Flat Heads in Babies: Early Intervention Matters

Did you know that according to the American Academy of Pediatrics, nearly half of all newborns develop a flat head by 4 months old? The good news is early intervention with a pediatric physical therapist can help ensure proper head shape development and support your baby's growth and development. Additionally, pediatric physical therapy is the gold standard for treating flat head (plagiocephaly) and is most effective when initiated within the first two months of life. 

Three types of head shape variations can occur in babies: plagiocephaly, brachycephaly, and scaphocephaly.

• Plagiocephaly is the unilateral occipital (back of the head) flattening with possible facial asymmetries. Positional plagiocephaly is the most common and is caused by sleep position. It's often linked to congenital muscular torticollis (CMT), which causes a head tilt to one side and a chin rotation away from the tilt. Torticollis can also present with facial asymmetry, difficulty feeding on one side, and a preference to use one hand more. 

• Brachycephaly is the flattening of the central occiput (back of the head) with the skull appearing wide and short. 

• Scaphocephaly is a long and narrow skull shape and is common in premature babies or those who spend extended time in the NICU or are positioned side-lying. 

Causes of flat spots include:

• Pressure on the head in the womb or during birth.

• Global tension throughout the body, increasing forces on the back of the head.

• Preference to turn head to one side while sleeping

• Spending too much time in a supine position (lying on their back) with very little or no time spent in prone. 

• Excess time spent in carriers or position devices including swings, car seats, and strollers.

Other possible effects of flat spots:

• Facial asymmetries 

• Asymmetrical movements such as uneven eyes or ears, fuller cheek on one side, and/or nasal deviation

• Delayed milestones

• Cosmetic differences

• The preferred use of one hand

• Feeding difficulties

If you notice any flattening or a preference for turning their head in one direction, early intervention with a pediatric physical therapist specializing in infant development and torticollis is key. Early intervention is crucial for achieving the best outcomes, with shorter episodes of care. For example, babies referred before 1 month old have a 99% chance of optimal results with 1.5 months of treatment, after 1 month of age prolongs intervention to six months, and referrals between 6-12 months can lead to longer treatment durations (up to 9 months) and progressively fewer infants achieving optimal results. 

At Movevery, we will take a holistic approach to reducing global body tension through specialized pediatric physical therapy bodywork including Gillespie Approach Craniosacral Fascial Therapy (CFT) and Total Motion Release (TMR) Tots. In addition, we will suggest and coach caregivers on environmental adaptations to decrease pressure on the flatter spots. Then, through play-based activities such as rolling and tummy time, we will strengthen your child’s body to improve neck range of motion, optimize head shape, and ideally avoid a helmet. If necessary, we will provide guidance and advice for a helmet.

If you have any concerns or questions about your child, please book a complimentary consultation with us at hello@moveverypt.com.