This is a question that concerned parents ask very often. You look at your little one and it seems to you that The child keeps tilting their head to one side. You think to yourself, ‘I’m not going to panic; maybe it’s just my imagination’. After a while, you start to notice a distinct flattening on one side of your baby’s head. Your heart skips a beat, and an intrusive thought pops into your head: ’Is this just temporary? Will it stay like this, or have I done something wrong?’ You push the bad feelings aside, but a sense of unease lingers in the back of your mind.
Eventually, you go to see a doctor or a physiotherapist to discuss your concerns. In this situation, the key factor is how much time has passed since the parent first noticed flat head syndrome in infants until he decided to take action. Time is a factor that often determines the prognosis in cases of head asymmetry.
You still hear people say that „the child will grow out of it”; unfortunately, the latest research and modern paediatric physiotherapy They suggest something completely different. Find out whether time is on your side, or whether every moment’s delay makes it harder for your little one’s head to return to its normal shape.
Positional plagiocephaly – is it the parents’ fault?
Positional plagiocephaly, as that’s the technical term for it flat head syndrome in infants, … is currently one of the most common issues parents come to us about. As a paediatric physiotherapist in Warsaw, I see the anxiety in parents’ eyes every day in my practice. The first visit is particularly difficult – parents worry that they’ll be told they’re not good parents, or that they’re doing something wrong. None of that will happen!
We physiotherapists are here to support you, dear parents, in your fight for the healthy development of children. We are parents ourselves and we know that there isn’t a single parent who doesn’t make mistakes. The fact that you’ve come to see me shows that you are attentive and caring parents who want the very best for your child.
What causes a flat head in a baby?
A newborn’s skull It is extremely flexible. It is a fascinating mechanism – the bones must be soft and flexible so that the baby can pass safely through the birth canal, and later on, so that the brain can grow rapidly.
However, this very flexibility means that if a child’s head As it rests on one side for most of the time (due to gravity and the hard surface), it becomes deformed. This can be compared to a soft ball which, when compressed and left in one position for a long time, begins to lose its perfectly round shape.
If you’d like to read more about the causes of a crooked head in children, please take a look at our article: Where does a crooked head in an infant come from?
‘It’ll sort itself out’ – fact or myth?
The most important question that almost every parent asks me is: „Will it sort itself out?” The answer, although it may not be what you want to hear, is: it doesn’t happen by itself.
The medical literature emphasises that There is some improvement as the child’s motor skills develop. Once a baby begins to control their head confidently, roll over and spend more time on their tummy, the pressure on the back of the head is reduced. However, if the flattening is already visible, the baby’s increased freedom of movement alone is unlikely to be sufficient to restore the symmetry of the head.
Research published, amongst others, in Journal of Craniofacial Surgery indicate that Without active physiotherapy support and changes to care routines, the asymmetry may remain visible even during pre-school and school age. In adults, it is very common to observe asymmetry of the head, manifested by one ear protruding more than the other, one eye being larger than the other, a lopsided mouth, the head tilted towards one shoulder, or a flattening of the skull at the back or on one side.
Why is a baby’s head like plasticine?
To understand why it is not worth waiting indefinitely, we need to look at the biological clock. The skull is at its most malleable during the first 2–3 months of life. This is the ideal time for intervention. Around the fifth month of life, the rate of head growth slows down, the bones begin to harden, and the scope for reshaping the head using physiotherapy methods decreases dramatically. As the child approaches their first birthday and the fontanelle begins to close It is no longer possible to change the shape of the head without helmet therapy.
Let’s also remember that flat head in an infant This is often more than just an aesthetic issue. As paediatric physiotherapist in Warsaw I always explain to parents what is „underneath”. Significant asymmetry of the head puts pressure on the child’s brain at the point where the head is flattened.
It is also often the case that head asymmetry is caused by abnormal muscle tone or torticollis. If a child has a restricted range of movement to one side, they will constantly rest their head on that same side. In such cases, until we relax the tense muscles, stretch the contracted tissues and strengthen the weakened muscles, we will not achieve muscular balance. As a result, the child’s head will become increasingly flattened in the same spot.
How can you help a child with head asymmetry?
If you notice a slowdown, don’t panic, but take action.
