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Flat Head Syndrome and How to Treat It

 Asymmetric skull shape in children may frighten many parents, but it is important to know that there is often no reason to worry. In many cases, this phenomenon occurs as a result of the surface of the baby's skull and is known as flat head syndrome, or, less commonly known as plagiocephaly. As mentioned, this is usually a problem that doesn’t affect health, but in rare cases failure to treat it may create future complications and regardless, there’s no reason not to try to change the situation for reasons of aesthetics. Learn how to identify the symptoms of the problem, why it exists, and how to treat it so if you ever come across it as parents you’ll know what to do.


What is Flat Head Syndrome?

Flat head syndrome is quite common in many infants and is expressed as a flat area at the back of the head, especially in the first few months of life. Almost everyone who raised young babies up to the age of 7-8 months and stroked their heads in the back felt that this area was flat and had relatively little hair. Usually, the flat part begins to take shape after six months, and this happens because babies are already strong enough to lift their heads and turn them sideways. On the other hand, in infants with a developmental delay or those who spend a lot of time lying on their back at later ages without movement, health problems may arise beyond the aesthetic aspect.

What are the causes of flat head syndrome and what are the complications that can arise?

Our skull protects the brain with several layers and membranes. In adults, skull bones are hard, but in infants, these bones are soft and easily molded by external pressure. Two of the main causes of the flat head phenomenon are the infant's lying position during the day and the position of the fetus in the womb, especially in the case of twins. During the first few months of life, infants sleep on their backs for most of the day, which is a recommendation of most world health organizations. This position creates pressure on the bones of the head, which may cause physiological changes due to the pressure applied to one area following immobility.

As a result, there is a movement of the head bones that can cause the posterior region of the skull to be flat, asymmetries in facial features and in extreme cases, an imbalance between the ears leading to repeated infections to the point of hearing loss, as well as strabismus and difficulty focusing both eyes simultaneously. The good news is that with correct treatment there is a possibility to fix the injury that was created, provided that the problem is caught in time.babies

5 Ways to Treat Flat Head Syndrome

As mentioned above, it is possible to treat cases of this syndrome and there are several ways in which one can improve the flat appearance of the skull and avoid the complications that may result from flat head syndrome. To prevent it from appearing and to assist in the recovery process, you may want to implement some of the following treatment methods:

1. Daily tummy time

Daily stomach time is a type of exercise for babies. Putting little ones on their bellies during their waking hours, of course, under strict supervision, strengthens their neck and shoulder muscles and allows them to control the muscles in their upper bodies. These exercises, which are also a form of physiotherapy, help speed up the process of turning over and rolling, which are an important part of the child's development, in addition to preventing the increased pressure on the back of the head which is responsible for flat head.

How and how much

First, make sure your baby is relaxed, not tired, hungry or, not feeling well.

  • Place a slightly rigid mattress on the floor and not on a bed or high place so that there is no falling risk.
  • Stretch a thin blanket over the mattress and spread your baby’s favorite toys or a mobile phone, make sure you remove all safety and health hazards from the mattress.
  • Place your baby on his/her stomach, use the toys to stimulate them to raise their head, and with time their shoulder belt.
  • It is recommended to do this with your baby for 30-60 minutes a day divided throughout the day, depending on the baby's ability. The best time to start this activity is after your first visit to the pediatrician. If you are persistent with this, by the time your child is 4-6 months they will be able to roll over and do tummy time on their own!

2. Gentle massage

If you notice that your baby's neck muscles are shrunken or loose or that their head is permanently resting in a certain way, try a gentle neck massage. The role of massage is to soothe the muscles of the neck and promote motility in this part of the body. Just note that sometimes the massage isn’t so comfortable and pleasant to the baby, and if he/she complains and moves uncomfortably, stop and try later - don’t be discouraged to try again.

How and how much

There are a number of times that are suitable for massage, but the most recommended are about half an hour before a meal, or after a shower before bedtime because a pleasant massage improves the quality of sleep and speeds the process of falling asleep. Massage should be performed at least once a day.

