Flat spots on the head, or positional plagiocephaly, is a condition that is becoming more common. In fact, in a recent study researchers in Canada found some degree of plagiocephaly in almost half of the 2-month-olds they examined!
Why are we seeing more plagiocephaly? More babies are sleeping on their backs rather than their bellies. This puts pressure on the back of the head. Babies have soft, malleable skulls to help them get through the birth canal and to allow for the rapid brain growth that happens during infancy. This makes their skulls sensitive to pressure, especially when that pressure is always in the same place.
We want babies to sleep on their backs to decrease the risk of sudden infant death syndrome (SIDS). Since the American Academy of Pediatrics (AAP) made that recommendation in 1994, the rate of SIDS has dropped by half.
It's important to know, too, that plagiocephaly doesn't cause brain damage. As far as we know, having an oddly shaped head has no effect on brain function. It can, however, lead to teasing and self-esteem problems if the shape is very abnormal. Parents and pediatricians can help by being aware of the problem — especially because there are ways to fix plagiocephaly if it's caught early.
The key to preventing flat spots is to change the position of your baby's head throughout the day so that pressure isn't being put on the same spot. To do this, parents should:
Most flat spots are mild and go away once babies are a little older and spend less time lying down. In severe cases, we sometimes prescribe a soft helmet for babies to wear. It doesn't push or mold the skull. Instead, it shields the skull from pressure and allows the head to grow naturally into a rounder shape.
If you are concerned about the shape of your child's head, let your doctor know at your next checkup. But whatever you do, keep putting your baby on her back to sleep!
Claire McCarthy, M.D., a senior medical editor for Harvard Health Publications, is an assistant professor in pediatrics at Harvard Medical School. She is an attending physician and Medical Communications Editor at Children's Hospital Boston.