Baby's Misshapen Head

Parent Q&A

  • Experience with craniosynostosis?

    (3 replies)

    Our eight month old has been recently diagnosed with unilateral coronal craniosynostosis. His head and face were always a bit asymmetric, but it became clear that he wasn't growing out of it - in fact it was getting more noticeable. We're working with Dr Sun (neurosurgery) and Dr Pomerantz (plastic surgery) at UCSF Children's Hospital, and have been happy with our experience there so far, but just to cover our bases we're scheduling a second opinion appointment at Stanford. We're probably looking at surgery in the next few months, since Dr Pomerantz prefers to operate somewhere around the child's first birthday. In the meantime, we'd love to connect with other families who've also dealt with or are currently dealing with craniosynostosis! 

    Hello!  I am a Pediatric Anesthesiologist at UCSF Benioff Children's Hospital in SF.

    I'd be happy to chat if you have questions about the surgical period/anesthesia.  It can be pretty stressful facing surgery for a young one, but things overall tend to go pretty well.


    Our baby was diagnosed with sagittal craniosynostosis by his pediatrician at his 2-month checkup; we met Dr. Sun a few days later and had endoscopic surgery the week baby turned 3 months, followed by roughly 3 months of helmet therapy. He's almost a year now and doing great overall. We also met Dr Pomerantz but ended up not needing him to be part of our baby's surgical experience. Our surgery and followup visits have all happened at Children's in Oakland.

    I know our situation's not quite the same as yours, but I'm happy to answer any questions you have -- please please feel free to contact me! Some highlights of our experience:

     -- we were in the hospital 2 nights, one in ICU and one in the regular surgical ward. It was not a lot of fun, but it was overall quite manageable -- they provided a breast pump and a place for 1 parent to actually stretch out and sleep. We did have to share a room in the surgical ward which was a little rough. I have no idea how COVID may have impacted any of this stuff or how UCSF's practices are different.

     -- the helmet was kind of annoying but not a big deal at all. The orthotist at Children's, Bobby Smith, is fantastic.

     -- our baby has definitely had some 'after-effects' of his surgical experience; nothing major, but they're there. His motor skills are a little 'behind-the-curve' (he didn't crawl til 9 months and now at almost 11 months is juuust starting to work reliably on pulling up); he's had ongoing minor digestive issues that we suspect may be related to the antibiotics he got or just the general 'slow-down' the surgery put on his system; and his sleep was kind of a mess for months after the surgery (though he was also 3-4-5-6 months old, so I don't know that I'd even call that one a relevant correlation). Overall, though, he's a healthy, happy, round-headed kid :)

    happy to talk more if you think it'd be helpful. The team at UCSF and CHO is fantastic and your son is in the best hands (quite literally: people fly from all over the country to have Dr. Sun do their kids' cranio surgeries, so can't get much better than that). <3

    Our daughter also had unilateral coronal craniosynostosis and had surgery when she was 8 months old at Stanford. She is now 11 years old and doing well. We did get a second opinion at UCSF at the time, and were very happy with the teams at both hospitals, we lived in Palo Alto at the time, so Stanford was just closer for us. I think the care teams at both locations have turned over since our daughter's surgery, so I can't provide feedback on the doctors, but I'm happy to discuss our experience with you.

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2013 - 2014 Discussions

Helmet for baby with flat head

May 2013

Our son is 7 months old and since he was about 3 months his head has been noticeably flat. We had him evaluated at CHO at 4 months and again at 6.5 months. Both times they said that his head should continue to round out some and that they did not recommend a helmet. They said they would prescribe one if we wanted to pursue it anyway and the treatment would take about 2 months. His head has improved slightly but is still very flat/indented on the back and the overall shape is definitely more blocky than round. We believe it will always be somewhat flat - the degree of flatness being the big unknown. We have agonized over this decision (should we put him through this, how we/he would feel later if it doesn't round out, how important is ''perfection'' etc.). The window is closing for us to decide as this is one of those things you can't go back and fix later. Wondering what people's experience has been with the helmet itself. How did your child/you respond to it? Anyone else go with the helmet voluntarily? Are you glad you did? Wish you didn't? Didn't but wish you had? Thanks in advance! Leslie

Go to see a cranial specialist immediately. Every day counts because you might miss a crucial growth spurt where you can significantly reduce the flatness. It takes about a month to get an appointment at Children's Hospital so make your appointment with your pediatrician immediately to get a referral. I highly recommend Dr. Toth. Seriously, a helmet or band is not a big deal at all, if you catch it early, you could be looking at a few months of adjustment, versus a LIFETIME of flatness. It does not get better on it's own. By age one the ability to adjust is significantly lower and by age two there is virtually nothing you can do to fix it. Right now check out the Plagio/Brachy Yahoo group for extremely helpful advice and interventions you can start at home now, like having your baby sleep on the other side, never letting his head touch the stroller/seat, etc during the day.
Hi there!I completely understand what you are going through. We agonized over that decision too. My daughter (who's now 3 years old) used one. She developed a flat head and was slow to crawl, sit, etc.. (probably because of sleeping on her back), and had torticolis. At around 5-6 months of age she went to physical therapy to try to correct the torticolis, with repositioning exercises, etc.. this and help her position. We did all the exercises, but after 2 months of therapy her flatness did not improved; she slowly learn to sit, roll, etc.., but was slower than most babies. The physical therapy was good for those things, but didn't do much for the flatness (I guess, it was already late for the head to reshape by itself, but that's my guess...). At around 8 months of age we had to make a decision too. It wasn't clear what the cons of having a flat head would be (besides the aesthetic), but the window was closing too for us. Some evidence in the literature says that it's important to correct that for proper cognitive development, etc.., but that wasn't clear and a couple of doctors we saw didn't think that either, but didn't oppose to using one. But our physical therapist heavily recommended. Either we did right then, or she would have a flat head. Against what we first thought, our daughter didn't mind the helmet at all; she first was surprised, but by the second or third day she was wearing it constantly except during her bath (her hair sweat though, so you should start it before the summer) and to take an occasional picture. She didn't care. Most of the improvement in flatness happened within the first month, and then, after a little over two months, her head became much rounder and we were done with the helmet. She was surprised when we took it off, and tried to put it back on. I would say there are no downsides to do it (if $$ is a concern, then that's other story). People might look at your kid sort of funny, like he has something weird, but you can explain, and these days you see more and more of this. All this said, this was more than 2 years ago, and the advice on this might have changed. You say your doctors do not recommended it, or think it's necessary. I would say that the other important thing is to make sure that your kid sits a lot, doesn't spend a lot of time on his back, etc... One of the reasons why there are so many flat heads today is that, babies sleeping on their backs. There has been a large increase in the number of babies that develop torticolis, because their necks are weaker as they do not spend much time in their tummies early on. Good luck with your decision! Carolina.
Hi there, I agonized over the decision about the baby helmet, as well. Our baby's head kept getting flatter and flatter because she always looked one direction when she slept. Dr. Toth at CHO told us that it likely would not correct itself, so we went ahead with it. Looking back, it was totally not a big deal. She had it on for just shy of 3 months, and did not seem to even care about it being there. It did not influence her sleep or anything like that. I took it off each day for an hour or so when I bathed her and washed her hair (the helmet made it really stinky!). We are really happy that we made the decision to do it, as it was very easy to fix when she was so little (6 months). The only thing that bothered me about it was that people in the supermarket, etc... kind of shied away from her or us, perhaps thinking that she had some head injury or something. Funny thing was that parents with toddlers approached me and asked where I got it, claiming that they needed it for all the head bumps. Anyways, I would go for it. Taking action now is better than regretting non action in the future. anonymous
our baby had a very very flat head that peaked maybe around 7 months, right before he started to sit and crawl. I was worried but the doctor said it would be fine so we didn't do anything about it. Now that he is 2 it is completely not noticeable. The doctor was right, his head grew so much that what seemed like a huge flat spot is now a tiny little flat spot on the back of his head under all his hair. I'm glad we let him be. anon
My son had a big flat spot at around 2 months. All the pediatricians I asked at Kaiser (I think I got 3 opinions) felt a helmet was not needed as it was completely symmetrical. I agonized about it too. In the end we decided not to do it for various reasons. 1) cost...we don't have that kind of money to get a helmet and our insurance did not cover it 2) there is no guarantee it would work or how well it would work 3) it potentially could round out on its own with out all the cost or the hassle 4) in most cases it is purely cosmetic. In your case it does not sound super severe if most dr. are not recommending it.

