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What does your baby’s head shape have to do with sleep?

It may seem like there is no connection at all between your baby's head and the way they sleep but, as a sleep coach and a newborn care specialist I have learned how important it is to take into consideration how your baby lies down and how the baby's head is shaping as it can affect some other

If you have a young child at home, chances are you have heard or even read about putting your baby to sleep on their back.

This practice was pursued more ferociously when the “Back to sleep” campaign was launched back in 1994. It simply stated that “The American Academy of Pediatrics” recommends that healthy infants, when being put down for sleep, be positioned on their back”. Since then, the rate of SIDS (Sudden Infant Death Syndrome) has decreased by about 70 percent.

But as the rate of SIDS decreased, the number of children that need to use a helmet to correct a flat head syndrome has increased.

The flat head syndrome, more appropriately known as plagiocephaly, is a deformity of the skull in which one side is flatter in the front and the contralateral side is flatter in the back. In more common words: plagiocephaly is an asymmetric head shape.

There are certain things that can cause plagiocephaly:

  1. Prematurity: When a baby is born premature, their heads are still a bit softer and therefore are more maleable. In fact, we observe it in NICU babies more often than in non NICU babies.

  2. Intrauterine constraint: Having less and less room in utero. This happens often with multiples

  3. Gender: Boys are more prone to a flat head syndrome than girls, which I personally believe is because of a softer skull.

  4. Firstborn: Let’s say that the first child has a tougher time coming out of the womb, opening up the canal for potential future siblings. So it is more likely that they experience a bigger force in the delivery.

  5. Torticollis: torticollis is tightness on one side of the neck, making baby be prone to turning the head towards one specific side most of the time. If you notice that your baby is always turning their head towards one specific side, you may want to speak with a pediatrician about it and get a referral.

Now, these are things you have no control over. If your baby is a premie there is nothing you can do, right?


In fact, early detection is key here! Just by being aware of this it will make you more careful about how you position your baby. Also, if you suspect that your baby may be developing the flat head syndrome during the first five months of age, I want to prompt you to get a referral from your pediatrician because it is still possible to fix it without having to rely on a helmet. And let's be honest here: nobody wants to put a helmet on their baby. They need to be worn for around 23h/day for a few months and, even though babies get used to it fairly quick, still, they are not precisely cheap.

If your baby is between the ages of 6 and 18 months and your pediatrician detects any form of plagiocephaly, he may refer you to a practitioner who specializes in providing plagiocephaly helmet therapy. We are lucky to have a provider like STARband, whose Cranial helmets are custom-made of plastic and foam to gently correct your baby’s head shape as they grow.

But what about the causes that you can actually control? Let’s have a look, shall we?

Sleep positioning and tummy time: when babies sleep on their backs, there is an external force that presses on the back of their heads, making it more likely to flatten it on that side (brachycephaly) Same happens when our babies spend too much time lying on their backs playing with their overhead gym. Solution: Tummy time! I know that this can be difficult when your baby is younger than 2 months. They tend to not tolerate tummy time too much, but you can introduce tummy time in daily activities! How about putting baby on their tummy when you are massaging with lotion after their bath? If you use a colorful cover for your changing station you can make it extra interesting for your little one. I have found some really good covers here

It is also a good idea to have some space for tummy time everywhere the baby and you may potentially be. There are tons of very cute and comfy playmats easy to keep clean for baby. Check these here.

If your baby is showing more of an elongated head shape, meaning that the sides of the head are more flat, then an overhead gym can help you!

How about introducing tummy time in your daily routine? You can have baby on the tummy when applying lotion on the back! Find some little moments like this and introduce tummy time little by little.

One sided handling: This happens more often than we notice! Because a majority of people are right handed, we typically hold our babies on the same side every time, which leads to more pressure on that side. If now you are thinking “Oh yes, I may be doing this!” Then the solution is very, very simple: alternate positions frequently! If baby is always laying on the same position, mix it up! The more variety, the better. If they have a flat head already, then insist on the other side. And be mindful that this is not only when you hold your baby to sleep, but also for a feed or play.

Containers: DocATot, Bjorn bouncy chair, Bouncer, car seat…. All of these are containers. You put baby in them and they restrict baby’s moves. Are they entirely bad? No, but try to limit their usage to 1-2 hours per day. The less, the better.

In fact, staying out of containers promotes regular development. We want the baby to move around, discover his/her own limits, practicing holding the head up or trying to roll over.

Now, I sincerely hope that this post creates a bit more of awareness about a topic as important as your baby's head shape. As always, I am here if you need more info or references.

Need some more guidance on how to approach your baby's sleep when you are already dealing with plagiocephaly? You can book your 1 hour consult here!

Sleep tight!



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