Most parents have heard about the “Back to Sleep” program which was widely started in 1992. This program was started in an effort to decrease the number of SIDS (Sudden Infant Death Syndrome) cases. While SIDS rates have dropped in half, the incidence of “Positional Skull Deformities” or “Positional Plagiocephaly” have increased from roughly 1 in 300 in 1992 to 1 in 60 births currently.

Positional Skull Deformities vary widely in severity and treatment. Baby’s skulls are very soft and pliable during their first year of life. Parents frequently notice the misshaping around the 3-4 months of age mark. The skull shapes seen most are a flattening of the back of the skull or of one side (egg shaped).

So what can you do as a parent if you think your baby has the beginnings of misshaping?

Increase supervised “Tummy Time”. Make awake activities on their stomach more frequent. This decreases pressure on the back of the skull and increases their head and neck control.

Rotate their sleeping positions. Put them down on their sides, not just flat on their back unless their doctor recommends otherwise.

Try to limit their time in car seats, swings, strollers and cribs. All of these are noted for keeping them in a position which applies a lot of pressure to the back of their head.

Get a Physical Therapy referral. For children who might have some tightness of their neck (Torticollis), a stretching program may be beneficial.

Obtain a Cranial Remolding Helmet.

These are those cute baby helmets some of you might have seen. Cranial Remolding Helmets are custom made devices which utilize specific principles to treat the skull to grow in a more even shape. They require regular monitoring to insure the proper shaped outcome. This mainstream treatment is reserved for the moderate to severe cases. This treatment can be highly effective when properly utilized.

There are other causes of Skull Deformities besides just positioning. This is why discussing your observations with your Pediatrician is important. Your Pediatrician may recommend a referral to a specialist if needed in order to rule out other conditions. The thing to realize is time is critical when beginning whatever treatment plan. The 4-6 month window is optimal in allowing enough corrective treatment time prior to 12 months old (this is when the skull becomes much harder to reshape).

Remember, mild flattening is completely normal and normally resolves by 12 month but when in doubt, listen to that voice saying “We should ask about this”.

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