CHICAGO (American Academy of Pediatrics) -- There has been an increase in the last several years in the number of children with flattened heads, according to a clinical report from the American Academy of Pediatrics (AAP) entitled, "Prevention and Management of Positional Skull Deformities in Infants." The report says the increase is probably due to recommendations by the AAP that children be put to sleep on their backs to prevent Sudden Infant Death Syndrome (SIDS). The report notes that the condition is, on the whole, preventable and treatable.

Read the full story

July 11, 2003

By Alice Chang, M.D.
Harvard Medical School

How does this article relate to me?

It is important to realize that there is no danger to the child's health or brain development in having a flattened head. I can lend a cultural perspective to this issue. When I was a child on a trip to Korea with my parents, my mother pointed out that my head was shaped differently than people born and raised in Korea. In Korea, having a flattened back of the head was desirable. It was a sign of a good mother, who was attentive to her child’s position on his back, keeping his head lying straight so that the back of the head would be perfectly flat. At the time I was a baby born in the United States, pediatricians and Dr. Spock were recommending that babies sleep on their stomachs. With a baby resting her head on one cheek or another, the back of the head was round instead of flat.

Now, pediatricians recommend that babies sleep on their backs to lower the risk of sudden infant death syndrome (SIDS). My mother will tell you that the Korean people knew what they were doing way before medicine figured it out. Traditions can develop from scientific reasons. Perhaps, people noticed that babies with flattened heads had a better chance of surviving. Who knows? In any case, if an entire country promoted a flattened head without any reports of brain or neurological problems, it is unlikely that it is anything dangerous. So what we are really talking about now is a matter of cosmetic appearance.

What changes do I need to make?

So what's a new parent to do? Safety should be your biggest concern. Keep your baby on his or her back when sleeping and unattended. When babies are on their backs, you can vary the position of the head towards the left or right. While you might make more of an effort to change positions while babies are awake, place them on their stomachs only when you or someone else is watching them carefully. If you notice a flattened or asymmetric head shape, you can take the steps in the related article, as well as asking your pediatrician about what positions would best work to revert to the rounded shape again. If your baby has a flattened area of the skull at birth, often simply from the childbirth process itself, you might want to pay more attention to varying the baby's head position from the beginning. A flattened area from birth makes it more likely that the baby's head will want to stay in a particular position.

What can I expect in the future?

Special skull-molding helmets or surgery would be necessary only in extreme cases. With the American Academy of Pediatrics making an effort to better educate pediatricians and parents about watching for flattening and varying positions, such extreme measures hopefully won't be necessary.

Related Areas:

SIDS