What Can You Do if Your Baby Has a Flat Spot?
More than half of babies with flattened heads will improve by six months of age, so try not to worry. However in some cases it will not and, as a baby’s skull becomes harder and less pliable as she grows, the earlier you take action the better. If you notice any flattening of your baby’s head talk to your doctor or health visitor about it straight away. Depending on the severity, your doctor may refer your baby to a specialist for diagnosis and treatment.
If you are concerned about your child's head, then follow your instincts. We have read numerous comments from parents who were told by their doctor not to worry and that their child's head would round out on its own as they grew, only to later bitterly regret listening to this advice when their child was left with a permanently flattened or distorted head. The following tips are easy to implement and, if nothing else, it helps enormously just knowing that you are being proactive and doing everything possible to help your child rather than putting all your faith in nature and hoping your child's flattened head will correct on its own.
To prevent and treat baby flat head, it is important to avoid continued pressure on the same area of the head. The following tips will help reduce the risk of your baby developing a flat head, stop an already flattened area from becoming worse and (in many cases) improve an existing flattened area. It may be helpful to take photographs from above your baby’s head every couple of weeks so that you can track any changes and see whether any flat spot is improving:
1. Tummy Time, Tummy Time, Tummy Time!
Give your baby plenty of supervised tummy time from day one. Not only will this be good for your baby's head but it helps the development of her motor skills. Babies who do not spend time on their tummies have been found to suffer from developmental delays. You should aim to build up to 30 to 60 minutes each day.
If your baby is not comfortable on her tummy, distract her by joining her on the floor, you can encourage and distract her by talking, singing, shaking a rattle, playing peek a boo or even doing some sit ups or press ups yourself. Until she can get up on her forearms independently you can prop her up with a rolled up towel under her chest and armpits to make her feel more comfortable. It's not much fun lying with your face in the carpet! Or you can purchase a Tummy Time Cushion which is good for raising your baby's face and chest from the floor which will strengthen your baby's neck and back muscles whilst giving her a better view and leaving her arms free to play with toys placed in front of her, making tummy time more enjoyable. Tummy Time Cushions also usually have rattles and squeaky toys on them to help entertain your baby during her tummy time.
2. Flat Head Pillow
Invest in a good flat head pillow. A flat head pillow is a special pillow which significantly reduces the pressure being exerted against your baby's head which helps stop an existing flat spot from getting worse and gives any flattened area a chance to round out. A flat head pillow should ideally also be used as a preventative measure for babies under six months, even if your child has not developed any flat spots, as a flat head pillow will help preserve your child's natural round head shape.
Use a flat head pillow in the pram, bouncy seat, swing, on the activity mat – whenever your baby is lying or sitting down. It is worth getting several then you can leave one in the pram and have another for use in the house.
We used the Clevamama Clevafoam Baby Pillow (although there is another pillow which is now available on the market which I personally think is much better for a number of reasons). The pillow worked extremely well and we firmly believe that using a good flat head pillow together with a sleep positioner were the most instrumental things we did to round out our son's head.
The Clevamama Clevafoam pillow is made from memory foam which reacts to the heat and weight of the baby's head and moulds itself around the head, reducing pressure against the skull by 50%. It has been scientically proven to prevent and treat baby flat head syndrome. The contour of the pillow keeps the baby's posture in the optimum position for her spine and for maintaining an open airway. Toddler size Clevamama pillows are also available as well as replacement pillow covers.
The drawbacks of the Clevamama pillow are that, because it is made from memory foam, it has been chemically treated which is an issue which new parents are becoming increasingly aware of. Also, it is not breathable, so a baby should not be left unsupervised when using the pillow nor should it be used in a cot overnight.
At the time I was researching the best pillow to use for our son, I found another pillow on the internet (the Mimos pillow) which was my preferred choice but unfortunately at the time it was only available in Spain. The good news is, it is now available worldwide and the manufacturers sent me a sample of the Mimos pillow to review.
The Mimos pillow does everything the Clevamama pillow does and more! Plus it successfully addresses the drawbacks of the Clevamama pillow. It reduces the pressure against the baby's skull by an incredible 400% (compared to 50% for the Clevamama pillow). It is fully breathable and does not contain dangerous chemicals. For me this is the ideal pillow and if we are fortunate enough to have more children I will certainly be using the Mimos pillow for my new baby.
For the full reviews and for more information on the above pillows, as well as other pillows on the market have a look at our flat head pillow reviews.
3. Limit Use of Swings, Baby Rockers and Car Seats
Limit the time your baby spends in seating devices such as baby swings and baby rockers which exert pressure on the back of the head and when they are in one, use a flat head pillow. Try to only place your baby in a car seat when she is a passenger in a car. It is tempting to leave a sleeping baby in a car seat and to carry the car seat into the house and also, when out and about, to attach the car seat to the travel system and use it as a pram attachment. However car seats, by their very nature, are designed to constrict your baby's movement, and prolonged time in this position can create a flat spot on her head (as well as restricting her breathing from the hunched position of a car seat).