First of all, check where a good one is available paediatric physiotherapist in Warsaw or somewhere near you. Choose one who has extensive experience of working with babies and who has a certificate in one of the neurodevelopmental methods, namely NDT Bobath Baby or Vojta.
Choosing the right therapist is crucial, as with plagiocephaly, every day counts. A skilled specialist will increase your chances of achieving satisfactory results from the treatment.
Whilst you’re waiting for your appointment, try following these few steps, which I recommend as both a mum and a therapist:
- Don’t worry about things before they happen
You’ve spotted the problem, booked your little one in to see a specialist, and you’re about to introduce a few rules to help with symmetry. That’s already a huge amount, so remember that you’re the best mum you can be. Your little one needs a mum who smiles so that they can smile back. - Tummy time
This is absolutely essential. Every minute spent on your stomach is a minute without any pressure on the back or side of your head. It’s also the best workout for the abdominal muscles and shoulder girdle for children. Of course, this is only the case if the child is lying on their tummy in the correct position (with their weight evenly distributed on their forearms or hands, on a firm surface, and without tilting their head backwards)! - Changing the position of the child in the cot
Babies love looking at a light (a window or a lamp) or at a parent coming into the room. That’s why you should regularly change the side on which you place your baby in their cot, to encourage them to turn their head towards the side they like less. - Carrying in active positions
Avoid overusing car seats (outside the car), rockers and baby bouncers. Whenever you can, carry your baby in your arms in positions that do not put pressure on the back of their head or on the side that is not flattened. - Alternate feeding
Even if you’re bottle-feeding, switch sides, just as breastfeeding mums do. This encourages your baby to turn their head to both sides.
More often than not, home remedies aren’t enough
Some minor flattening responds very well to the above changes. However, there are many situations in which the help of a specialist is essential. As paediatric physiotherapist I would advise you to see an orthopaedic specialist, a paediatric neurologist or a paediatric physiotherapist if:
- The child is much more likely to look in only one direction and protests when you try to turn their head in the opposite direction.
- The flattening is so pronounced that it shifts the line of the ears (one ear appears to stick out more).
- Do you notice any asymmetry in your face (one eye seems smaller, or your forehead is more prominent on one side)?.
In such cases, physiotherapy using methods such as NDT-Bobath or the Vojta method i paediatric osteopathy They help to balance the tensions in the child’s body, which is essential for the head to take on a natural rounded shape. In extreme cases, where physiotherapy proves ineffective after the age of 6 months, doctors may recommend helmet therapy; fortunately, however, in most cases, early intervention makes it possible to avoid this.
Patience versus vigilance
As a mum, I know it’s easy to feel guilty. I want to reassure you, flat head in an infant This is a problem faced by a very large number of babies today. It is not necessarily the result of neglect; sometimes a baby is born with asymmetry because it was positioned asymmetrically in its mother’s womb for a long time. Sometimes head asymmetry is the result of damage sustained during childbirth (neck muscles, brachial plexus). The orthopaedic specialists’ recommendations regarding safe sleeping on the back are also significant, as they are vital in the prevention of hip dysplasia.
The key, however, is balance. Sleeping on their back – yes, but time spent on their tummy and a variety of positions throughout the day – are essential. For proper motor development, a baby also needs to lie on their sides. A child’s head It has enormous potential and is highly malleable, but it needs your help and expert guidance from a specialist to realise this.
Is time on your side?
When it comes to flat head syndrome, time is on your side only if you take action. A baby’s head will not magically round out on its own unless the underlying cause (e.g. muscle asymmetry, torticollis) is addressed. The sooner you start taking preventative measures and doing the right exercises for a flat head, the sooner you’ll see the results. Remember that we are not just fighting for an aesthetically pleasing future, but for a child’s normal psychomotor development.
Don’t wait until flat head syndrome in infants „It will sort itself out.” If you’re concerned about the shape of your baby’s head, or if you notice that your child favours one side, consult an experienced paediatric physiotherapist. Sometimes, just one visit can put your mind at rest and provide you with a clear plan of action that will restore your child’s full range of movement and a beautiful, healthy smile (and head shape!).
Would you like to check whether the shape of a baby’s head Does it require treatment? I’d like to invite you to a consultation at specialists from Kids Medic – Together, we’ll make sure your little one gets off to a healthy start!
Anna Bernaś
Paediatric physiotherapist
Source of photos: Magnific.com
