Flat head syndrome is the name given to the condition noticed in babies when they develop a significantly flattened part of their skull.
There are 2 main types of flat head syndrome:
This is where the baby’s head becomes flattened on one side. This is most commonly positional, and is caused by the baby favouring their head to one side, and the pressure of whatever surface the baby is on repeatedly over time causes the skull to develop flatter. Plagiocephaly can also be caused by craniosynostosis (when the gaps between the baby’s skull bones fuse too early) but this is far less common.
This is where the baby’s head become totally flattened at the back, and the skull takes on a strange widened effect. This is seen a lot in “good” babies who end up quite happily lying on their back for long periods of time.
Why does this happen?
When an infant is ready to be born, their skulls have to be very mouldable. This is to allow safe passage into the world through the birth canal. The many small bones of the skull shift over each other during birth and then in an ideal world, just pop back out again into a perfect head shape.
Whilst some skull distortion is normal in the early days, any skull malformation after 2weeks could be a cause for concern. I often see plagiocephaly cases in babies who have had an assisted delivery (forceps or ventouse) or a prolonged second stage. I have also seen cesarean babies with similar issues, so a restriction in utero may be a contributing factor. The truth is, nobody knows for sure the exact moment that these problems begin.
If a baby’s head is fixed in a certain position then they aren’t likely to move their head much in a less comfortable position themselves. So say for example, baby Thomas had a slow delivery, with exhausted Mum pushing for 2 hours to try and get him out. All seems well and when he is a month old, mum is looking back through pictures on her phone and notices he always holds his head the same way. His head is always slightly twisted around to the right. She mentions it to the health visitor but she says this is nothing to worry about. Another month flies by and Mum notices that Thomas’s hair at he back of his head has rubbed off on one side only. She doesn’t often look at the back of his head so doesn’t worry about it too much. Another month passes and Granny mentions a “flat spot”. Mum noticed it too but just assumed it would go away. Thomas now always sleeps facing the right side and never turns his head to the left. More weeks pass, Mum mentions the worsening flat head to the doctor and the doctor claims “You won’t notice it when his hair grows in…” Mum is left confused and upset.
I hear stories like this at least weekly.
As it stands in our locality, no treatment is available on the NHS for flat head syndrome. Banchory Chiropractic Clinic is experienced in dealing with this problem, and see many babies with flat head syndrome. That being said we only spend a comparatively small amount of time with your little one, and often we see babies later than we would like. This is why it is essential to do everything you can to help this condition or even better – avoid it beginning in the first place.
Often parents who bring their babies in with flat head syndrome tell me they wish they had come sooner. I urge you to trust your instinct; have an experienced bodyworker such as a chiropractor or osteopath check your baby for body tension patterns that can result in asymmetries.
In the meantime – here are some important things to get into the habit of doing to improve or even avoid your baby developing a flat head.
Minimise use of travel systems
Travel systems have undoubtedly made the life of the modern mother much easier. Being able to lift your car seat straight out of the car and onto the buggy without even altering any seatbelts definitely saves a lot of stress. However… These travel systems unfortunately encourage the baby to remain in the same position for a very long time. If you have a particularly chilled out baby they might often spend hours in the car seat without you realising.
Car seats are a necessary evil, but please be aware that the practice of having your baby in and out of a car seat for most of the day will undoubtedly make a flat head worse.
Take some time to notice where you baby focuses the majority of his attention while in the car. If you baby likes to look out the window, position the car seat on the side of car so that the baby rests on the rounded side of the head to look out the window. If your baby likes to look into the car, then position the seat on the side of the car so that the baby has to turn to rest on rounded side of the head to look inside of the car. If your baby has no preference, you can always help encourage the baby to rest on the rounded side by hanging some toys on back rest of the car’s seat or using a suction cup type mobile and sticking it on the window.
I know it is not always possible to avoid using the car seat, but whenever you can, please consider using a carrier instead and try to only put the in their car seat when they are in the car!
For me, having a baby carrier was a lifesaver. I couldn’t imagine parenting my children without one! There are loads of reasons why you should get comfortable using a carrier (a great article to read about it HERE) but as a chiropractor I am especially focussed on how great it is for your baby’s optimal spinal and skull development.
With a carrier, you don’t have the problem of your baby’s skull getting any pressure on it. So if your baby has a flat spot developing then a really easy way of avoiding any pressure on it is to put them in a carrier.
I appreciate that not everyone is confident using a wrap or carrier with their baby. This is why it’s a great idea to get some help with it. Our local NCT holds a brilliant “sling meet” once a month, with loads of different wraps and carriers to get your started. If you miss that, there are a few private “sling consultants” to help you find the carrier that works best for you and baby. Read THIS for more information
Baby seats and bouncers
Most babies with plagiocephaly will favour turning their head to the side of the flattened area. Often these seats/chairs will stay in the same place in the home. It might also be the case that the seat faces something exciting for the baby to look at, maybe mum tends to be busy doing something to one side, or the TV might be on, or there is a sibling to watch!
If you think this might be something that happens in your home, consider moving the baby seat around so baby has no choice but to turn their head to watch everyone else. Babies will always favour watching something exciting than a blank wall.
The same concept goes for any rugs/cots/playgyms that your baby frequently spends time on.
Your health visitor will by now have mentioned how important it is for your baby to have tummy time. I personally believe tummy time is essential for your baby’s development, whether it be time lying tummy down on a parent or on the floor. Usually tummy time has to be little and often as many babies won’t like it at first. The sooner you start this practice the better! Even if your baby manages a minute at a time, this is fine, just keep cuddling baby and try again and again. I also love the tummy time roller cushions, I find many babies will enjoy lying on these. An example of one I recommend here:Baby Einstein Rhythm of the Reef Prop Pillow. Be led by your baby in terms of how much tummy time they will tolerate, but please keep trying.
As a general rule, you want to try and avoid any pressure of any kind on the “flat spot” of your baby’s head, and encourage them to put pressure on the more rounded side. Of course some pressure will occur, but over time things will improve with perseverance. Correcting a flat head is a marathon, not a race!
Some cranial bones begin to fuse at around 12 weeks (we use this as a sort-of indicator of how effective treatment will be) so I find that the earlier these problems are looked at the better the physical outcomes are. It is NEVER too late to see an improvement, but the level of improvement varies depending on how early the treatment begins. We see many babies with this problem, and whilst you can do everything you can at home to improve plagiocephaly, our job is to release any tension patterns that are causing your baby to be in this position.
Our number is 01330 824040 should you have any questions or concerns.
We run a drop-in infant baby clinic in Banchory on Mondays from 10-12. There is no need to book and there are toys set up and usually lots of other mums in the same position as you! For more information about our drop in clinic, visit our webpage HERE.