Your friend’s new baby is starting to develop an odd shape. Or you are out in public and notice a young baby with plagiocephaly or brachycephaly.
Once you become more aware of how normal and abnormal baby head shapes look, you may start to notice a lot of babies who have some degree of head flattening from deformational plagiocephaly or brachycephaly. After all, recent studies suggest that almost 50% of babies have this issue. However, you may not know whether or not it is appropriate to let the parents know there is a potential problem. And you may not feel comfortable talking about the subject to the parents because you are unsure of how they will react.
What is the right thing to do?
Is it appropriate to say something?
It is obviously an individual decision about whether to say something or not, and your comfort level with this may depend on how well you know the parents. In my opinion, if the problem appears to be significant, it is certainly appropriate to mention something to the parents if you are comfortable doing so. The worst that can happen is the parents are offended. If the parents are friends of yours, they will probably understand that you are only telling them about this because you have the best interest of their child at heart.
How to bring up the subject
This can be a delicate situation. One approach is to gently try to determine if the parents already know about the potential problem. You could say something like, “excuse me, but I wanted to mention that I noticed your baby’s head has a flat spot, and I wonder if you were already aware of it.” If they say yes, then your job is done unless they have other questions. They will likely appreciate your concern and you can move on.
Sharing your own personal experience with flat head syndrome is another way to ease into the conversation, if you have gone through this with your own child.
If you are hesitant to bring up the subject, think about the possible consequences if you don’t bring it up. Head flattening needs to be treated as early as possible, and once the baby is over 18 months of age it can be impossible to do anything about it. The earlier it is addressed, the better the success rate of treatment. Strategies such as repositioning and tummy time should start as young as possible, and helmet therapy is best started by 4-8 months of age.
A more subtle way to bring this up is to say that you have seen some articles recently about how common flat head syndrome is today, and ask if your friend or acquaintance has heard about this issue. If they haven’t, you can mention that you are mentioning it because you noticed a flat spot on their baby’s head, and that they may want to discuss it with their pediatrician.
My personal experience
We used to see a couple with a sweet little baby boy every Saturday morning at our local coffee shop, and we had spoken with them multiple times as he was about six months younger than our son. After our son went through his helmet therapy (he wore his helmet from 8-12 months of age), we noticed that this boy also seemed to be developing brachycephaly. We were afraid at first to bring up the subject to his parents, but we did, and we were very happy that we discussed it with them. The parents were very appreciative of our concern, and also of the information that we were able to give them about the condition.
Fortunately in this boy’s case, measurements were taken and his case was not deemed severe enough to need a helmet. But the parents had the piece of mind that they had done the right thing, and a decision was made when the boy was still young enough to have gotten a helmet to correct the condition if he had needed it.
I felt really good in the end about my decision to let the parents know.
If you have had experience with bringing up this delicate subject, or have decided not to, please share your thoughts in the comments below.