I am happy to report at 22 month you can barely tell he has a flat spot. But it did take awhile. I have had several friends who have passed on the helmet too. Their children are older (5 years old) and I can not tell at all they had a flat spot. If you feel my son's head it is a little flat/square. He is beautiful and that little imperfection does not take away from him at all. Plus I heard that the head can continue to round out for several years still. My two cents. HTH Margaret

Flat heads -- why the concern?

May 2013

All the posts about babies with flat heads prompt me to ask: what is the concern (other than aesthetic) about flat heads? I was a baby during the era when infants always slept on their tummies, yet I have a very flat skull. Some other members of my extended family do too, so I've always assumed it's a genetic trait. I'm not aware of any deficit attributable to a flat skull -- though I do joke that I'm not good at math because the math portion of my brain should have been where the flatness is. Seriously, is there new research on flat-headed babies? My head doesn't roll off the pillow

My mother has an extremely flat head and she cannot wear hats without a chin strap because they come right off at the slightest breeze. Also, she has to perm her hair to ''round out'' the look of her head because it looks so odd otherwise. Sounds laughable, but she hates it, and always made sure her kids slept on their sides to avoid this issue. (it's also a concern because your head is *supposed* to be rounded!) -charlie brown head
I also wondered and think that maybe it is a way for the medical community to make some money. Apparently it can cost upwards to $3-$5000 for head shaping units. Is it really necessary? I don't think so, we all Survived. What's next? Baby's feet too flat! Hmmmmm
The ''flat head'' issue we are talking about here is not one genetic, but it's caused by the babies sleeping on their backs. That's an aesthetic thing for sure, but more importantly, it's still not clear whether this kind of flatness (caused by putting pressure in the back of the skull)can cause neurological/developmental problems. More likely it will not, but the research, up to where I know, it's not conclusive. Before deciding on a helmet for my daughter I did some research, read papers, talked extensively to the drs, etc.., and I concluded that it was better to just do it. This was about 2.5 years ago, so things might have changed. Still, I consider that the aesthetic concern (if the head is severely flat) can be a valid issue too. I don't know if I would have done it out of aesthetic concerns only. I am glad I decided to do it for my daughter. Carolina
Well, the flat head may just be cosmetic, or it may not. I will say for my son, his wasn't just flat, but asymmetric. He favored tilting his head to one side, so there was bossing in his forehead that was becoming noticeable and his ears didn't line up. Yes, it may stay ''just'' cosmetic, but it may also lead to vision issues, jaw issues and so on. We were extremely pleased with the results of his helmet, despite the cost. Not saying it's for a mild case, my other son's head is still slightly flat on one side, but not noticeable with hair now. We really just didn't want to regret not doing something when we had the chance. -No helmet regret

Baby's flat head

April 2013

Hi, My 3 month old's head is even more flat now. The pediatrician said not to worry too much about it. Our baby is a back sleeper and the back of his head that is flat isn't growing hair. Any advice from parents out there to help with this? I am hoping he won't have to wear a helmet at some point. Thanks! Anxious Mom

Your current doctor could be wrong. I would ask for a second professional opinion. I used to know someone whose daughter's head was very misshapen (looking from above it's sort of like an obtuse triangle without the corners of course). According to her, the child's doctor said that's fine and it would eventually plump back up. In my experience, it will never plump back out even if it's a little flat. JL
I worried about this a lot, but it becomes a non-issue over time as baby develops. A few pointers for the meantime- For daytime, try the Boppy Noggin Nest for the stroller, bouncy chair and gym. Other than that, try to avoid buckets and baby wear instead where possible. Do tummy time to get the baby on belly- this can be really tough. Whether or not tummy time works, with time, baby will start moving head more and the flat spot will begin to fill out. Couldn't hurt to check with your pediatrician to see if baby has more flat head than normal. It'll all be fine! No longer a worry
Our first kiddo has somewhat of a flat head. Our pediatrician told us at the time that it was a mild case and that he did not need a helmet. However, I could definitely see that his head was somewhat flatter in the back.

However, we had a couple of other babies after our first, and their heads are fine. The difference, I think, is that our first l-o-v-e-d the baby swing, and looking back we probably over-utilized it. That, combined with the fact that he was a pretty decent sleeper even early on, led to him having the back of his head against something (swing or crib mattress) a lot of the time.