If prolonged use of a car seat or other seating device is unavoidable, regularly alter the position of your baby's head so that she is not resting on the same area of her head for prolonged periods of time and use a baby flat head pillow to relieve the pressure on her head. Whereas a normal flat head pillow is fine to use in a swing or bouncy seat, for a car seat only a pillow specifically designed for use in a car seat should be used so that the effectiveness of the car seat in protecting your child in a crash is not compromised. We used a specially designed Car Seat Flat Head Pillow, which reduces pressure against your baby's head by up to 50%.
4. Sleeping Position
Encourage your baby to turn her head to a different side each night/nap time by alternating the end at which you place your baby's head in her cot or crib and hang a mobile on the side you want your baby to look.
If your baby has a tendency to always sleep with her head facing the same way, thereby flattening that side, you may want to consider trying a sleep positioner, which is what we used to kept our son off the right hand side of his head and to encourage him to face the other way when sleeping. But are sleep positioners safe?
Sleep positioners which are flat with sides bolsters, or have an inclined wedge with side bolsters are not safe and should not be used. There have been reports of these types of sleep positioners causing infant deaths. Babies have died after rolling over and which could cut off their air supply. Accordingly we would not recommend either of these types of positioners and would only suffocating against the bolster sides of the positioner or after becoming trapped between the positioner and the side of the cot. Babies on an inclined positioner could scoot themselves up the positioner and end up with their head hanging over the high back recommend the Snoozzz Sleep Positioner and Sleepwrap.
The Snoozzz Sleep Positioner and Sleepwrap (the equivalent outside of the UK is the Safe T Sleep sleep positioner) is a flat positioner which does NOT have side bolsters or a wedge so it does not have the safety concerns of other types of sleep positioner. A wrap with a velcro band keeps your baby in position which also gives them extra security as it provides a swaddling effect. It can be used to position your baby on her back or side (although please note that the guidance is for babies to sleep on their back to reduce the risk of cot death). The Snoozzz sleep positioner is suitable for use from newborn up to 36 months so, unlike other sleep positioners, your baby will not quickly outgrow it.
The Snoozzz Sleep Positioner can be used in conjunction with a flat head pillow such as the Mimos Pillow or the Clevamama Baby Pillow. You can also use it to gently encourage your baby off the flattened side of their head. The way to do this is to position your child in the sleep positioner so that she is still lying on her back but slightly rotated towards the non-flattened side eg if the right side of her head is flat, position her so that she is lying on her back but slightly on her left hip and left side, with her right hip and right side slightly raised. This then makes it difficult for her to turn her head enough to the right to be able to lie on that side of her head. Use a flat head pillow to ensure the non-flattened side does not become flattened. She may protest a bit at first (our son did) but within an hour on the first night he accepted the new position.
However, if you do struggle to keep your child positioned like this, then use the sleep positioner to simply keep her positioned on a flat head pillow. Even though she will probably turn her head to the flattened side again, the sleep positioner should ensure that her head remains on the flat head pillow, and the pillow will help stop the flattened side from getting any worse and give it a chance to round out.
As soon as your baby is able to fully support her head (usually at around 12 weeks) you can sit her in a Bumbo baby seat. You should not leave your child sitting in a Bumbo for prolonged periods of time, but it is a great way to give them a different view of the world, to improve their neck muscles and to give their head a break from being pressed against a hard surface. We used the Summer Infant 3 Stage Super Seat as it adapts to your growing child so lasts longer than a normal Bumbo seat and comes with a swivel table with activities on it to entertain your baby. (Never leave your child unattended in a Bumbo and only ever use it on floor level.)
If your child is too big for a Bumbo, you could use a Jumperoo. Not only does this relieve the head from external pressure, we found it was also excellent for strengthening our son's neck muscles and noticed an improvement in his head control in just one week, which in turn helped his flat head by enabling him to alter his head position unaided.
6. Alternate Sides at Nappy Change
Alternate the way you lay your baby at each nappy change so her head is at a different end each time, as they will tend to rotate their head to look at you. Right handed people also tend to place babies on the nappy changing unit with baby's head to the left, which means baby turns her head to the right to look at the changer, which encourages flattening on that side.
Place a flat head pillow under baby's head at nappy changes, especially when out and about and using hard plastic nappy changing units. The love nest pillow is ideal for carrying in a nappy changing bag, it is a heart shaped pillow with a hole in the middle to cushion baby's head so that it is not resting directly against a hard surface. The Love Nest Pillow is a good pillow to have as a small additional pillow to use in conjunction with the Clevamama Baby Pillow for use in a bouncy seat or swing or to carry in a nappy changing bag. We had two Love Nest Pillows and left one on the nappy changing unit at home and the other in the nappy changing bag.
If re-positioning is unsuccessful or if the flat head is severe, a cranial remoulding helmet is an option. This needs to be worn for 23 hours a day and is usually worn for 3 to 6 months depending on the severity of the condition. The earlier any treatment is started the better. The recommended time for wearing a helmet is 4 to 7 months old but it can be used up to around 12 months of age (sometimes 18 months depending on the child) but it is likely that it would then need to be worn for a longer period and the results may not be as good as they might have been had treatment started earlier. A helmet costs several thousand pounds but numerous parents have reported being delighted with the results and if your child is suffering from a moderate to severe flattening it may be something you wish to consider for the treatment of flat head syndrome.
For further information and more practical tips, download our free "The Ultimate Practical Guide to Preventing and Treating Baby Flat Head" by completing the form at the top of this page.