While back sleeping has saved many lives, there has been a corresponding increase in the number of babies diagnosed with "positional" skull deformities, usually a flat spot on the back of the head. This can develop when a baby continually rests his head in the same place, be it in a crib, a car seat, or an infant carrier. To help prevent and treat these abnormalities, the AAP recently issued new guidelines. Here's an overview.
Continue to place your baby on his back to sleep. First and foremost, always place your baby on his back at naptime and when you put him to bed at night. This greatly reduces his risk of SIDS.
Vary his sleeping position. Alternate which side you turn your baby's head to whenever you put him down to sleep. You also may want to periodically move the crib to another part of the room so he'll have to turn his head in different directions to see what's going on.
Provide "tummy time." Allow your baby to lie on his tummy when he's awake and you're watching him. This helps prevent flat spots on the head, and also strengthens the upper body muscles needed for pulling up and crawling.
Limit time spent in infant seats. Unless he's riding in a vehicle, try to limit the amount of time your baby spends in a car seat. The same goes for swings, carriers, and bouncy seats, where the back of your baby's head rests against them.
Regularly visit your pediatrician. Schedule and keep your baby's checkups. If your pediatrician discovers any positional flattening, she may recommend adjustments or exercises to strengthen your child's neck muscles. With these changes, most flattening improves within two to three months. If it doesn't, you may be referred to a specialist to determine whether further treatment, such as a "skull-molding" helmet or, in very rare cases, surgery is necessary.