Our other children were not as into the swing and therefore we hardly used it. Also, after my first I was pretty concerned about the others getting 'flat head' so I made sure that they got plenty of tummy time early on and really made sure not to keep them in their infant car seat/bouncy seat too long, instead opting to snuggle 'em against me or carry them in the Moby or the Ergo. I really think this helped.

Anyway, I would pay attention to how long your baby has the back of his head against something (not including sleeping time, of course), and see if you can shorten/eliminate it. I'll be this would help, but if your kiddo still ends up having somewhat of a flat head, don't despair. My eldest is now in grade school and while I can still see that his head is flatter in the back if I concentrate on it, I'm fairly certain that others don't notice it (after all, when was the last time you paid attention to the backs of older kids' heads?). Fellow Mom

Hello Anxious Mom, I read your post and completely understand your concern - our son, too, had a flat head as an infant and we were very concerned as well. In our search for a solution, we came across the Noggin Nest - a pillow with a round hole in the middle that our son used EVERYwhere (naps, nighttime, car seat, etc.) and it made a HUGE difference. They sell for about $15 and you can find them at Target, Babies R Us, etc. but often just online. Do a google search and you'll see them. We couldn't have been happier with the results! Anonymous
If your baby's head is flat and getting flatter at age 3 months, ''don't worry too much about it'' is not good advice. You should worry. I hope your doctor also gave you lots of tips for mitigating the flatness (which is called positional plagiocephaly or flat-head syndrome). Do NOT wait to do something about this - there are simple steps you can take at home. If they work, you won't need the helmet. But if you wait too long, the flatness could be permanent. Read this BabyCenter article for a thorough explanation of what's going on and what you can do, including practical tips for helping your baby's head round out: . (Caveat: I'm an editor at BabyCenter. The article was approved by our medical advisory board.) This is a common problem now because babies spend so much time on their back. Please don't take a wait-and-see attitude. I know other BPN parents will chime in here and give you the same advice! -- Dana

2010 - 2012 Discussions

Infant's flat head

June 2012

Our pediatrician recently told us at our daughter's two-month appointment that she is developing a flat head. She advised us to refrain from using the bouncer, play gym, etc. or anything where our daughter is on her back. Our pediatrician told us to take her out of her swaddle at night so she has the freedom to move her head back and forth. She told us to sew a rolled up cloth under one side of her pajamas so as to cause her head to tilt one way when she sleeps. She also said to use the carrier more often so she is upright. Most importantly, she told us to increase the amount of tummy time to strengthen her neck.

Does anyone have any advice on how else to deal with a flat head? I think our daughter may just be prone to it due to the shape of her head, but I'd definitely like to prevent having to use a helmet down the road. Thanks! Concerned Parent

We also had a ''flathead'' infant and were thrilled to find an inexpensive remedy that worked - it's a pillow called the Noggin Nest, made by the pillow company Boppy. We bought ours at Babies R Us but you can do an internet search and find it many places for around $15. We used it every time our son's head was lying flat - when he was sleeping (nighttime as well as naps), in his car seat, etc. It worked great, and I HIGHLY recommend it! parent of a former flathead

Helmet therapy for plagiocephaly?

May 2011

Have you gone through corrective helmet therapy for your baby's flat head (positional plagiocephaly)? Or, have you elected not to go through helmet therapy? Our 8-month-old has a moderate to severely flattened head on one side. We were told by a specialist today that he should have a helmet that he will wear 23 hours a day for 6 months. It's not the end of the world, but it seems drastic and we would prefer not to go through that. I would love to hear about experience and results from parents who both did and did not choose to use a helmet. Thank you! want a rounder-headed baby

Eight months is a little late to address plagiocephaly, but improvements can be made. You say you want a rounder head: DO IT. Your child won't even care about the helmet and the time goes by in the blink of an eye. True, it's just a cosmetic fix (I'm assuming they already did the CT scan to rule out other abnormalities causing the misshapen head)...but why wouldn't you want to correct something for your child that's easily correctible? It doesn't mean you love your child less if you want to correct a physical doesn't mean you can't see past it for the beautiful child you have.

My son was put in a helmet, finally, at 10 months, when I knew he had a flat head from 3-4 months, but his doctor kept insisting it'd correct itself. It didn't. He was in it about 6 months, 23 hrs a day, and honestly, the time is irrelelevant. As a toddling boy, quite frankly, sometimes it was a relief he was in it. It saved quite a few bumps.

Just don't make the mistake of projecting how you would feel to wear a helmet on your 8 month old. Yes, you wouldn't like it as an adult. But your child doesn't have these feelings yet. You will be so happy you corrected an obvious physical deformity...there are plenty of things in your child's life you will not be able to. --glad my boy had a helmet, and his rounder head is the proof

I joined the Yahoo group for Plagiocephaly and I have to say, it really is the best resource for support, information, advice, etc. My daughter was diagnosed with plagio at 3 months by her pediatrician. I estimated about 7 mm deflection and we were really vigilant about repositioning. It did get better, but now at 8 months, it has slowed down since her head growth slowed. We were referred to Children's Hospital in Oakland and the doc said that we were doing a good job and to keep going with repo. We have a follow up next month to make sure. I was absolutely ready to get her a Starband (and still am if doc says to do it). In my opinion, a helmet is a relatively easy way to make a difference-6 months will pass by like nothing. This is your window of opportunity in terms of growth, you are already at 8 months, if you wait past 1 year it might be too late to make a difference. You can read thousands of questions/answers/stories/issues in the yahoo groups, it really helped me make an informed decision. -Plagio Mom
Do the helmet. I am an occupational therapist and have worked with LOTS of babies who have had the helmets and it really isn't as bad as you think. They just get used to it being there and it is no big deal. Better to do it now while your baby is young and to correct it early on. If you wait longer, the treatment will take longer. It may not even take as long as they said it would if you are consistent with having your baby wear it 23 hours per day. You'll be amazed at the before and after pictures. Good luck! Pediatric OT

Plagiocephaly: your experience?

Aug 2010

Help! My 9 month old has positional plagiocephaly (misshapen head). It's not severe but definitely noticeable. We've asked our doctor who says that it will PROBABLY correct itself over time. We have friends who wished they had done something because their babies' heads did not correct themselves fully. They did get better over time, but they live with small to medium sized flat spots.

