One evening when my youngest son was about 2 months old, I looked over at my son asleep on my husband’s chest and a soft stirring melody started playing in the background, birds straight out of Sleeping Beauty began to chirp in the distance.

I just couldn’t help but sigh overcome with emotion at the perfect and beautiful sight.

Oh wait that doesn’t sound right ….

Maybe that was the commercial playing in the background 9because that’s how ad execs just LOVE to portray life with an infant). In reality I think it happened more like this:

My husband was partially conscious on the couch after we both got about three hours of sleep the night before, I’m cleaning off the kitchen table for the millionth time that day ( I swear it’s the portal to Gort’s hoarder house from Halloweentown). I look up to glare at my husband as he lets out particularly loud snore, which makes the baby lying on his chest stir, and then I do a double take.

Maybe it’s the light….

Maybe it’s the angle..

Maybe I’m so tired my brain has finally given up and I’m hallucinating.

I approach my sleeping child to inspect his head and, still debating if I’m hallucinating, ask my husband

“Does his head look kinda flat to you?”

After repeating it a few more times, my husband rejoined the realm of the living enough to look and it was confirmed my precious baby’s head was beginning to look like he had a few run-ins with a frying pan.

 

 

So of course to Google I ran.

After searching for “Flat heads on babies,” “Babies with flat heads,” “How can I keep my babies head from getting flatter,” “Why does my baby have a flat head,” and every combination of the words flat+ baby + head you can imagine, I came to realize this is far from an uncommon issue.

I am not a medical professional  but here is what I learned over the following months, I hope having it all in one place will save you the hours I spent combing baby boards and medical journals. 

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Don’t Beat Yourself Up!

 

Plagiocephaly is the broad medical term used to describe any misshapen head, and we were looking at Brachycephaly specifically, in which only the back of the head begins to look flat.

This is a fairly new issue so unfortunately mom and grandma won’t have any advice.

Before the “Back to Sleep” campaign all of us mothers know so well, Plagiocephaly was practically unheard of. While laying your baby on their back to sleep has been proven to reduce the absolutely terrifying risk of SIDS, the repetitive pressure it puts on the back of your baby’s head causes their little malleable skull plates to change shape.

Try to remember that there was nothing you intentionally did to cause this and honestly science doesn’t seem to have the answers as to why some infants are more effected than others.

I think we can all agree Back to Sleep is still a good thing.

I’d rather my child grow a rhinoceros horn than up his chances for SIDS. So while you don’t want to go against SIDS recommendations, there are a few things we did to help start to round out that billboard on the back of his head.

 

 

Sit, Stand, or Hold

 

Stay at home moms I’m sorry but your home is about to look a lot messier unless you are a baby wearing prodigy (in which case teach me your ways).

One of the best things you can do to round out your child’s head shape is to get them off of their back as much as possible for as long as possible. You can’t change the damage that has already been done but by keeping any pressure off of those areas you can encourage the skull plates to grow in that direction.

Our pediatrician told us that normally when they see cases of Plagio a child has been left in a “container” for more than three hours during the day.

That phrasing sounds bad, like horrible parent bad, but rephrased into if your child has been in their carseat, swing, Pack n Play, crib, Rock n Play, or ANYTHING that has them in a position lying on their back, it is easy to see how those 15 minute breaks to shower or cook, sitting in the pick up line for your older children, or god forbid walking around your grocery store can add up to over three hours.

I won’t lie this one has been a PAIN.

I added up all the times my child has to be in a “container” and there was really nothing left for when we were at home.

So I started making small changes. I started bringing our Tula Baby Carrier when I knew we would be out for awhile. We held him when he was awake when we were out at meals. I glued him to me during the day and only laid him down for diaper changes, when I had to shower, and for bedtime.

For short periods I could leave him in his Little Einstein Activity Center or Bumbo, but it was never for long enough to get anything done.

My house got a bit messier, we ate pre made freezer crock pot meals for a month, but slowly I saw changes. He developed a new curve to the bottom of his noggin where it was flat before, his head started to look rounder and the flat spot shrank and became less noticeable.

Obviously not every mom is in the position I am considering the vast majority of moms work outside the home, but if you work talk to your child’s daycare or care provider.

My oldest was in daycare for four years and one of the things I LOVED about his daycare was how responsive they were to my concerns. I didn’t have to deal with this exact issue with my oldest but there were many other conversations that occurred ranging from diaper rash to fire ants to biting, and each and every time the daycare listened and worked with me to ensure my son was as safe, healthy, and happy as possible.

So reach out and be reasonable, they may not be able to exclusively hold your child all day but ask them if you dropped a Bumbo off if they could monitor them in it. Tell them why you are concerned and ask if they have any suggestions. Come up with creative safe solutions that will be possible for them to implement.

