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Ask Dr. Sears: When a Baby's Head Is Flat

Q. My infant has been diagnosed with positional plagiocephaly. What is this condition?

A. It means flattened head, and we pediatricians have seen a lot of it among our patients since 1994. That's when the American Academy of Pediatrics launched its "Back to Sleep" campaign, which advised parents to put infants to sleep on their back instead of their tummy to lower the risk of SIDS (sudden infant death syndrome). Because a baby's skull bones move easily to accommodate the growing brain, persistent pressure on the back of the head will flatten the bones in that area and result in a prominence of the bones in the front or sides of the head. However, it's still crucial to put your baby to sleep on his back to prevent SIDS  -- especially since positional plagiocephaly is usually a harmless cosmetic quirk that corrects itself within the first year.

But that's not to say you can't try to rectify the condition sooner. Some easy techniques that you might try:

Put your baby to sleep in a different direction each night. Most infants have a preference for turning their head to one side or the other, so place your child with his head toward the head of the crib one night and toward the foot of the crib the next.

Keep your baby on his tummy while he's awake  -- especially during playtime. This limits the amount of time he's putting pressure on his head, and it doesn't put him at risk for SIDS, which is strictly a sleep disorder.

Hang a safe crib toy, family pictures, or some other distraction on one rail of the crib one night, and then switch to the other rail the next. This will encourage your baby to turn his head from side to side.

In very rare instances, positional plagiocephaly doesn't correct itself on its own. Then a baby might need to wear a molding helmet or band for a few months. This acts like a brace to encourage the flattened area of the head to grow proportionately.

Fortunately, most infants' heads tend to round out by their first birthday, as they start to shift around more at night and resettle themselves in various sleep positions. But it's perfectly fine to take action as soon as you notice the condition.

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