It's common for babies to be born with misshapen heads after passing through the narrow birth canal due to their malleable and separate skull bones. Newborn and infant skull bones will usually not fuse together until after their first birthday, allowing enough space for rapid brain growth and development.
Often, a baby’s head shape will even out after birth, but sometimes, they develop flat spots or uneven head shapes in the months after. Here is what you need to know about baby head shapes and potential problems.
A Baby’s Skull
Newborns and infants have five major bones in their skulls:
- Two frontal bones
- Two parietal bones at the top of their head
- One occipital bone in the back of their head
When your baby is born, their skull bones are connected by flexible spaces called sutures. These sutures meet together at two fontanelles, soft spots where your baby’s skull bones have not yet closed together. These sutures and fontanelles allow your baby’s head to squeeze through the birth canal and expand rapidly as their brain grows and develops.
Babies' Head Shapes: When to Worry
If your baby spends a lot of time on their back or with their head turned to one side, you might notice that their head shape has become uneven. Their unfused bones mean that continued pressure from lying in the same position for long periods can cause flat spots and an uneven head shape. The medical term for this condition is deformational/positional plagiocephaly.
Typically, your baby’s flat spot is considered a cosmetic problem. Plagiocephaly does not affect your baby’s brain growth or development.
A more serious condition that causes babies to have abnormally shaped heads is called craniosynostosis. Babies with craniosynostosis have skull bones that fuse together before they should. Craniosynostosis can cause significant problems for your baby’s development because their brain won’t have enough space to grow normally.
If you have any concerns about flat spots, or if your baby’s head shape is severely misshapen, you should talk with your child’s pediatrician.
Plagiocephaly Causes
Deformational plagiocephaly happens when your baby’s head rests in the same position for extended periods. This is often caused by back sleeping or laying in infant swings, strollers, rockers, car seats, and carriers for a long time.
Sometimes, babies that are twins or multiples can be born with plagiocephaly. This happens because of pressure on their heads from a lack of space in the uterus.
Plagiocephaly can also be caused by muscular torticollis: tightened neck muscles that make your baby turn their head to one side while sleeping.
Plagiocephaly Symptoms
The defining feature of deformational plagiocephaly is a flat or uneven baby head shape. Often, the back of their heads will appear flattened, with the top of their heads appearing to stick upward. If you look at your baby’s head shape from above, you might notice that one side of their head looks flatter than the other, or their ears appear uneven.
Plagiocephaly Treatment
Deformational plagiocephaly treatment depends on how severely your baby’s head is misshapen. For mild cases, moving, holding, and repositioning your baby more often can help normalize their head shape by removing the continuous pressure on their heads while they are laying down. Some easy steps you can take to manage or prevent your baby from developing more severe plagiocephaly include:
- Practicing safe and regular tummy time
- Holding or carrying your baby more often
- Using a baby sling or front carrier rather than leaving them in the car seat carrier
- Changing your baby’s sleeping direction in their crib or bassinet
- Limiting the time your baby spends in their baby swing or bouncy seat
If your baby has muscular torticollis, physical therapy can help stretch their tight neck muscles and help them to move their heads more easily.
Babies whose head shapes don’t improve by the time they are six months old and those with more severe cases might require a special baby head-shape helmet. This helmet will be custom-measured to fit your baby’s head. It's designed to relieve pressure on the flat spots of the head and encourage a more rounded and normal shape. Your baby will usually need to wear the helmet for about 22 hours each day for several months.
Baby head-shape helmets are most effective before your baby’s first birthday. After this time, your baby’s skull bones will fuse together and make treatment more difficult. Early diagnosis and treatment will help to give your baby the best possible outcome.
