Your Quick Guide to Preventing "Flat Head"

Here's a simple proactive plan you can start from day one (that isn't just "do tummy time"!)

If you’re a new or expecting parent, chances are you’ve heard the term “flat head” tossed around, and maybe it’s made you a little nervous. As a first time mom myself, I was more worried about torticollis than "flat head" and when my son developed both I felt defeated and very worried. The truth is, flat head syndrome (or plagiocephaly or brachycephaly) is incredibly common, but also very preventable with the right strategies in place from the start.

This guide walks you through exactly how to support your baby’s head shape during the early months of life, particularly from birth to 4 months old. These tips are not overwhelming or stressful, but practical things I did with my second child to avoid flattening. Many other parents have implemented these exact strategies too through the education and work we do at Infant Insights.

To start, why does "flat head" happen?

Flat spots typically develop when a baby’s head stays in the same position for too long, especially during those early weeks when their skull bones are SO soft. At the newborn stage, and until 4 months old, our babies do not move a ton on their own and do not have adequate head control to sit up on their own. They rely on us to omve them, and therefore us to avoid flattening from developing on their head. 

Here's some visuals on different types of "flat head" 👇 

Source: Cranial Center

These head shape changes are common, but they can all be prevented with a few easy-to-implement tips!

Tip #1: Prioritize Tummy Time

Tummy time is one of the most effective ways to reduce pressure on the back of your baby’s head. Start with just a few minutes at a time after diaper changes or naps. Except your baby to only tolerate a couple minutes at most in the newborn stage. Your baby is developing head control at this age and tummy time requires a lot of strength. 

As your baby grows, tummy time will become much easier. Around 3-5 months, your baby will be completing tummy time like a champ with more time tolerated as their head control develops.

Here's a quick guide to tummy time tolerance 👇 

Pro Tip: Tummy time doesn’t always have to be on the floor! Laying your baby on your chest while you're reclined, allow your baby to lift and turn their head in the baby carrier, or complete tummy time on an elevated surface. 

Step #2: Don't Sleep on Sidelying Play

Sidelying is another AMAZING (and often forgotten!) position for babies. Sideying helps to round the head shape and avoid back flattening, plus this gives your baby a new view on the world to work on midline orientation, rolling skills, and visual skills. 

Place your baby on their side on a play mat with a rolled-up towel behind their back for support, or roll your baby out of tummy time and slightly to their side with their hips closed. Be sure to switch sides (EVEN IF YOUR BABY HAS A SIDE PREFERENCE) each time to ensure the head stays narrow, rounded, and the neck does not become tight(er). 

Step #3: Avoid Containers When You Can

I know that containers are inevitable at times, especially when you have laundry to do, dishes to clean, and maybe even other kids to attend to. 

Using containers are okay, but be sure to do so within moderation. Best case scenario is doubling the amount of floor time with container usage. You may also consider alternating your baby's head in the container using a rolled blanket or prop to ensure all sides of the head are keeping contact with the surface.

Car seats, swings, bouncers, and loungers all have their place, but too much time in these “baby containers” can contribute to flat spots.

When using car seats, try to aim for only using them in the car. Using a car seat as a stroller can increase your baby's risk of "flat head". Using a baby wrap, like a Solly baby wrap, is a great alternative to the car seat.

Try to keep your baby’s awake time mostly on open, flat surfaces like a blanket on the floor. It doesn’t have to be fancy! Simple and supported is best. I promise, THE FLOOR IS BEST.

Step #4: Rotate Your Baby's Head During Sleep

Since safe sleep means babies sleep on their backs, it’s extra important to help them shift pressure from one side to the other.

Here’s how: alternate which end of the crib your baby sleeps at each night, and gently turn their head to ensure they are looking out into the room. If your baby is resistant, stretches are important to ensure you address the tension in their neck ASAP. Find stretches inside our FREE "Flat Head" guide.

Another strategy is to think of your baby's head like a pancake. We want to be sure that all sides get proper attention (sides, one side, or back), so one side of the head doesn't get "burnt". If your baby sleeps the majority of the time on the right side at night, be sure to prioritize left side pressure during the day. This may require you to prop them up slightly with a rolled blanket, but this alternating pressure day-to-day will keep the flattening away!

Tip #5: Start Stretches If You Notice a Side Preference

Like we mentioned above, side preferences are so common. If your baby always looks one way or tilts their head to one side, it may be a sign of neck tightness, and possibly torticollis. This can lead to flat spots if not addressed.

Early stretching routines (under the guidance of your pediatrician or therapist) can make a huge difference. The earlier you catch it, the easier it is to manage.

Step #6: Check The Head Shape Every 2 Weeks

Starting around 2 weeks old, take a quick head shape check every couple of weeks from the very top view. Look down at the top of your baby’s head when they’re calm or sleeping, and notice if one side seems flatter than the other. See the photo below as a guide 👇 

All rights reserved: Infant Insights

Early changes can be very subtle, but catching them early gives you time to adjust positioning before the flatness becomes more pronounced. Right flattening = more time on the left side needed. Left flattening = more time on the right side needed. Back flattening, or widening of the head = more time on the opposite sides needed.

Last thought - some flattening is normal. 

At the end of the day, there is no perfect head shape. And some mild asymmetries are completely normal. 

Making small, consistent habits like those mentioned above really add up in preventing "flat head". And if your baby does develop a flat spot, don’t panic. Early action, like that we teach inside our "Flat Head" Course can often correct it without the need for a helmet.

If you want a step-by-step plan for "flat head" correction - check out our course.

I know the feelings all too well of navigating "flat head" with your baby. This can bring up emotions of anxiety, doubt, fear, worry, and feelings of defeat. You are not alone as "flat head" affects 50% of babies. 

If you need help navigating "flat head", or anything in the baby stage - Infant Insights is here.

Feel free to share this post with a new parent friend who’s wondering about flat head too! ❤️