 

Do More Tummy Time

 

 

Maybe I’m just unlucky but neither of my children have been particularly fond of tummy time. Sure I’ve picked up a few tips and tricks along the way to make it bearable (a post for another day) but it certainly isn’t always easy.

Did you know the AAP (American Academy of Pediatrics) recommends starting tummy time from the day you bring your child home from the hospital?!

I didn’t and if you did I guess you get a mommy point ( don’t get too excited my point system is based on Whose Line Is It Anyway).

The AAP recommends STARTING your newborn tummy time routine with 3 to 5 minutes two to three times a day (yes they need to be awake and you need to supervise). Then from there you slowly increase the time intervals as they gain  strength.

Tummy time is an extremely valuable tool when dealing with a flat head because not only does it get them off their back, but it builds up the muscles that allow them to turn their head, sit, and become mobile. We loved our Baby Einstein Play Gym which made tummy time a bit more bearable.

 

Beware of Products

 

If you type in head shaping pillow into any search engine your inquiry will be met with hundreds of products and glowing reviews.

You think to yourself this will be easy, I’ll just order one of these and everything will be hunky-dory!

Unfortunately it’s not as simple as it appears. The AAP’s current guidelines specifically state to “Keep soft objects and loose bedding away from the infant’s sleep area” and even more specifically state to “avoid the use of commercial devices that are inconsistent with safe sleep recommendations.”

So yeah, all those products that claim to shape your baby’s head while they sleep fall into the no category as far as SIDS guidelines are concerned.

Often if it is a reputable company there will be a disclaimer hidden in the fine print, something to the effect of “only for use when supervised, not for use when sleeping.”

Even the carseat products pose issues in that they could A) void your car seat’s warranty if it specifies “non approved after market additions” and B) they often once again specify for use only when the baby is supervised (and that’s kinda hard to do if you are driving).

 

I won’t lie I was pretty disheartened when I pieced the above together a few months ago.

That being said we did purchase one product: The Boppy Noggin Nest Head Support. I liked it because it was usable in pretty much all our “containers” and that it had cut outs for straps to make it safer than some of the alternatives. We have NEVER used it in his Pack n Play or Crib and only use it when we are supervising him. It has been perfect for trips to the store, meals out, or trips to the zoo.

 

Give It Time

 

Many studies and word of mouth stories alike have the same ending. Once your baby can sit or becomes mobile there is significant improvement seen in head shape.

Obviously this is largely due to that they are spending far less time lying on their back ( which is why picking them up and doing tummy time are great ways to speed up the process). The great news is the skull doesn’t completely harden into it’s final shape until your child is up to 18 months old.

So while this is a problem, there is time and there is a great possibility that it will get better organically.

 

Talk to Your Doctor

 

 

Obviously I am not a medical professional.

I am a mom who has dealt with the issue of Plagiocephaly, I have learned a fair amount and consulted many resources, but I am not the best source of information, your child’s Pediatrician is.

So call them!

Depending on the severity and your child’s age they may have you come in right away or they may instruct you to do some of the steps above and wait til the next check up to do an evaluation.

At the appointment they may ask how often you have been doing tummy time, they may ask your daily routine, and they may have some more great insights on measures you can take.

They may examine your child for underlying conditions which could be contributing to the issue and depending on the severity they may send you to a neurologist or a cranial helmet company.

Yes you read that right.

If you didn’t know what they were for before, those head helmets you’ve seen decorated with flowers and cars are pretty much exclusively used to correct a misshapen head.

One other tidbit they are rarely covered by health insurance and can be expensive (think 3-5k). The reason it is rarely covered seems to be two fold:

A) It is considered cosmetic.

B) There was a study which showed similar levels of “complete correction” in children who wore helmets and those who did not.

Personally I think we’ve made enough of an improvement that I doubt my son will need a helmet but if he does I do plan on asking for a neurologist appointment as opposed to a direct referral to a cranial helmet company.

Mainly because I want the opinion of someone who deals with these cases far more often than my pediatrician to explain my options, detail the severity, and explain any other actions I should take.

A lesser reason is in rare cases where it is covered by insurance a neurologist recommendation and documentation proving we tried other alternatives seem to be contributing factors. Also while I am sure cranial prosthetic companies do derive satisfaction from helping children, at the end of the day they are still for-profit businesses and I do not want to be pressured into any purchases as far as my child’s health is concerned.

 

Having a flat head is not the end of the world, having a healthy and happy child is SO much more important. The good news is there seems to be a consensus  in the medical profession that this issue does not impact either of the above and is solely cosmetic. So take a deep breath mama it will be okay. Plus look on the bright side  they have to grow hair eventually right?!

 

 

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