Mothers call it flat head syndrome or the more technical medical term, plagiocephaly. The good news is that  there is a remedy which is called, cranial therapy and cranial molding helmets or baby helmet therapy.  It’s hard to believe but this condition affects nearly one in two infants worldwide.  This flat spot on the back of the head or the side of the head can be caused by several circumstances. The skull of a baby is quite soft and even the slightest pressure from  everyday surfaces can cause misshaping. Babies can develop misshapen heads from a number of causes.

1. Position of the baby in the womb – Sometimes there is not enough room for the baby to move in the womb. A baby can be in a breech position or stuck in one position in the womb.
2. Multiple Births – Limited space in the womb can lead to head distortion
3. Premature Birth – These babies are required to spend long periods of time in the neonatal hospital units with their head in a fixed position while hooked to a respirator. Also, the skulls of preemies are especially soft and susceptible to misshaping.

Imagine a new mom, who finally finds a place that her baby can sleep peacefully. She then discovers that the baby gear is the primary cause of the condition. The mother than notices that the back of her adorable ( and perfectly formed at birth ) baby’s head is becoming slightly misshapen.  What we are talking about the infant car seat.  Yes, that carefully chosen car seat with a special pattern that his or her mother chose with such love. The pink hearts for her baby girl and the blue doggies for her baby boy is the cause of flat head syndrome.

Those who were not gifted yet to have the privilege of bringing their own baby home from the hospital may ask; “who would put their baby to sleep in the car seat at home when there is a perfect crib ready?” Great question and the answer is quite elementary.  The baby car seat is probably the closest object that is similar in shape to the mother’s womb. Many mothers of newborns find this position a comfort for their baby. Furthermore, when bringing the baby into the house from the car, the baby is not woken by the transfer to the crib.

Before the 1990’s, car seats remained in the car and each time the mom or dad needed to go shopping or visiting, the baby had to be removed from the seat and transferred to the stroller (disturbing the baby). Today, the car seat is simply transferred and attached to the stroller. What moms are not noticing is that the baby is being restrained to one position for hours. Unfortunately, this has a negative impact on the shape of the adorable babies head.

Since the 1990’s the incidence of plagiocephaly has increased dramatically . The tragedy of SIDS, Sudden Infant Death Syndrome has been drastically reduced by positioning newborns to sleep on their backs.  This is the accepted protocol today in most communities and cultures. With this great discovery comes a consequence and price. The increase of flat headed babies.

Tummy time is the exercise activity of keeping the infant on his tummy for a prescribed  amount of time. While awake although effective it’s challenging to say the least as any parent can attest to.

Three categories of plagiocephaly

Why is this condition called plagiocephaly? Often the misshapen head resembles a parallelogram when looking at it from a distance above the baby.  There are three subcategories to this condition.

1) plagiocephaly – as stated above

2) scaphocephaly – long and narrow shaped

3) brachycephaly – wide and flat.

Is plagiocephaly dangerous and can it be cured by itself?

Although not life threatening, this condition should not be ignored by the parent. Flat head syndrome will usually not go away by itself.  It could also have social and psychological repercussions if left untreated.  Children are very sensitive to “flaws” and have no hesitations in mentioning their friend’s blemish to them.  A misshapen head can have serious reverberations on the the child’s own self image as he or she matures. And surprisingly there have been recent studies claiming that there can be auditory processing problems. Difficulty with vision as well and dental function and other issues.

The use of cranial orthosis or helmet therapy is used to correct plagiocephaly.  Helmets work by directing growth from the flat spot. These helmets must be worn early enough at the time when the skull as well as the brain are actively growing.  At the time of the baby’s doctor visit or checkup, the pediatrician will recommend a helmet after a complete evaluation of the baby’s head and head shape. The parent is then referred to a local certified orthotist and a custom made helmet will be ordered for the baby after taking detailed measurements. A trained Orthotics Specialist is trained to meet stringent criteria set by the American Board for Certification in Orthotics. After the required years experience, and exams the specialist  becomes a C.O ( certified orthotist). The parent should check to make sure the specialist he sees is certified correctly.  

Do the descriptions here seem like they are similar to your baby’s symptoms? Are you agonizing whether to treat your baby’s flat head syndrome?  Rest assured that these helmets do not harm the babies head and flatness does not return after treatment. Parents can get confused by well meaning grandparents and other lay advisors.  How does a parent know what is best? Unless the parent is very diligent when the baby is born to include tummy time at regular intervals the advice to leave well enough alone doesn’t necessarily hold true. If  the flattening is acute and the baby is older than five months cranial therapy is the effective and lasting treatment.

A groundbreaking study that was published in April 2015, provides compelling confirmation that helmets will correct plagiocephaly when self help therapies such as tummy time do not help. As of late, many Pediatricians agree that the only way to successfully treat flat head syndrome

is with cranial helmets. A wait and see attitude is very detrimental.  Once a baby reaches 12 to 14 months of age the skull becomes harder and the only alternative would be surgery which can be dangerous and is only recommended in extremely rare cases.

The first group of flat headed adults are now starting to be acknowledged by cranial therapy clinics.  These are the babies whose parents were instructed to sleep them on their backs only, in order to prevent SDS (Sudden Death Syndrome).  There has been a huge increase in inquiries from parents of children ages 2-5 years of age as well as even from teenagers and young adults. They are seeking advice on improving uncorrected head flattening’s.  Unfortunately, and sadly all that can be done for them is to give them reassurance and guidance and even a referral to a social worker. Fortunately, for today’s parents of infants this will be totally unnecessary thanks to the development of cranial helmet therapy.