So, I'm looking into what there is to do. There are helmets, band & craniosacral therapy. And of course, repositioning his head during sleep, which is what we are doing. It's hard with a 9 month old. He moves a lot during the night so we are usually checking a few times and repositioning him every night. There has been some improvement, but some of the issues of the shape are on the top of his head and positioning him doesn't help that area.

I'm hoping to get feedback from the fine folks of BPN on your experiences with any of the above treatments and/or hear about any others that I don't know about yet. There is so much information to sort through. Not to mention me feeling like something has to be done and we're running out of time. And, not wanting to make the wrong choice.

BTW - we do have an appt. to talk with a doctor about the helmet in a week and I'd like to meet with a CST practitioner, so any pointers on what to ask would be great too! Thanks. Cris

Hello. Short story: GET THE HELMET ASAP.

Long story: I was in your EXACT shoes when my child was 9 months old. But I had noticed my son's head was VERY FLAT in the back at 4 months and raised concerns then with the pediatrician. All the pediatricians in the practice assured us at one time or another that ''Oh, he'll be sitting up more soon, it'll correct itself.'' Well, no one listened to me. The main problem was that he slept flat on his back all night and was a WONDERFUL sleeper - 12 plus hours straight every night. Great for my sleep, but bad for his head. So by 9 months, the back of his head looked like a sheer cliff. FINALLY, his main pediatrician assented to giving us a referral to the main cranio-facial doctor at Children's in Oakland. He was pessimistic because to correct with a helmet, it's best to start at FOUR MONTHS (when I started begging my pediatrician for assistance but was rebuffed). We went to get a 2nd opinion then in San Francisco. The doctor there said he'd put Declan in a helmet - because why not?

You see, we had also tried in vain to reposition our boy -- safety pinned towels to the side of his pajamas so he'd tilt one way and then another on the next night ... but that didn't work. Neither did a wedge pillow. He'd eventually nestle right back into where his flat head met the flat mattress because it was most comfortable -- flat on flat, after all.

We went back to Oakland Children's and all of sudden the doctor thought a helmet would be ok. So we did it for 6 months. It WORKED. His head isn't flat in the back anymore. Now, it would have been a much more drastic improvement if he'd had the helmet earlier, say even 3 months earlier. His head shape is unlike anyone in our family's - very round because the skull pushed out that way while flattening in the back.

Anyway, good luck. Get the helmet. The 6 months go by FAST and the child is remarkably cool with it. Take all your pictures during the 1 hr break each day for bath and helmet cleaning. You won't remember it at all hardly! --Charlie Brown's Mom

My daughter, who just turned 8, had very noticeable plagiocephaly when younger due to sleeping on one side and probably also due to the use of vacuum suction during birth. I got quite stressed about it and did consider the helmet, but after much research, decided to go with craniosacral therapy when she was around 2. It's a very gentle method- almost like a massage of the scalp, but during one session I did see a significant movement of an obtruding area of her head. We did not follow through with a lot of sessions, however. The head does seem to round out quite a bit without much intervention as the child grows, but it does not become perfectly round. However, only I the mom could probably notice the lack of complete symmetry in my daughter's head at this age, especially with her mid-length hair. I suspect that none of us has perfectly round heads. I know the condition looks pretty significant right now, through, and sympathize with your concern and not knowing how it'll turn out. I don't know up to which age helmets help, but perhaps you could also check out craniosacral therapy, which is gentle and supposed to be great for babies anyway in multiple ways. been there
My now 2 year old boy/girl twins were diagnosed with positinoal plagiocephaly when they were 5 months old. Initially, our pediatrician gave us the typical advice that it would likely correct itself. However, my husband and I really pushed for a referral to a neurosurgeon at Children's hospital (which you need for children's hospital to take your appointment, even if you have a PPO which we did)for both children because we didn't want to take that chance. We felt strongly that we wanted to get a second opinion from a specialist. We saw neurosurgeon Dr. Peter Sun at one of his monthly clinics specifically for positional plagiocephaly at children's hospital and after the first meeting with the babies, he immediately recommended that helmet therapy would be of great benefit for both of them. He also told us that starting therapy before 5 months (but certainly the sooner the better) had the most chances of correcting the condition. We immediately were referred to a helmet company to have the babies' heads scanned and measured and fitted for helmets and they spent the next 4-5 months with the helmets. At the end of treatment, there was a remarkable difference and we couldn't be more thrilled that we pushed for that initial referral from our pediatrician. The strongest piece of advice I could give you is to trust your gut and push for what you want. If you want a second opinion or want to see a specialist, ask for it until you get it. If you have other specific questions, I'm happy to chat with you as well. Jua
Our child had plagiocephaly as a result of poor sleep position. Our pediatrician referred us to a doctor at Children's Hospital in Oakland who, after a very brief consultation, referred us to CTRS on 40th Street in Oakland. At CTRS measurements were taken and our child was fitted for a helmet which was worn from age 5 months to almost a year. We had periodic visits (about every 3 weeks) where new measurements were taken and the helmet was modified as needed. This all took place about 3 years ago.

After overcoming the initial guilt about allowing our child to sleep in a poor position and feeling neglectful about it, we embraced the treatment and are very pleased with the outcome. The head is near normal and the months in the helmet are long forgotten. The technicians at CTRS were great. We had the added benefit of a supportive medical professionals and very easy-going child. We found some additional support and information from the Plagiocephaly Group on Yahoo Groups.

All the best in your search and decisions. Plagioparent

2007 - 2009 Discussions

Back of baby's head is flat!

June 2009

My 10-week old baby boy has an alarming flat area on the back of his head from sleeping on his back. Our pediatrician told us that this will resolve itself but it's so severe that we question if this truly will be the case. As it seems that we would not be the only parents encountering this issue from having babies sleep on their backs, we are hoping for your advice/suggestions on how to stop his head from getting flatter short of having him sleep on his tummy (which is a big no-no) or on his side sandwiched by two rolled up towels (he refused this technique). Many thanks! anon

You might want to read this BabyCenter expert's advice, which offers a number of practical tips (one example: Put your baby down to sleep with his head at different end of the crib each night. Your baby will probably turn his head to look out into the room, shifting the pressure onto the side of his head. Alternating sides each night will help prevent one side from flattening.)

Will sleeping on his back cause a flat spot on my baby's head?

