Q; What I can do to prevent my baby developing a flat head on one side?
A; Awareness, and what you do at home, is the starting point. Parents can help their baby to develop good and balanced neck mobility.
When your baby is asleep in his or her cot, pram or buggy, you could gently turn his or her head to face the other way.
When your baby is in her or her car seat, place a rolled up muslin on the side your baby tends to turn or lean to, to give support.
When putting your baby into their car seat, take care to get him or her nice and straight in the seat before you start your journey. Car seats ideally should only be used for travel. Once you have arrived at your destination, take your baby out of their car seat. Make sure the seat isn’t too big or too small.
When carrying your baby in a sling, notice if he or she is looking to one side, and if so, think about what you can do to reposition or support his or her neck. Try to get used to us- ing the sling over both your right and left shoulders and alternate.
Modifying daily Activities
As a mother and father you are the center of your baby’s little world. Your baby loves to gaze and play with you. This is the most fantastic tool you have to help your baby turn his or her neck in a particular direction.
If your baby generally looks to one side, talk, sing and play with him or her from the other side.
Babies often turn their head in the direction of light, so positioning your baby so that when they look towards the light they are looking away from the side they prefer.
When bottle feeding, make sure you can feed with your baby in your right and left arms, and alternate between arms. If your baby prefers turning their head to the right, holding them to feed in your right arm will encourage them to turn their neck to the left and vice versa.
As breastfeeding mothers generally feed from both breasts, they generally don’t need to worry so much about feeding position. However, if a baby has a tight neck on one side, it may be more difficult to latch that baby on one breast, or feeding may be more painful on one side. If that is the case I would suggest getting a baby check by a cranial osteopath, as releasing neck tension can make a big difference to the ease and comfort of feeding.
When carrying your baby in your arms, notice if he or she always looks in one direction, and if so think about what you need to do to encourage them to look the other way. You may want to carry them on your other hip, or support his or her head differently. Having toys, especially musical toys and mobiles, on the side you wish your baby to look to can be helpful.
Tummy time, lying baby on their front, gives your baby’s head an important break from having constant pressure on the back of his or her head. It importantly helps your baby to develop good head and neck control, and good strength in the shoulders and back to pre- pare them for crawling.
You can never start helping your baby to get used to being on their tummies too soon, re- member many of us were put to sleep on our tummies from day one. Tummy time is most successful when your baby is not tired or hungry...
From birth you can put your baby on his or her tummy when they are awake. Little and of- ten is the best way to start. Your baby may just be happy in this position for a few moments but gradually you will be able to extend the time.
When your baby is on their tummy on their play mat, get down on to the floor and play with them. Put toys, and books they like in front of them, think of games you can play with them, like peek a boo, playing with a mirror is good too.
When you lay down, you can have your baby lying on your chest. When you are sitting, you can let your baby lie tummy down across your knees. You could massage your baby’s back after they have had a bath. Let your baby spend a little time on their tummy after a nappy change
If your baby really will not tolerate time on his or her tummy, then rolling up a small blanket, and tucking it under his or her chest with arms forward can be helpful. Also removing socks can be helpful too, because your baby can use their feet without them slipping to give themselves greater stability.
If you are concerned about your baby’s head or neck, a baby check with a cranial osteopath can help identify why your baby is not moving his head correctly or why your baby is developing plagiocephaly. Cranial osteopathy is a very gentle treatment that aims to help restore good balance and mobility in a baby so they are starting life with good foundations for development.
If despite your efforts to reposition your baby’s head, he or she still always wakes lying with their head to one side, or he or she is starting to develop flat spot at the back of their head, then you may wish to consider using one of the special baby pillows that are available to help prevent plagiocephaly.
The Swedish Health department recommends that all newborn babies should sleep on their backs with a soft pillow to help reduce the possibility of developing plagiocephaly, but this is not currently a UK recommendation.
There are a number of pillows that are available, please enquire at Fulham Osteopaths reception as we hold stock.
If you have been following repositioning advice, and encouraging your baby to spend time on it’s tummy, and you think his or her positional plagiocephaly is getting worse, you should consult your GP. An Osteopath, (who must specialise in babies), will also be able to give you advice about any next steps.
If you feel your baby’s head is not growing, if there are any ridges on your baby’s head, or if there is some delay with his or her development, consult your GP. Nobody minds helping to answer the questions you have!
Babymoov Lovenest Baby Pillow - it is a red heart shaped pillow, for babies up to about 3 months of age. It can be purchased from online at www.mykiddistore.com, or from JoJo Maman Bebe.
The Butterfly Baby Head Support Pillow is also very good, and can be purchased at
Lilla Kuddis Baby Pillow – a simple soft rectangular pillow that is only available on- line at www.lillakuddisbabypillows.co.uk
Q; If my baby has a flat head when should I be concerned?
Better to be safe and reassured. Just ask somebody who sees this often and they will instantly know where your baby is on a spectrum.
There is another type of flat head shape, known as Brachycephaly. With this shape baby’s head is very flat at the back and quite broad. Sometimes this head shape can be caused by a baby lying flat on their back. It is then known as Positional Brachycephaly and repositioning and tummy time are important. However, just occasionally this head shape can have another cause and it is important that your GP checks your baby over in case X-Rays are needed.
Q; I have seen a baby wearing a helmet to correct their head shape, do you think this is a good idea?
There is a time and a place for everything, and with some severe cases of positional plagiocephaly or positional Brachycephaly, that have not responded well to repositioning, and tummy time combined with cranial osteopathy, a helmet may well be an appropriate treatment.
I don’t think a helmet should ever be the first course of action. Repositioning, tummy time, modified daily activities and a cranial osteopathic check over should be the starting point. A baby’s head shape should be monitored for improvement and if there is little or no improvement with a severe case over a few weeks, a helmet may be beneficial. This is only ever true for a small number of babies. There is an optimum window of time, between 4-9 months of age, where a helmet can be most effective in helping promote good head shape. There is not need to panic if you think your baby has a misshapen head, as there is plenty of time to try more conservative approaches.
I recently had a baby referred to me aged 12 weeks with the most severe case of plagiocephaly I had encountered. I felt a second opinion was important, and sent the baby to a centre that specialises in treating babies with misshapen heads through the use of a helmet.
The parents had to wait several weeks for an appointment. In the meantime, I treated the baby weekly, and the mother was very diligent at following my advice regarding position- ing, tummy time and modified activities. By the time the appointment came along, the degree of plagiocephaly was significantly less. Although a helmet was recommended, the parents decided to wait a little longer and see how thing continued to progress. This baby is now 6 months old and has an almost perfect head shape. A helmet in this case was actually unnecessary; although when I first met the baby I was almost certain a helmet would be required. Change is an unpredictable thing!
So to conclude, these days there are many options to get assistance if you have concerns about your babies head shape. In most cases, with some advice and perhaps treatment, things steadily improve.
Melinda Cotton, DO, is a consultant osteopath at Fulham Osteopaths, SW6 5HA and has been in practice since 1989. Should you wish to discuss any matters raised in this question and answer or to make an appointment, she can be contacted at Fulham Osteopaths on 020 7384 1851.