Flat Heads and Back To Sleep

Date: Thu, 12 Aug 1999

There has been increased publicity about an increase in flat heads in infants who sleep on their backs. In general, this seems to be an over-reaction to a self limiting problem. Remember that the Back to Sleep recommendation is that babies should SLEEP on their backs. During wakefulness, it is best to allow them time on their stomachs to enhance development. This would also have the effect of relieving any constant pressure tending to flatten the head on one side. One can also place infants to sleep with their heads turned in both directions (Sometimes an infant will resist sleeping with the head in a certain position. Many times this can be solved by putting the infant the other way in the crib, so the door to the room, or other point of "interest", is on a different side of the baby). In any event, even when a baby develops a flattened head, this usually resolves with time (by 6-months to a year of age), as the baby spends more time up. The use of helmets (usually costing in the range of $2,000) or surgery to correct this is rarely needed.

However, if there is concern about a flattened head in your baby, it is best to be proactive. Place your baby in different positions while awake and alternate the sleeping head position (as above) before you notice head flattening.

Finally, as in many things, this depends on your point of view. During the CHIME study, when we were seeing a large number of SIDS siblings who participated in the study at Childrens Hospital Los Angeles, many SIDS parents proudly showed us their babies' slightly flattened heads as a sign that they were doing everything possible to try to reduce the risk of a SIDS recurrence.