And this more comprehensive BabyCenter article on plagiocephaly (flat head syndrome):

It's definitely better to address this sooner than later. Dana

While 10 weeks is early, and this flatness WILL probably resolve itself (if it's not the more serious condition of craniofacial synostosis), I too became concerned about my baby's flat head around the same time. I pointed it out to the doctor, and she said it would resolve itself when he starts sitting up, blah blah blah.

Well, they kept saying that until he was 9 months old. The problem was, he was quite big for his age, and an incredible sleeper. And a sleeper in just 1 position - on his back. At 9 months he still could not turn over from back to front. Finally, at 9 months, my pediatrician's group (a different doc than his main) relented and referred us to a consult. Why they had to wait so long was beyond me - it was no skin off my ped group's back to refer us. Meanwhile, I had been genuinely VERY concerned as of 4 months.

We went to two craniofacial doctors. One in Oakland, one in SF. Both were FLABBERGASTED that we had not been referred earlier - like at 4 months. They both said that pediatricians are NOT dealing with this properly and they should be referring patients at 4 months - because that's when you will have much more success reshaping a plagiocephalic (misshapen) head with a helmet.

So yes, we had to have a helmet (as it was not a premature closing of the skull's sutures, aka craniofacial synostosis, as determined by a CAT scan).

We were at a serious disadvantage not getting the helmet earlier. His temples were sort of bulging out, his face was round, and the back of his head looked like a sheer cliff. The growth rate of the head is minimal between 9 months and 18 months, but that's what we had to do. He looks good now at 16 months - but then again, I'm his mom. Just today I got a comment about how round his head was and how I must be the au pair because he doesn't look like me (WHATEVER!). I have to let it go that we didn't get the helmet earlier, but it ANGERS me because I was on top of the situation from the get-go, and no one would listen to me. --Charlie Brown's Mom.

Someone may throw a brick through my window for saying this, but I sometimes let my infants sleep on their stomachs as long as it was during the day and I was right next to them -- right after a feeding, I would lay them down on a blanket on the floor next to me and sit there with them while they slept. Never at night.

However, you really have to get some side-sleeping in somehow. Can you roll him over to his side after he falls asleep? I alternated depending on which side I had nursed them on to make sure to switch it up. If that doesn't work, try swaddling him super tight, and sleeping him at an incline strapped into a bouncy chair on his side, with his bum slung through one of the legholes. Again, you need to stay nearby to make sure he is secure. You can also do this in a baby swing.

An Ergo, sling or Bjorn will also get him off his back for naps during the day, but obviously you can't do that for every nap, and you probably don't want to set that habit by making it an expectation rather than an occasional variation. Good luck! Creative sleep strategist

I wish my mother had let me sleep on my stomach. In the photos of me as a child I call myself ''little box head'' because my head is so flat. It never did round out and, while not a terrible liability, I would have like to have a rounder skull. Little Box Head
I don't know what to say to make you feel better, but my son, who is now 5, has a flat head. It still bothers me. We did the ''back to sleep'' but I even used those memory foam pads and still, flat head. The doctor told me it would ''resolve itself'' but it didn't. It was also suggested I try a helmet but that just seemed like a horrible thing to do. In the end, his head is flat, but no one can really tell these days except for me. Now that he has hair, it seems like he'll be ok. So, not exactly the best news for you, except that it's not the worst thing in the world. Now, if it's so flat it's distorting his face or something, then maybe you need to look into getting a helmet. But, you need to do it soon while things are still moving around. The weird thing is my second child who also slept on her back, did not get a flat head. I guess some children are just more suceptible. Good luck. mommy of a beautiful flat head
Our daughter was 14 months old when we adopted her in China. The back of her head was so flat that for the longest time, I winced every time I saw her profile. She was also bald back there -- no doubt that she had spent most of 14 months on her back! I never thought it wouldn't change as she spent more and more time with her head off a mattress, but our pediatrician thought it was so bizarre that he sent us off to Oakland Children's for a consultation with a specialist. That did alarm us. But the specialist walked in the door of the examining room and immediately said we had nothing to worry about -- he spoke with such warmth and certainty. But the ridiculous thing is that he told us her head was flat BECAUSE she was Chinese! Jeez. So much for specialists. Anyway, we left quite sure that she would be fine whether or not her head shape changed. Others in the same boat were told to buy special little pillows, to prop with towels, to try all manner of tricks. We did nothing of the sort and within a year, maybe two, her head was perfectly curved. (She's a teen now and still sleeps only on her back, by the way.) My advice is don't waste a second of your time worrying about a flat head. Just enjoy your child. been there
Our daughter was born with a torticollis (tight neck muscle) and therefore couldn't move her head much. Besides, she went to the NICU when she was born and was always put on the side in her isolette. She developed a flatness on one side, severe plagiocephaly. She is 16 months old and has been wearing a helmet for 11 months. Things are much better. We did a lot of things to improve her head shape: put toys on the opposite side for her to look at, play with a light ''wand'' going back and forth: side to side, so that she'd look both ways, and ultimately went for the helmet. It's a good thing we had her in one early, the earlier the better... Hope this helps. Sarah
Hello, Both my niece and nephew had this problem. My nephew's doctor told his parents that he would grow out of it, so his mom got a second opinon. He said the same thing. He is now three. His head is still flat, but you can not tell because of his hair. He is a totally healthy and happy little boy.

My niece's doctor had her wear a special helmet that helped shape her head correctly. They said she might have to wear it for 9 months to a year (I think). She is getting it off after only 3 months. It started working the first month, and her head looks totally normal. She was six months when she got it.

Just two different stories that I thought might help you decide what to do. anon

My son also had a very flat head and I was worried about it. I was assured that it would reshape itself and it did. Once he started to crawl around and then began to walk a bit, his head rounded out just fine. I'd say that it lasted to about 16 to 18 months. Now at age 4 and a half he looks at photos of himself and laughs with me about his formerly flat head. David
Hi-I had a similar problem with my son,who is now 4 yrs. old.Although, his head wasn't extremely flat, what I did to prevent his head from continuing to flatten, was to carry him (when he was napping) in a Baby Bjorn carrier facing me,or having him nap on my chest, although this position might not be too restful for you, or monitor him when he sleeps on his back and gently turn his head to either side so the pressure is off the back of the head.Anyway,with this combination throughout the day, helped to balance my son's head. Hope this helps. Denise
I would like to add one more thing to this discussion after reading the responses you got. I'm ''Charlie Brown's Mom'' who had her son put in the helmet at 9 months. I would like to say that just repositioning our kid, trying pillows/towels pinned to the back of his nightclothes, did not work. Nor did a wedge pillow. Nor did just turning his head. And no way would he sleep on his tummy or his side. It's a self-perpetuating situation because as the skull gets misshapen by the position the child likes to sleep in, it's MORE comfortable because it's the same shape as the mattress. He/she will PREFER to sleep in that position, and that position only.

