How is an uneven head shape treated?

Your baby's head shape will most likely even out on its own. But changes in the way you position your baby can minimize unevenness and hasten its resolution. For example:

  • Change direction. Continue to place your baby on his or her back to sleep, but alternate the direction your baby's head faces when you place him or her in the crib. Or place your baby's head near the foot of the crib one day, the head of the crib the next. You might also hold your baby with alternate arms at each feeding. If your baby returns to the original position while sleeping, adjust his or her position next time.
  • Hold your baby. Holding your baby when he or she is awake will help relieve pressure on your baby's 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.
  • 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. Never rest your baby's head on a pillow or other type of soft bedding.

Helmets and head shape

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If unevenness doesn't improve by age 4 months, your baby's doctor might prescribe a molded helmet to help shape your baby's head. The helmet provides guided growth, maintaining contact with the baby's head in all areas except for the flat spot.

Molded helmets are most effective when treatment begins by ages 4 to 6 months, when the skull is still malleable and the brain is growing rapidly. To be effective, the helmet must be worn 23 hours a day during the treatment period — often a number of months. The helmet is adjusted regularly — sometimes weekly — as the baby's head grows and changes shape. Treatment with a molded helmet isn't likely to be effective after age 1, when the skull bones are fused together and head growth becomes less rapid.

Recent research, however, suggests that repositioning with or without physical therapy might be as effective as helmet therapy in many cases.

Beyond positional molding

Sometimes an underlying muscular issue — such as torticollis — causes a baby to hold his or her head tilted to one side. In this case, physical therapy is important to help stretch the affected muscles and allow the baby to more freely change head positions.

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 grows. This condition, known as craniosynostosis, is typically treated during infancy. To give the brain enough space to grow and develop, the fused bones must be surgically separated.

Remember, most cases of unevenness in babies' head shapes will resolve on their own. If you're concerned about your baby's head shape, check with your baby's doctor.

Jan. 29, 2015 See more In-depth