it quickly if it occurs.

3. How to Recognize the Signs of Flat Head Syndrome in Your Baby

It’s important to check your baby’s head regularly, especially in the first few months, to spot any signs of head flattening early.

How to Check for Flat Spots, Asymmetry, and Disproportion:

1. Lay Your Baby on Their Back: Check to see if the baby can easily turn their head to the right and left. A flat area in the back on one or both sides is a common sign.
2. Look for Head Asymmetry or Disproportion: Observe the head from above—one side may appear more rounded or pushed forward than the other. The head may appear abnormally wide or abnormally narrow.
3. Check Neck Movement: See if your baby consistently turns their head to one side, which could indicate torticollis or limited neck movement.

Early Signs to Look for and When to Consult a Healthcare Provider:

• A flat spot or asymmetry that doesn’t improve with repositioning or tummy time.
• Your baby’s head appears to be misshapen or uneven, especially as they get older.
• Difficulty moving their head or consistently tilting their head to one side.

If you notice any of these signs, it’s important to consult your pediatrician. They can perform an assessment and determine whether flat head syndrome is present, and if so, what the best course of action is. Early intervention is key to avoiding long-term effects and ensuring your baby’s healthy head development.

Visual Cues for Differentiating Mild from More Pronounced Cases:

• Mild Cases:

In mild cases, you may notice subtle flattening on one side of the head, but there will still be noticeable roundness overall. There may be minimal or no noticeable tilt of the head, and babies with mild cases can usually turn their neck freely.

• More Pronounced Cases:

In more pronounced cases, the flattening will be more noticeable and might affect not just the back of the head but also the forehead and ear positioning. There could be visible asymmetry or noticeable neck stiffness, and the baby may struggle to turn their head.

4. Diagnosing Infant Flat Head: What to Expect from Healthcare Professionals

If you suspect your baby has flat head syndrome or plagiocephaly, it’s important to consult a healthcare provider for a proper diagnosis. Pediatricians are trained to identify and assess the severity of the condition.

Diagnostic Methods:

• Physical Exam:

The first step is a physical exam where the pediatrician will check the shape of your baby’s head, observe their neck movement, and assess overall head symmetry. They may also check for signs of torticollis or other underlying conditions. Find a clinic here to schedule a free evaluation for your child.

• Imaging:

In some cases, your doctor may recommend a referral to a craniofacial specialist if the condition is more severe, or they suspect any bone abnormalities. The specialist may order an x-ray or 3D imaging to get a more detailed view of your baby’s skull.

Importance of Early Diagnosis:

The earlier flat head syndrome is diagnosed, the easier it is to treat. Mild cases can often be improved with simple positional adjustments, while more severe cases may require helmet therapy or physical therapy. A timely diagnosis can prevent complications, such as facial asymmetry or developmental delays.

What to Expect During the Assessment:

• Head Measurement:

The pediatrician will measure the shape and size of your baby’s head to track any changes over time.

• Neck Mobility Check:

Your healthcare provider will check your baby’s neck flexibility and positioning to rule out torticollis or other conditions that may contribute to infant flat head syndrome.

• Questions About Habits:

They may ask about your baby’s sleep positions, feeding routines, and time spent on their back or in car seats, swings, or bouncers.

Once a diagnosis is made, your healthcare provider will discuss the best course of action and may refer you to a specialist if necessary.

5. Treatment Options for Flat Head Syndrome – Plagiocephaly

Once plagiocephaly is diagnosed, there are a variety of treatment options available, depending on the severity of the condition. Early intervention is key to ensuring your baby’s head develops properly.

Positional Therapy:

The most common first step in treating infant flat head syndrome is positional therapy. This involves changing your baby’s position to relieve pressure from the flattened area of the skull. Here’s how parents can help:

• Tummy Time:

Make tummy time a frequent daily routine, starting as early and as often as possible. This helps strengthen the neck muscles and relieves pressure from the back of the head.