Also, carrying our boy was an impossibility. I'm strong but he weighed 30 pounds at 6 months. I couldn't carry him when he slept. You may not be able to either. Also, he NEVER liked being carried that much anyway. He preferred to be in a swing, or in his crib.

Finally, I'll add that the helmet is not cruel. It does not hurt. My guy cried the first time the orthotics guy put it on, but that was more because he didn't really like the orthotics guy. That was the only time. He never cared about the helmet. And he was nine months old when he first wore it. The younger kids that get it at the times they should - around 4 or 5 months - are MUCH less aware and they adapt SUPER easily. Anyway, a helmet also came in handy when he began walking because he would have really cracked his head a few times there...!

I also got the helmet in a color of his dad's school and put some stickers on it so it looked like a football helmet. Combined with a baby's football jersey,...he actually looked SUPER cute. --Charlie Brown's Mom - and a fan of the helmet.

Hi, both my boys were born with torticollis leading them to always have their head in the same spot which led to flatness. With my first, the docs said ''it'll go away'' and so I waited. He was already 6-8 months old by the time I finally got them to refer me to PT and the children's hospital. By then his head was misshapen. We put him in a helmet and I've never been happier about it. His head went from weird shape to nearly perfect in 4 months.

When my second was also born with torticollis, we acted more quickly. I got him in PT nearly from day one and as the torticollis resolved early, he avoided the flat head and we avoided the helmet.

DO NOT BE AFRAID OF THE HELMET. My experience: 1) the kids look cute in them. 2) many other parents are aware of the helmet and we got a lot of support from people in the street. 3) the kids head reshapes very quickly the younger they are but as they get older, the head grows less quickly so you have to have the helmet on for longer. Do it early if you are going to do it. and 4) most important, babies don't notice the helmet, aren't bothered by it in the least, and it's over before you know it.

Finally, though, the reason we took the aggressive route and went with helmet versus ''it might resolve itself'' was simple. Once he's grown, you can't fix this problem. The time is now. So for me there wasn't really a ''choice.'' I'd rather regret having done something & it didn't work out than having not doing something and later regretting it. the time is now.

We loved the helmet, our son not from the first second minded it, and we have some adorable pictures of his blue eyes peeking out from under his beautiful blue helmet. happy helmet mom

2004 - 2006 Discussions

3-month-old with Torticollis and Postitional Plagiocephaly

June 2006

Hi, Wondering if any parents can share advice on infants who have been diagnosed with both Torticollis and Postitional Plagiocephaly? My son, who is 3 months old, seems like he may have both (his Pediatrician has just referred me a Physical Therapist and a Cranio-Facial Surgeon). He was born with a squished face and nose, and we were told that he must have been compressed in the womb (he dropped quite early), but they suspected all would normalize over time. His nose popped back into place within the first few weeks, but his cheeks and eyes still seem a little asymmetrical. He also tends to tilt his head to the left and look towards the right (same direction that he was squished while in the womb), and has developed a flat spot on the back of his head - off to one side. It's not dramatic, but noticable if you study his face - and especially when you look at him in a mirror. If any other parents have info on how treatment works (or doesn't) for PT and or DocBand (helmut) therapy, I'd be most appreciative of the information. Thank You gs

My twin son who is now almost 11 months old has had plagiocephaly since birth (he was basically squished in the womb by his twin sister!). Our pediatrician in Oakland insisted that his head was fine and that in time it would round out. At their 7 month old well-baby visit I pleaded to the doctor to please refer us to a specialist since I did not notice any change in his head shape.

We moved relocated back to the east coast 3 months ago and luckily found a pediatrician who 100% agreed that my son had a severe case of ''flathead'' and needed to start treatment with a DOC band ASAP. He is now wearing his DOC band and after only 3 weeks of treatment his head is noticeably in a much better shape, basically a ''normal'' head shape.

I urge you as a parent to advocate for your child and see a pediatric neurologist very soon. From all the research I have done, the best time to start treatment for plagiocephaly is between 3-5 months for the best results. In addition, the younger a baby starts treatment, the shorter amount of time they need to wear a DOC band.

You can visit the Cranial Technologies website at They do not have a clinic in the Bay Area, but they do have one in San Diego.

Please feel free to contact me with any questions. Good luck! Dana

My baby was also diagnosed with mild positional plagiocephaly when he was around 4 months old, last year. He wore a helmet until he was almost 11 months old and the changes were noticeable. I know that his head is not 100% symmetrical, but nobody notices that.

His cranio-facial specialist was Dr. Elio Gizzi, a very knowledgeable and kind person, who is director at the Craniofacial Center in Children's Hospital Oakland. We were advised that a helmet would not be necessary, because the asymmetries would correct by themselves. However, we did not want to wait and see if they would correct or not and we opted for the helmet.

The orthotist who made his helmet was Peter Villalpando, from Walnut Creek. He is very sweet with the babies, and he explained everything to us. The helmet must be wore a couple of hours during the first day, increasing until the 5th day when the baby will be wearing the helmet almost 24 hours.

