Uneven Shape of Baby’s Head

In the recent past some mums have asked Pregnant the question: ‘can the uneven shape of a baby’s head be reshaped after birth?’

This feature explains what parents can do if the shape of their baby’s head does not self correct as expected.

How Common Is Uneven Head?
Quite common! It can happen when the baby is in the uterus, during delivery or after being born. It is known as plagiocephaly and pronounced play-gi-o-cef-a-ly.

The bones of a newborn baby’s head are delicate and flexible so the head is soft and may change shape easily.

A new parent may expect that the baby’s head will automatically be symmetrical. This may not necessarily be the case.

Note however that plagiocephaly means the rest of the head has an uneven shape. It is not the same as a small flat spot on the back of the head, which is normal.

The Causes
‘Moulding’ of the head as the baby ‘navigates through the birth canal. The skull bones shift slightly to ease the exit.

Flattening of the head at one spot may happen if a baby lies with its head in the same position for a long time or repeatedly. For instance, lying on her back with head always facing up or turned one side.

Ordinarily, a baby should be able to turn her head from side to side by the age of six to eight weeks.
A stiff muscle in the neck, known as ‘torticollis’ or ‘wryneck’ may prevent this natural movement, forcing the baby to lie in one position and pressurise one spot of the head.

How It May Look
Example of an uneven head.

—A flat spot on one side at the back of the head.
—One ear located further behind as compared to the other.
—One side of the face looking further forward than the other.

Should It Worry You?
No. Your baby’s head should go back to a normal shape within six weeks after birth. Sometimes a baby’s head does not return to a normal shape and the baby may have developed a flattened spot at the back or side of the head.

You need not to be alarmed since the condition does not affect the development of a baby’s brain.

However, you need to observe whether the flattening makes it harder for your baby to turn her head, which can worsen the condition.

If you have concerns about your baby’s head shape you need to talk to your health care provider when your baby is between four and eight months of age. This is because the greatest amount of self-correction will occur before 12 months of age.

The Remedies

Counter positioning
—this involves ensuring that your infant does not rest on the flat spot, by alternating her head’s position. The techniques can be taught by health care providers and involve laying your baby on her side while putting her to sleep and varying her sleeping (and head) position after every one or two hours.

Corrective Helmets
—this is a procedure that involves fitting a helmet on the baby’s head. It becomes necessary when the uneven shape is more severe or where the counter positioning described above does not work.

Cranial (head) remodeling helmets are lightweight and made of a thin hard shell with a foam lining for comfort. The helmet helps the skull re-shaping process by removing the pressure over the flat area, allowing the skull to grow into the space provided. Helmets work best between four and eight months of age. A health care provider makes a casting of your baby’s head and custom makes the helmet. You do not need to shave your child’s hair.

The helmet must be worn for 23 hours a day and may come off for one hour (i.e. to wash your baby’s hair). The helmet shape must be adjusted by the health care provider every one to two weeks and treatment usually takes between two to six months.

Wearing the helmet does not hurt and babies usually get used to it very quickly. Parents can get quite emotional when their child first wears the helmet. However, it important to know that this is a common feeling and to remember that treatment is temporary and the outcome is normally satisfactory.

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