• Repositioning:

Change your baby’s head position while they are sleeping or resting to avoid putting pressure on the same side of the skull.

• Carrying Your Baby:

Instead of always placing your baby in a swing, hold them upright or use a baby carrier to give their head a break from pressure. Car seats should be reserved for safety during driving and not as alternate carrier.

Physical Therapy:

If your baby is diagnosed with torticollis (neck muscle tightness), a physical therapist may recommend exercises to help improve neck flexibility and prevent the head from turning to one side. These exercises can help your baby move their head more freely and relieve pressure on the flattened area of the skull.

Orthotic Helmet Therapy:

For more severe cases, orthotic helmet therapy may be recommended. This involves custom-made cranial helmets designed to gently reshape your baby’s head as they grow. The helmet works by resisting growth in areas of the skull that do not need to grow while allowing space for the flattened areas to expand.

Orthotic helmet therapy is most effective for babies between 4 and 6 months of age, as this is when their skulls are growing the fastest. As the child gets older, between 6-12 months of age, treatment is still an option, but the infant’s head growth is slower. Treatment usually lasts between 3 to 6 months, depending on the severity of the condition.

6. What to Expect with Orthotic Helmet Therapy

Helmet therapy is an effective treatment for more moderate to severe cases of flat head syndrome or plagiocephaly. If your baby is prescribed a helmet, here’s what you can expect during the process:

Timeline of Therapy:

• Scanning for the Helmet

The orthotic clinician will use a scanning device to acquire a three-dimensional (3D) image of your baby’s head. This is a very safe and quick experience, and is often completed in a few seconds or a couple of minutes at most.

• Fitting the Helmet:

Your baby’s helmet will be custom-made based on measurements of their head. The fitting process usually takes about an hour. Your specialist will ensure that the helmet fits correctly and comfortably.

• Treatment Duration:

Helmet therapy typically lasts 3 to 6 months, depending on the severity of the condition and your baby’s age. Treatment may be shorter or longer, but most babies wear the helmet for 23 hours a day, with only short breaks for cleaning or feeding.

Tips for Parents:

• Ensuring Comfort:

It may take a few days for your baby to get used to wearing the helmet. Start with short periods and gradually increase the time as they adjust. Be sure to apply the helmet correctly each time and check their skin each time it is removed.

• Maintaining the Helmet:

Helmets need to be cleaned regularly to ensure hygiene. Follow the care instructions provided by the manufacturer or cranial clinicians. This usually involves cleaning the helmet with shampoo and a soft toothbrush and then disinfecting it with isopropyl alcohol. Both the baby’s head and the helmet but be completely dry before the helmet is reapplied. Some babies may need to wear a liner inside the helmet to keep it clean.

• Monitoring Progress:

Regular follow-up appointments with your healthcare provider will allow them to monitor your baby’s progress. They may adjust the helmet to ensure it’s continuing to reshape the skull as needed.

Adjusting to Helmet Therapy:

While it can take some time to get used to wearing a helmet, most babies adapt quickly. As your baby’s skull gradually reshapes, you’ll begin to notice improvements in the overall symmetry of their head. Be patient, as the process can take a few months, but with time, the results are often very positive.

7. Lifestyle Adjustments for Parents

Supporting your baby through orthotic helmet treatment can require some lifestyle adjustments. Here are some practical tips to make the process smoother for both you and your baby:

Practical Tips During Treatment:

1. Sleep Positioning:

Continue to place your baby on their back to sleep, as recommended by pediatricians to reduce the risk of SIDS. However, make sure to vary their head position during sleep by gently turning their head from side to side. You can also try using a specialized sleep pillow, under your pediatrician’s guidance, to help reduce pressure on their head.

2. Incorporating Tummy Time:

Tummy time is essential for strengthening your baby’s neck and shoulder muscles. Aim for several short tummy time sessions each day, gradually increasing the duration and frequency as your baby gets stronger. This not only helps reduce the pressure on the back of the head but also promotes overall development.