The big problem was that our baby was in helmet therapy during summer, and he sweated a lot. At the beginning he was uncomfortable, but then he got used to it. Other inconvenience was to teach caregivers at child care to put/take off the helmet when necessary, but we managed to do that. You will have to visit the orthotist every two or four weeks, depending on the stage of treatment your baby is, and you need to be aware that the treatment should begin before the 6th month in order to have better results. Feel free to email me if you have further questions Cristina

H there - just wanted to let you know that my son had a little of what you are describing. I noticed he had a ''flat head'' at around 3 months; caused from always sleeping on one side. His head was flat at the back on one side, very noticeable to me and my husband, and plus my baby had no hair back then. The doctor noted my concerns but reassured me that it was no big deal, quite common and there would be no neurological damage. Good news: my son is now 2 years old, has hair (not a whole lot!), and you'd never know that he has a flat spot. I also have a friend whose son had a flat head, they tried the helmet treatment, said it was awful and gave up, now her son too has hair and the flat spot is nowhere to be found. I know this is only part of what you are experiencing but I hope it gives you a little reassurance Cathy
my son had torticollis and cranial sacrial therpy cured it . maybe we were just lucky but we went twice and his head straightened out and it was all good. good luck :)

4-month-old's misshapen head

Sept 2005

Has anyone had any experience with an infant born with a mishapen head? This is NOT positional plagiocephaly but seems more like a type of craniosynostosis (premature closure of the sagital suture in her skull) called ''scaphelocephaly.'' She is a happy, healthy, developmentally appropriate 4 mos old girl. We see a physical therapist. We have now been advised by her pediatrician to get a CT scan and consult with a neurosurgeon at Kaiser. Anyone with experience with this? anon

Our daughter was born with Saethre-Chotzen syndrome, with bicoronal synostosis, which means she had multiple sutures closed. Not only was her head misshapen, but it got more misshapen the older she got and the more she grew. She had a CT scan at 1, 3, and 5 months of age.

The reason your pediatrician has recommended a CT scan is with Craniosynostosis, the brain continues to grow in the path of least resistance. They need to make sure the brain has somewhere to grow. Unfortunately, even if the brain has open sutures where it can grow, it's hard to predict what appearance the child will have as the brain grows. In the case of our daughter, she went from a slightly misshapen head to a severly misshapen head.

When she was five months old, she had bifrontal craniotomy surgery at Children's Hospital of Oakland. Dr. Peter Sun was her neurosurgeon and Dr. Bryant Toth was her plastic surgeon. (They are both fantastic as is the CHO craniofacial program and staff, and I can tell you lots of detail about that if you like.)

Our daughter continued to have problems. (This is due to the nature of her syndrome, which is an active process. Lots of kids that have simple Craniosynostosis have one corrective surgery and that suffices.) She had multiple CT scans and finally had a second surgery at 13 months.

The surgeries were quite dreadful and it was a terrible time. I tried many alternatives including acupuncture and cranio-sacral therapy, but it became obvious that surgery was our only option. I hope that you won't have to go through that. You may email me for more information if you are interested. Laurel

I'm a pediatrician who works at Kaiser in Pleasanton (I live in Berkeley, though). I have dealt with kids with craniosynostosis in my practice. If your pediatrician recommends that your child get evaluated, don't delay. If your child has this problem, it is best fixed around the age of 6 months old. Without treatment, not only will your child have a severe cosmetic issue, but can even sustain brain damage from increased pressure to the brain from lack of normal skull growth (not imminently, though. Don't panic!) Our group recently had a lecture from the neurosurgeon who runs the plagiocephaly clinic at Kaiser Santa Clara (I tried to get his name for you, but unfortunately, I couldn't access it from my home system). He loves working with kids with craniosynostosis and explained to us the newer surgical procedures. Craniosynostosis surgery is much less complicated than it was even 10 years ago. It now requires only two small incisions and babies go home within 2-3 days. After that, the child wears a helmet for a number of months to help reshape the skull. As a parent, I can see how frightening this is for you; the need for sedation for the CT, the procedure itself, and, of course, the fear of neurosurgery. But if your child truly has this problem, it's worth going through. Double check with your pediatrician (who does have access to his computer system) that the person you're referred to is the one who does the plagiocephaly clinic (there is only one in the Northern California region). He has a lot of experience and I was impressed at how articulate he was. I think he helped pioneer some of these new surgical techniques, too. I got the feeling he would have a good bedside manner. I wish you the best with this difficult situation. Madelyn
My neighbor's granddaughter had surgery to correct craniosynostosis a few months & is doing just fine. Grandma says that she'd be more than happy to put you in touch with the parents to discuss. cs

Two-year-old with moderate flattened head syndrome

June 2004

I have a 2-year-old with moderate flattened head syndrome (positional plagiocephaly), which was not treated during infancy following our pediatrician's advice. Everyone told me her head would round out on its own, but it is still rather noticeable at 2 years of age, especially since her hair is naturally thin. Her head is oblique, and her ears are assymetrical. Does anyone have an older child (2+ years old) whose flattened head did round out on its own eventually without treatment, or can share experiences similar to ours? I know it's a totally cosmetic problem in our case, but I'm still concerned as cosmetic problems can have social consequences in one's life.

I wrote in awhile ago about this (see the archive link), and my son is now 4.75 yrs. old and his head did round out slightly but is still flatter on one side (but his facial features/ear line- up, etc. are still more or less symmetrical). So, I think you might see a specialist then try to decide if you need to do anything about it. Tracy
My son had the same problem. We took him to a cranial sacral therapist and it worked wonders. Over the course of several treatments there was visable change. I highly recommend it. If you don't know anything about this very gentle treatment, do a web search and you'll find a lot of it. There is also info in the Network archives. It is very, very gentle and relaxing treatment - no weird twists, pulling or poking.! Just gentle pressure w/ the fingers (equivalent to the weight of a nickle.) We go to Nancy Burke in Richmond, tel. 236-1007 - there are recommendations for her in the archives as well. She sees a lot of kids and has tons of toys & books on hand to keep them distracted while she does the treatment.

Another person I highly recommend that I've gone to is Michelle Reddel at 510-649-9169, 2560 Ninth Street #313 in Berkeley. She does a combination of chiropractic cranial sacral work. I know many people are sceptical of alternative treatments like this, but what do you have to loose. It's not invasive or painful, there's no medication nor needles. I have seen it work wonders with children that have colic as well as other issues too. anon

2003 & Earlier

Misshapen head from vacuum extraction

Oct 2002

My baby was delivered vaginally but with the aid of vacuum extraction. She's now 9 weeks old, and her head is still quite misshapen (elongated and flattened on one side, where I believe the vacuum was applied). Does anyone else have experience with this, and have any idea when the head will become more normal-shaped (and when I should start worrying)? Thanks for any advice. Kim

Don't worry, most likely her head will plump out on its own over time. My now-6 month old was also vaccuum-assist and had a cone on top of her conehead for quite a while. It was obvious even from a distance and a little scary.

Our pediatrician recommended lots of tummy time and to see if we could get her to sleep with the rounder side down (reducing the pressure on the flatter side).