  • To do this, lay baby on his/her back, hold their head between your palms, and gently massage the scalp with your fingertips, as if you were shampooing their head as you would in the shower. Avoid pressing in the front and back grooves and other soft parts of the baby's head.
  • Now continue to massage the ears on both sides by applying gentle pressure between the thumb and forefinger.
  • Place both hands on the sides of your baby's head, and follow the shape of their face from the top of their head to their chin.
  • Now move your thumbs between the eyebrows and massage the area while lifting and lowering the area. From there move on to the eyelids, nose, and cheeks.
  • With your fingertips, rub the jaw in small circles and release.

3. Changing the position of the head in bed

As we’ve already said, one of the causes of flat head is little to no movement of the head for many hours. In addition, there are times when we allow our baby to sleep in bed on a preferred side or they fall asleep in a swing or bouncer and his/her head is tilted and pressed on a certain side of the head, which creates physiological changes. Beyond the flat area that forms, shortening of the neck muscles can occur and may cause torticollis, which is where the child can’t easily move their head from side to side.

What to do and when

If your right hand is stronger than your left, you probably tend to cradle your baby with his/her head in your left hand, creating a situation where you're placing more pressure on the right side of his/her head most of the time - the opposite is tru if you’re a lefty. So be aware of this and make sure to put the child in a different position every time they go to bed so that they can exercise their neck muscles. In addition, if your baby falls asleep in a car seat or bouncer, you should move them to their bed as quickly as possible and lay them on their back; Besides being uncomfortable, these positions aren’t healthy for the neck, the spine, or skull bones. Change your baby's sleeping position at least once throughout the night before you go to bed and get them used to falling asleep in all positions because it will make it easier for you and it's very healthy for them.

4. Holding baby in your arms during waking hours

During a baby’s first few months of life, one of the parents is usually at home during the day to take care of them, but because of the lack of personal time that is created by the many things needed to be done such as feeding, washing, diapering and so forth, some parents prefer to keep baby in front of a screen playing different children's videos and sounds. If this happens occasionally for stimulation, it may be beneficial, if this is how your clearing to some free time for yourself. However, know that if done too often you might be causing two problems, one is an addiction to the “soothing screen” and the second is flat head syndrome, thanks to the baby being kept in the same position for a long time.

What to do 

First, try not putting them in front of a screen even if you are very tired, at least not for a prolonged period of time. If your baby is calm and in the mood, put him/her down for some tummy time. Also, know that spending time holding baby creates an amazing connection between you and reduces the amount of time your baby is lying on his/her back.


5. Customized helmet

A pressure helmet is the last solution doctors usually recommend and is often used only when there is no other choice and the asymmetry is very noticeable. The helmet looks like a regular adult helmet and is padded with hard foam. Its purpose is to prevent the skull from growing in certain directions and thus forcing the brain to push the skull out in the flat area. You should know that the helmet is effective only if you start it at the age of 6 months at the earliest and before the age of 12 months at the latest because that is when the bones of the skull begin to heal and harden. This helmet is used for several months and needs to be worn for 23 hours a day. It doesn’t work for everyone, and it should be decided on based on the case. Therefore, this method should not be used independently, rather only after consulting with a pediatrician.

In conclusion
Flat head syndrome is a common phenomenon today, especially following the American Academy of Pediatrics recommendation to have babies sleep on their backs to prevent cases of SIDS. Small babies who spend most of their time lying on their backs in the first months of their lives tend to keep their heads in the same position for a prolonged period of time, and because of the weight of the head, pressure is exerted on a specific area leading to a change in the structure of their soft skull. If you want to avoid this, keep changing their head position, let them play while lying on their stomach, and massage them. Keep your child moving their head in different directions on the surface with their head resting, thus preventing the physiological change of the skull structure. Remember - there is no need to worry. If you diagnose the syndrome early on, prompt treatment solves the problem in the vast majority of cases.
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