As a baby massage teacher, I see more babies than I ever knew I’d want to, and I love it. There’s little as beautiful as seeing that bond between a mother or father and baby. However, it’s not unusual, week after week, to see babies brought into the room in their car seats. They’re taken out and put down on the mats on their backs, and then after the session and after being redressed, are put back in the car seats. As a result, I see many babies, by the time they get to me at six weeks or so, with a bald patch or a flat head – known as flat head syndrome.

There are different types of plagiocephaly – flat head syndrome – but the one that’s been reported in the media recently and is most common is positional plagiocephaly, and is caused by pressure on the skull due to being in the same position for long stretches of time.

Moving a baby from a cot (crib) to a car seat to a play gym and back places pressure on the skull, causing it to flatten. While vaginal birth can often cause a misshapen head anyway, by about six weeks old, the head should be rounded out. If plagiocephaly occurs after six weeks, it is probably due to this pressure.

In a recent Daily Mail article, Kate Chauhan, an orthotist at the Steeper Clinic in Kingston upon Thames, says, “It depends on the severity but if there is a big shift, it can push the face forward and this can mean the ears are out of alignment. This can result in a higher incidence of ear infections. There are also links between plagiocephaly and esotropia — or wandering eye.”

Ms. Chauhan adds that babies spend too much time curled in a C-shape in car seats and rockers when their body needs to be flat so that it can start to adapt for walking later on. “Every bit of the body is affected if a baby is kept in a sedentary position. That child may get niggles later — lower back problems, knee problems — when they start to play sport. Restricting early movement has an impact on how the eyes develop and this can affect reading and writing, because the eyes can’t grasp what is on the page. They also miss out on sensory experiences and touch.”

The website Babyflathead lists ten tips for preventing and treating baby flat head syndrome. We all know that prevention is better than cure, these are steps you can take even if your baby is already showing signs of having a flat head.

1. Tummy Time
   Fear of SIDS has made us all terrified of putting our babies to sleep on their tummies. It’s really important to do, however, and the earlier you start, the better. (It also helps with colic and wind, by the way!)
2. Flat Head Pillow
   The website lists a variety of support pillows with pros and cons.
3. Limit Use of Swings, Baby Rockers, and Car Seats
4. Hold and Carry Your Baby
   A sling is a fantastic way to keep your baby close and your hands free. I’ve even taught classes with my baby in my sling, they’re that supportive to your needs. Make sure that you buy a sling that supports your baby’s hips, and not one of the popular but dangerous “crotch dangler” styles.
5. Sleeping Position
   Alternate which side your baby sleeps on, or use a sleep positioner.
6. Sitting
   When a baby can hold its head up, it can sit in a Bumbo seat or play nest (but also not for extended periods of time!) to give the head a break and strengthen the neck muscles.
7. Alternate Feeding Sides
8. Alternate Sides at Nappy Change
   The logic they use here is that baby will turn his head to look at you, so using different ends of the changing table means baby is looking at you from different sides.
9. Swimming and Softplay
   Participating in activities that help strengthen babies’ necks will help them get off their backs sooner.
10. Massage Your Baby
    Apparently stiff neck muscles are a common cause of flat head. Massaging your baby’s head, neck, and back will help release the stiffness.

Remember that there are different types of plagiocephaly, and that they are generally treatable while baby’s head is soft. If these measures aren’t working, however, you will need to ask your pediatrician to refer you to a specialist, and a cranial remoulding helmet might become necessary.

For most babies, however, a combination of the ten steps above should resolve, and preferably prevent, flat head syndrome.

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