At 3 months when she was better but still nowhere near round, we asked our pediatrician about options and she sent us to Dr. Peter Sun at Children's to make sure that it was positional plagiocephaly (even though it was because of the vaccuum, not from sleeping on her back...) and not that the bones of her skull were fusing incorrectly (this condition is very rare).

He could tell on sight that it was not the incorrect fusing and said that if at 6 months it wasn't significantly better, we could try a helmet. She'd have to wear it 20 out of 24 hours every day for approx. 3 months.

Two reasons the helmet is not an automatic next step: 1. it's often not covered by insurance and 2. most plagiocephaly is due to kids sleeping on their backs, which has only been recommended for the past 10 years or so to reduce SIDs. So there hasn't been much research to show that kids with helmets end up significantly better than kids who don't do anything. The prevailing opinion seems to be that by the time they are 10, you usually can't tell the difference.

We just had her 6 month checkup and our pediatrician agreed that while her head is still sort of square-ish and flatter on one side, it is better and she's fine. We're hoping her hair grows in soon.

And I asked the guy who cuts my hair about head shapes and he laughed and said that most adults actually have oddly-shaped heads and that dealing with flat sides and odd bulges is actually a big part of giving a flattering haircut. Jenna

Facial asymmetry/positional plagiocephaly

May 2002

My 8 month old daughter has had an asymmetrical face since birth. At first the doctor thought it would even out, but it hasn't (the left side is slightly smaller - her eye, cheek and mouth). I'm not that worried about the visual aspect, but her tongue also seems to work less well on the left and I am concerned about a speech impediment. Her pediatrician doesn't think it's worth pursuing yet, but I'd like to see a pediatric neurologist to ensure that there are no problems that I could remedy early on. Does anyone have any experience with a similar problem and/or a specialist to recommend?

You might want to call the Cranio-facial Clinic (Center for Craniofacial Anomalies) at UCSF (Dr. Karin Vargervik) - Phone 415 476-2271 to simply ask how one decides if an evaluation is needed.

Many of us have some asmmetry without any underlying cause. Some asymmetry, however, can be attributed to an underlying syndrome. Our oldest son, 13 years old, has a very mild form of ''Goldenhaar Syndrome'' with hemifacial microsomia. Basically, the left side of his face and jaw are ever-so slightly smaller than the right side. Even now, most people don't notice. This syndrome can also affect the ear canal (slightly smaller, very slightly impaired hearing on the left side) and can involve the vertebrae. Our son had some surgery on the left corner of his mouth when he was 18 months old to correct a slight droop. His orthodontic needs are slightly more specialized. But basically, he's growing up without any challenges. He is still monitored periodically by UCSF.

It's probably worth a call to UCSF to just check in. Good Luck! anon

One of the top craniofacial/ped. plastics doctors in the country is William Hoffman, M.D. at UCSF. He is in the dept. of ped. plastics over at UC. Even though he does severe congenital malformations and trauma-induced reconstruction and repair, we had him excise a tiny benign cyst (inclusion cyst), that was little more than pea size, from my daughter's lower cheek. The result is beautiful, and eventually her tiny scar will disappear. She had to undergo general anaesthesia for such a procedure, and so having it done over at UC by a topnotch ped. anaesthesiologist was vitally important to us, as well. Dr. Hoffman would be a great place to start since, if your pediatrician is unable to guide you, he would be able to tell you what your child's condition is or isn't. Additionally, he has a lovely and forthcoming bedside manner, so you will get your questions answered. We also saw some of the ''after'' pictures of some of his more ''serious'' work--he is truly a surgical genius.
I saw this today article today and thought of your post: While I understand that you are not concerned about the visual aspect now, your child may be one day. I thought you might like to know that there are treatments out there. Best of luck to you. susan

Worried about 9 1/2 month old's flat head

April 2001

My 9 1/2 month old baby boy has a flat head from sleeping on his back and side. I understand that flathead is a result of preventive measures we must take against SIDs. I have pointed out the problem to my son's pediatrician. He agreed that the boy is getting flat head, but did not appear concerned and said there isn't much we can do about it. I'm not sure if that means there is nothing we can do about it or if that means our insurance won't pay for whatever needs to be done to correct the problem. Any ideas, suggestions, solutions or feedback on flathead? I've read articles about how to prevent it, but it's a little late now. Thanks, Jo Ann

My friend had this issue with one of her twins. Her Dr. initially dismissed her concerns. But when my friend pointed out that if you looked at the top of her daughter's head, her ears didn't line up, the Dr. agreed to send her to a Stanford specialist. The specialist immediately saw the problem (I can't remember the name for it). So the baby had to wear a helmut from age 6 months to about 14 months and the problem has been fixed (or appears to be, child is 15 months now). So my point is, if you feel like there is really something wrong with the shape of your child's head, talk to your Dr. again and possibly get a second opinion from a specialist. Having said all that, I know it is common for this to happen and I understand that the head rounds out as kids grow and sleep in other positions. Also, I have no direct experience with this issue. My kids would only sleep on their stomachs, so I weighed the risks and let them sleep on their tummies. Kris
I am an adult male with flat head -- I was born in 1949, before most people were ever concerned with SIDS, but i think my parents just worried a lot about me suffocating on my stomach, they were major worry-worts or, maybe they liked to look at me in the face without taking off their shoes. At any rate the back of my head is flatter than, well not a pancake, but pretty flat. At least my profile, as seen in certain photo or mirror situations always embarrassed me, but i really never was bothered by it at other times because 3 reasons: 1) I could never it see straight on in mirror 2) nobody ever said anything (or probably noticed, unless that person were similarly afflicted), and 3) i have a IQ of 144. In short, eh, do your best, but don't worry about it. It happens to a lot of bright kids. Maybe keep the environment interesting around the crib, you now, mobiles and friendly talk?
I was beginning to think my son was the only one with a flat head despite hearing that it is becoming more common. His is flat on the left side; his head was always turned to the side since he sucked his left thumb. The doctors kept saying he'd outgrow it, but he didn't, and now at least his hair is finally getting a bit thicker at 19 mos. Anyhow, CHO has a cranial/facial dept. if you really want to pursue it, but our neurologist said it wasn't anything to worry about unless the entire head/facial area is asymmetrical (distorted). I've heard of helmets being used to reshape the head, but our neurologist also that it's better not to put any pressure on the head. Tracy
You can give your child tummy time everyday to reduce the amount of time spent lying on the back.