3. Feeding Adjustments:

If your baby is used to feeding in one position (e.g., always lying down), try changing their head position slightly during feedings. Hold them in different positions to prevent constant pressure on the same side of their head.

4. Use of Baby Gear:

Minimize the amount of time your baby spends in car seats, swings, or bouncers. While these items are convenient, they can put additional pressure on the back of your baby’s head. Encourage them to spend more time on their tummy or being held upright.

Managing Time and Care Routines:

• Create a Routine:

Balancing helmet therapy with other daily tasks can be challenging. Establishing a consistent routine for feeding, tummy time, and helmet wear can help keep things organized.

• Take Breaks:

Caring for a baby in treatment can be demanding. Make sure to take time for yourself, whether that’s asking for help or taking a break when your baby is resting.

By incorporating these small adjustments into your daily routine, you can help your baby’s head shape improve while also supporting their overall development.

8. Myths and Facts about Infant Flat Head and Helmets

There are many misconceptions surrounding flat head syndrome and the use of helmets for treatment. It’s important for parents to have accurate information to make informed decisions. Let’s debunk some common myths:

Myth 1: Helmets Are Harmful for Babies

• Fact: Cranial helmets are safe and specifically designed to be worn by babies. They are carefully fitted to ensure comfort and allow for healthy skull growth. Helmets are regularly monitored and adjusted as needed during treatment.

Myth 2: Helmet Therapy Is Only for Severe Cases

• Fact: Helmet therapy is recommended for moderate to severe cases. Early intervention can provide better outcomes.

Myth 3: Wearing a Helmet Will Make My Baby’s Head Look Worse

• Fact: The purpose of helmet therapy is to gently reshape your baby’s head by capitalizing on natural head growth patterns. As the helmet resists growth in certain areas, it helps the skull to grow in a more symmetrical and proportional manner. The orthotic helmet mis a proven treatment for improving head shape.

Myth 4: Helmets Are Uncomfortable for Babies

• Fact: Babies typically adjust to wearing a helmet after a few days. The helmets are lightweight and breathable, and parents can monitor comfort by ensuring the helmet is applied properly and isn’t causing irritation.

By addressing these myths, parents can feel more confident in their decision to proceed with orthotic helmet therapy and better understand the role helmets play in their baby’s treatment.

9. Frequently Asked Questions About Flat Head Syndrome

Parents often have many questions about flat head syndrome and the treatments available, especially when it comes to helmet therapy. Here are some of the most common questions and answers to help guide you through the process:

1. What causes flat head syndrome in babies?

Flat head syndrome in infants, or plagiocephaly, is often caused by prolonged pressure on one part of the baby’s skull. This can happen when babies spend a lot of time lying on their backs, particularly during sleep. Other contributing factors include premature birth or conditions like torticollis, which can limit head movement.

2. Can flat head syndrome be prevented?

While you can’t prevent all cases of flat head syndrome, you can reduce the risk by giving your baby plenty of supervised tummy time while they are awake and ensuring that they alternate head positions during sleep. Avoid keeping your baby in car seats, swings, or bouncers for extended periods.

3. How do I know if my baby needs a helmet?

If your baby’s head remains flat or becomes increasingly misshapen despite positional therapy, helmet therapy may be recommended. A pediatrician or specialist can assess the severity of the condition and guide you on the best course of action.

4. Is helmet therapy painful for babies?

No, helmet therapy is not painful. The helmets are lightweight, custom-fitted, and designed to be comfortable for babies to wear. While there may be an initial adjustment period, most babies get used to wearing their helmets within a few days.

5. How long will my baby need to wear the helmet?

Typically, babies wear helmets for 23 hours a day, with a break during bath time or for cleaning. Treatment lasts between 3 to 6 months, depending on the severity of the condition and your baby’s progress.

