What Causes a Flat Head?
Flat head syndrome is a condition that can appear at any time from birth, but it tends to take a few weeks or months to become apparent. Sometimes parents or health professionals notice that their baby’s head seems to have an altered shape with part of it appearing to be flat. If the flattening is severe enough, there can be asymmetry in the face and forehead with and one ear further forward than the other. There are a number of medical terms for this, including plagiocephaly, brachycephaly or scaphocephaly. Here we will discuss what causes flat head in babies.
There are many different issues that can cause a flat head in babies, but they all stem from the fact that babies are born with soft skulls. Before a baby is born, the bone structure is not firm, but has to be soft and flexible to allow the head to descend through the birth canal. The bone plates in the head are not fused, but are held together with cranial sutures, which are essentially elastic tissues which need to be flexible to allow the brain to grow. Because the bones don’t fuse until the baby is a toddler, it means that the shape of the baby’s skull can be affected by a number of factors.
For example, the way that babies lay in the womb can affect their skull shape. This is especially the case with multiple births where there is less room for babies to move around. It is the same for babies when there is not much amniotic fluid in the womb. Because the skull strengthens considerably in the last few weeks of pregnancy as mineralisation occurs, premature babies tend to have much softer skulls which are more prone to becoming misshapen.
However, flat head syndrome most commonly occurs because of the baby’s sleeping position. This can be due to the very good advice to put babies to sleep on their backs or it can be due to a tight neck muscle on one side, called torticollis. The excellent ‘Back to Sleep’ advice has radically reduced instances of cot death. However, if the baby is positioned on their back for too long either in a cot, on the floor or on a firm baby carrier can result in the development of flat head syndrome. In mild cases, this will probably correct without clinical intervention and up to the age of four months it’s best to treat all babies simply through repositioning techniques. For example, babies can be encouraged to move their head by relocating mobiles and toys.
During the day when they are awake and parents are with them, it’s a good idea to place babies on their tummy which relieves pressure on the affected flattened part. Tummy time is a great form of exercise for your child and allows them to develop muscles in the hips and spinal extensors.
If you don’t see an improvement in your baby’s head shape after a month, it is best to seek advice from a medical professional who can suggest other possible interventions. These can include physiotherapy to increase the range of movement through to specialised bespoke helmets which will use normal growth to gently reshape the skull.
These helmets gently help the skull reform into the correct shape as the baby’s head continues to grow and fuse. The helmets are custom-made so that they fit each child perfectly and they are lined with soft foam to keep the babies comfortable. Babies are also reviewed regularly to ensure that they are responding properly to treatment.
In many cases, flat head syndrome can be corrected by repositioning, but more severe cases may need further intervention. It is important to realise that babies’ the growth needed to bring about correction is minimal when they reach about eighteen months, so it’s important not to delay seeking advice.