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Baby's head shape: What's normal?

Baby's head shape: What's normal?

Many newborns have slightly lopsided heads. Sometimes, it’s because their heads are molded unevenly in the birth canal. In other cases, head shape is affected by spending too much time in one position.

Although your baby’s head shape will probably even out on its own, varying your baby’s head position can help.

How position affects head shape

You’ll notice two soft areas at the top of your baby’s head where the skull bones haven’t yet grown together. These spots, called fontanels, are designed to allow a baby’s relatively large head to move down the narrow birth canal. They also accommodate your baby’s rapidly growing brain during the first 12 to 18 months of life.

Skull flexibility is a biological advantage meant to help babies survive and develop. But because your baby’s skull is malleable, too much time in one position can result in an uneven head shape well past the time when birth-related lopsidedness evens out. This is known as positional molding.

Positional molding is often most noticeable when you’re looking at your baby’s head from the top down. From that angle, the back of the head may look flatter on one side than on the other. The cheekbone on the flat side may protrude, and the ear on the flat side may look pushed forward. What you can do about it

Positional molding is most common in babies who spend most of their time on their backs in cribs, car seats or infant seats. Although this is the safest position for sleep, there’s plenty you can to do to keep your baby’s head from becoming flat or lopsided.

  • Change direction. Place your baby on his or her back to sleep — but alternate the direction your baby’s head faces. Or place your baby’s head near the foot of the crib one day, the head of the crib the next. Use varying positions in the car seat and other infant seats, too.
  • Hold your baby. Holding your baby when he or she is awake will help relieve pressure on the head from swings, carriers and infant seats.
  • Try tummy time. With close supervision, place your baby on his or her tummy to play. Make sure the surface is firm. If you must leave the room, bring your baby with you.
  • Get creative. Position your baby so that he or she will have to turn away from the flattened side of the head to look at you or to track movement or sound in the room. Move the crib occasionally to give your baby a new vantage point.

Helmets and head shape

Varying a baby’s head position is typically enough to prevent or treat flat spots. If the lopsidedness doesn’t improve within a few months, your baby’s doctor might prescribe a special headband or molded helmet to help shape the head. These devices work by applying gentle but constant pressure in an effort to redirect skull growth.

Helmets and headbands are most effective from ages 4 months to 12 months, when the skull is still malleable and the brain is growing rapidly. They’re worn continuously during the treatment period, with time off only to clean the helmet and the skin underneath. More serious causes

Rarely, two or more of the bony plates in a baby’s head fuse prematurely. This rigidity pushes other parts of the head out of shape as the brain expands. This condition, known as craniosynostosis, is typically treated with surgery during infancy. To give the brain enough space to grow and develop, the fused bones must be separated.

Metopic synostosis is a similar condition that causes a pointed forehead. It also may be treated with surgery during infancy.

Keep it in perspective

If you spend too much time worrying about your baby’s head shape, you may miss some of the fun of being a new parent. In a few short months, better head and neck control will help your baby keep pressure more evenly distributed on the skull. Chances are, your baby is right on track.

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