6. Can my baby sleep in the helmet?

Yes, your baby can sleep in the helmet. Always follow the instructions given by your helmet provider and ensure that your baby is comfortable.

7. How will I know if the helmet is working?

Regular follow-up appointments with your healthcare provider will help track your baby’s progress. The helmet will be adjusted as needed to ensure optimal reshaping. Over time, you should see gradual improvement in the symmetry and proportion of your baby’s head.

8. Resources for Parents

As a parent navigating the journey of treating infant flat head syndrome, it’s helpful to have access to reliable resources and support networks. Here are some trusted resources to guide you:

Support Groups and Communities:

• Flat Head Syndrome Support Groups:

Connecting with other parents who are going through similar experiences can be incredibly helpful. Online forums and social media groups provide a space for sharing advice, tips, and emotional support.

• Parenting Communities:

Many general parenting communities also offer advice on managing flat head syndrome. Websites like BabyCenter and What to Expect have active forums where parents share their experiences and offer support.

Reputable Organizations:

• Plagiocephaly Support Organization:

This organization provides resources and information on plagiocephaly, including treatment options and guidance for parents.

• American Academy of Pediatrics (AAP):

The AAP offers a wealth of information on infant health, including safe sleep practices and prevention of flat head syndrome. Their website is a great resource for up-to-date medical guidance.

• ●  Starband’s Resources:

As part of the Starband family, you can access additional information on helmet therapy, treatment options, and tips for caring for your baby during this time. Starband provides expert advice and is always ready to support you through every step of the process.

Finding Professional Help:

• Pediatricians and Specialists:

If you suspect your baby has flat head syndrome, the first step is always to consult with a pediatrician. As needed, they can refer you to specialists such as pediatric physical therapists, orthotists, pediatric neurosurgeons or cranial specialists who can assess the condition and recommend appropriate treatment options.

• Orthotic Helmet Providers:

Once treatment has been decided, you will likely work closely with cranial helmet specialists who will help with the fitting and monitoring of your baby’s helmet therapy.

Conclusion:

Navigating the journey of flat head syndrome treatment can feel overwhelming at times, but with early intervention and proper care, the outlook for your baby is positive. Remember that you are taking important steps to ensure your baby’s healthy development and a well-rounded future.

Treatment for infant flat head syndrome is a journey, and it’s completely normal to have questions and concerns along the way. The good news is that you’re not alone. With the right support, whether from healthcare professionals, support groups, or fellow parents, you can feel confident that you are making the best decisions for your baby’s well-being.

Next Steps for Your Baby’s Treatment:

1. Consult with a Pediatrician:

If you haven’t already, schedule an appointment with your baby’s pediatrician to discuss any concerns you may have about their head shape and whether helmet therapy is the right option.  Find a clinic here to schedule a free evaluation for your child.

2. Start Helmet Therapy:

If a helmet is recommended, remember that it’s a proven method for reshaping your baby’s head and promoting healthy skull development. Be patient and consistent with the therapy for the best results. You can take a look at our Starband Collection here.

3. Support Your Baby’s Development:

Continue to incorporate tummy time, neck stretches, and interactive play to help your baby develop strong muscles and motor skills. Following the guidelines given by your pediatrician.

4. Keep Following Up:

Regular follow-up appointments will be crucial to track your baby’s progress. Don’t hesitate to reach out to your healthcare provider with any concerns.

By taking these steps and staying informed, you’re providing your baby with the best possible foundation for healthy development. We hope this guide has given you the knowledge and confidence to navigate your baby’s treatment and next steps.

Take the Next Step in Your Baby’s Journey

If you’re ready to learn more about helmet therapy or have questions about how to get started, contact Starband today and get a free evaluation. Our experts are here to guide you every step of the way, offering personalized solutions and support to ensure the best outcome for your baby’s development.

Get in touch or schedule a consultation to learn more about how we can help transform your baby’s future.