What is Baby Flat Head Syndrome and What Causes It?

What is Baby Flat Head Syndrome and What Causes it-What is baby flat head syndrome and what causes it?

Baby Flat Head Syndrome is a prevalent condition these days and the purpose of this article is to examine more about what the condition is, what causes it, and how it can be treated.

How Common is Baby Flat Head Syndrome?

Flat Head Syndrome is a very common condition in babies today, and it can be caused by several different factors.  In the past it was thought that about 20-25% of infants who sleep on their backs develop flat heads, but newer studies show this percentage could be as high as 50%.   This is most commonly is in the form of positional plagiocephaly or brachycephaly.

The American Academy of Pediatrics initiated its “Back to Sleep” campaign in 1994, in which parents were encouraged to put their children down to sleep on their backs in order to reduce the incidence of Sudden Infant Death Syndrome (SIDS).  Similar campaigns were run in other countries, and the wonderful result of this is that the instances of SIDS have declined by over 50%.

However, as a result of children sleeping on their backs, flat head syndrome in babies has increased dramatically.  While this is not a very serious or life threatening condition, it can still be a major problem, although the severity can vary greatly from child to child.

Some babies seem are just more prone to developing flat spots on their heads than others, and the reason for that is just not known.

What are the types of Flat Head Syndrome?

The most common type of baby flat head syndrome is Plagiocephaly.  The term plagiocephaly derives from the Greek words for “slanted” (plagio) and “head” (kephale).  Plagiocephaly is asymmetrical flattening of the head, or flattening of the head on one side only.  Plagiocephaly is most easily visible from above, as the shape of the head forms almost a parallelogram.  In plagiocephaly often one ear is pushed forward, the forehead can bulge out on one side, and there can be cheek or eye asymmetry.

Brachycephaly is when both quadrants of the back of the head are flattened.  This is mostly visible from the top of the head and also from the side.  There is normally little facial or ear asymmetry, but the head may bulge out on the sides, and often the back of the head is higher than the front.

Sometimes a baby will have a combination of both plagiocephaly and brachycephaly.

This video illustrates the main types of flat head syndrome:

When does the flattening of a baby’s head occur?

Baby flat head syndrome can be visible at birth or develop within the first 6-8 weeks of life.

An infant’s skull is very soft and malleable, and head flattening can occur in utero.  This is more common in multiple birth babies, in babies whose mothers have a small pelvis, or babies who are in the breech position.  Rest assured that there is nothing the mother can do to prevent this from happening before birth.  It is very common for babies’ heads to become misshapen while traveling through the birth canal during the birth process, and most asymmetries even out on their own with no special treatment necessary.

What causes baby flat head syndrome?

Baby flat head syndrome often happens due to pressure on infants’ heads when they rest or sleep repeatedly in the same position (usually on their backs), when the babies’ soft and rapidly expanding head meets resistance due to consistent external pressure.  This is also more common now due to the prevalence of infant carriers and seats.  Premature babies are more prone to this due to the fact that they often must spend more time on their backs without being moved due to medical conditions or time spent in the NICU.

Sleeping or resting for long periods of time in the same position on the head in the crib, carseat, bouncy seat, infant swing, stroller, or rocker can all contribute to flat spots on the head.

A condition which is frequently related to plagiocephaly is congenital muscular torticollis, or a condition where the muscles of the neck are tighter or shorter on one side.  The baby’s chin will point to one shoulder, while the head will tilt towards the other shoulder.  Because a baby with torticollis will turn its head mostly to one side, the result is consistent pressure on the back of the head on the same side, which if left untreated can cause positional plagiocephaly.

A more serious but much more rare condition, craniosynostosis can also cause flat spots in a baby’s head.  Craniosynostosis is when the skull bones become prematurely fused together, and the skull grows in a misshapen way as a result.  An x-ray can rule out craniosynostosis.

If you suspect that your baby has flat head syndrome, it is critical that you consult with your health care practitioner and seek a proper diagnosis of the problem.

How is baby flat head syndrome treated?

If detected early enough, the best treatment for flat spots on a baby’s head is repositioning.  Repositioning works best when the infant is very young, ideally less than five months old but the sooner the better.  This is the first line of treatment, to reduce the pressure that is causing the flatness.  Changing the baby’s position during sleep, spending very little time in bouncy seats or swings, and giving the infant plenty of tummy time will all help with this condition.  The earlier and more aggressively you can begin repositioning, the better effect it will have on the baby’s head shape.  Note however that some children seem to just have softer heads than others, and some babies’ condition is more severe, so sometimes despite the parents’ best efforts, repositioning is simply not enough to adequately correct the problem.

If a baby has been diagnosed with muscular torticollis, then physical therapy is almost always recommended to treat that condition.

In more serious or severe cases, if the condition is diagnosed too late, or if repositioning is not effective, a cranial remolding orthosis, or baby helmet, is worn to correct the baby’s head shape.  The course of treatment is normally about 3 to 4 months, but in the more severe cases sometimes two helmets are needed, as the baby outgrows one before the necessary correction is achieved.  The baby will wear the helmet for 23 out of 24 hours every day during the treatment period.

If the diagnosis is craniosynostosis, then surgery is the only method of correcting the problem.

What are the consequences of baby flat head syndrome?

Baby flat head syndrome is in most cases a cosmetic problem.  However, if unresolved flattening is severe enough to cause facial abnormalities, then other problems such as those with chewing and vision may occur.  Another problem with more severe cases of head flattening can be difficulties with socialization due to the child being self conscious about their appearance.  Most doctors believe that baby flat head syndrome does not cause issues with brain development or learning, although there have been some studies that suggest it is a possibility.  Because this is a newly prevalent condition, adequate studies still need to be done to fully understand the syndrome.


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