Half of all babies have flat heads, how to prevent permanence

Teresa Tanoos's picture
Around half of all babies have flat heads that can be permanent

About half of all 2-month-old babies had flat spots on their heads after being screened by researchers for a new study, which is one of the first to assess just how common the problem is.

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The problem, say the Canadian researchers, is apparently due to all the devices created to hold babies safe and still.

“The reason why we want to catch this early is because if we see children with flattened heads, sometimes there are changes in their facial features,” said registered nurse Aliyah Mawji, who led the study from Mount Royal University in Calgary.

Pediatricians and pediatric nurses have noticed a significant increase in the number of babies with flat spots on their heads – a condition medically referred to as positional plagiocephaly, or "oblique head" in Greek.

Many health experts say the condition has to do with parents being advised to put their babies to sleep on their backs to prevent sudden infant death syndrome (SIDS). Such advice has tremendously decreased rates of SIDS.

However, given the natural anatomy of babies – with their large, heavy heads on top of weak scrawny necks – their heads tend to roll to one side when placed on their backs because their necks aren’t strong enough to support their ability to sleep face-up. This can lead to a flat spot over time because the skull is still soft.

As Mawji told NBC News, while researching the problem, she couldn’t find any studies that gave hard and fast numbers of just how common it is in babies.

“This was really surprising,” she said.

Accordingly, Mawji and a team of researchers conducted a survey in four Calgary clinics where parents brought their babies in to have their heads screened. The researchers examined 440 babies between the ages of 7- to 12-weeks. The results were astonishing.

“We found that 46.6 percent actually had some form of plagiocephaly,” said Mawji, adding that a slight majority (63 percent) had the flat spot on the right, which she said results at the moment of birth.

“This is actually due to the birthing process itself,” Mawji says. “The majority of infants come out in such a way that their head is turned to the right.” This tends to occur because the mother’s pelvis and spine consist of hard bones that don’t move; thus, a more flexible baby ends up getting squeezed out and twisted as a result.

While the condition is not considered medically dangerous, the researchers said the flattened head shape can become permanent, resulting in potentially negative psychological effects for the child as it grows up.

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"This is super common,” said Dr. Lisa Stellwagen, a neonatologist from the University of California, San Diego School of Medicine, who has also studied the condition, but was not involved in this research.

With the “overuse of car seats, and people not holding their babies like they used to, we've sort of rediscovered this problem with infants' head shapes,” Stellwagen told Reuters Health.

Mawji also talked about how a flat spot has the potential to become permanent, especially if nothing is done to correct it before the skull hardens as the baby grows.

Most of the cases Mawji saw were mild though – and not permanent. She notes, however, that while she made sure the babies in the study came from a wide range of family types, more research is necessary to confirm how common the condition is across the larger North American population.

In the meantime, the study led by Mawji and her colleagues has demonstrated that the condition is more common than most people think, but there are some proactive steps parents can take if their baby has a flat head.

First of all, move the child, advises Mawji.

“Even though it is still important to put your baby to sleep on the back to prevent SIDS, it is important to vary the side of the head that is down,” she says. “If you notice that one night when you put your baby down, the head is to the right, you want to make sure that the next night you are turning the head to the left side.”

She also advises being “mindful of devices or holding positions that put pressure on infant’s head,” which includes car seats and bouncy chairs. Parents and caregivers should make sure they are not always holding the baby in the same position at feeding time.

“Also, tummy time is important, too,” added Mawji, who advises putting the baby on its tummy when changing their diaper or playing, as that can strengthen the head, neck, belly and arms.

“Parents aren’t getting the message they should be doing these things,” Mawji says.

Regardless, some children have such severe cases that they need to wear a special orthotic helmet, which can cost up to several thousand dollars and have to be custom-made to properly fit. Experts says, however, that these helmets should be used only as a last result.

SOURCE: Pediatrics, “The Incidence of Positional Plagiocephaly: A Cohort Study”, Aliyah Mawji, et al, Pediatrics peds.2012-3438 (published ahead of print July 8, 2013), doi:10.1542/peds.2012-3438

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