Four Month Old with Flat Head on One Side

Updated on September 16, 2008
L.F. asks from McHenry, IL
31 answers

I have a four month old son that has flat head on the back right side of his head. I give him lots of tummy time and time where he is not on his back. When he sleeps he always seems to turn his head so that he is on the right back side of his head. The Dr. does not seem worried at this point. I am just wondering if anyone else has been through this and if so, how did you work on it?? Any tips, stories, ideas would be greatly appreciated! I did not have this with my first baby!

Thanks

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E.H.

answers from Chicago on

Good chance it will stay like that if he is already 4 mos. You can try a towel or blanket to keep his head to one side while he's sleeping so it doesn't cont. to flatten on that side.

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A.M.

answers from Chicago on

Some docs recommend not letting the baby lie when they are awake ie using a bouncy seat, an exersaucer once the baby has good head control and baby bjorn or other carrier.

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S.C.

answers from Chicago on

Hi L.!!
Your son may have torticollis?!?! See a Physical Therapist! Regardless of what your doctor may think! My son had it and began seeing PT at 8 weeks old. The sooner the better. Torticolis is when the muscles in your neck are weak and the child tends to always hold there head the same way causing a flat spot on the oppistie side. If it's not properly taken care of you'll eventually need surgery!!Good Luck!!

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N..

answers from Chicago on

My son had this. He had tortocollis and we decided to to put him in a helmet. We were told that he was more than likely born with muscle issues in his neck. There are tons of great suggestions already given for propping and switching directions in the crib, changing table etc. No matter what you decide these are all things you want to do.

I will say this, my Ped. at the time said he was border line needing a helmet and I pushed for the referral, his head was bad and you just don't know if it will correct on it's own. I am glad we did it because even with the helmet, his head is not perfect but I can't imagine how it would have been had we not gone with the helmet. We did take him out of it a bit early because it was getting tight so we could have had some additional results had we not made that choice. Also know that not only is the head flattening but the facial features will begin to change too due to the flattening of the skull. If one direction is being pushed in, it is going to push out to compensate.

Physical therapy was huge for him, he was in PT even well after his helmet was off. Torticollis effects the whole body. The whole right side of my son's body was effected and as we began to crawl and walk we was favoring one side of his body all because of this torticollis. You just would not think that his little neck would effect so much in his body. It is truly amazing what our therapist pointed out and was able to work with him on.

I am so happy with all the decisions we made. The helmet wasn't fun but honestly he never knew it was there, it was harder on me, I am sure of it. It is also true that if you wait, the length of time of treatment is greater as well as you will get better results the earlier you begin while their heads are still soft and growing. At 4 months he is heading into big growth spurts, this is the best time.

We got our helmet at Cranial Techs in Oakbrook. They have a website if you Google them. They were so nice and everything went very smooth.

Good luck, it is not an easy decision and it is hard to see a helmet on your child's head but they have a long life ahead of them and this is the only time for correction. It could straighten itself out but what if it doesn't? I was amazed at how many people commented that they knew someone with this or had a child with a helmet. Treatment is becoming more an more common. My husband had this when he was little, they did not have treatment then, but his hats don't fit right to this day.

Best of luck, feel free to contact me if you have any other questions.

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A.H.

answers from Chicago on

Greetings my sister, do not fret. During tummy time and napping make sure you have somrthing rolled up on the left side of your baby to prevent him from laying on this side of his body. apparently he is most comfortable or favor this side more. Correcting him with a deterent should allow him time to strenghten his right side more and learn to balance both sides of his body equally. Begin to shape his head rubbing in a circular motion to even out his head, remember his head is still very soft and delicate. However, because of the softness his head can be easily shaped African Americans always have reshaped their infants heads if the form was a bit off, and in some African cultures they shape their infants heads for cultural and traditiomal purposes. Try it about three times a day (at least) you should see a difference gradually.

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L.B.

answers from Chicago on

My son had plagliocephaly (the term for a flat head), his was caused by having torticollis from birth. He was fitted for a cranial reshaping helmet at 8 months old and wore it for 5 months. He now has an almost perfect (you would never know but as his mother I can tell a small flat spot) head. We did this through Midwest Orthotics. They are based out of South Bend but have offices all over the region and beyond. You can look up their information at their website www.midwestorthotics.com. You can also see a picture of what the helmet look like. It costs nothing to get a scan done of your childs head and their opinion of whether your child will need one or not. You also do not need a referral to have this done. This is also a VERY painless procedure, they put a stocking cap on your chlds head and metallic dots all over their head and face. They move a scanner across their head and face to make a 3-d image of your childs head on the computer screen. There they can take measurements to see if your child would need one.

We were lucky in that our child was very accepting of the helmet from the very beginning and we had no problem at all! There is also a yahoo group that you can join that has ALOT of information on plagliocephaly and was very helpul with questions. Just search plagliocephaly in yahoo groups and you'll find it.

If you have any questions about this please feel free to contact me. One other thing, the earlier you get tested for a helmet (and they need one) the better. Your child will not have to wear it as long and there is a better chance of correction. They recommend anything before 6 months old but it can be used for children up to 14 months old. The amount of time they wear it is based on growth spurts and the younger they are the more they have cause more change quicker and less time in the helmet.

Good luck!

L.

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E.G.

answers from Chicago on

I do marketing for Pathways Center (pediatric therapy center in Glenview, www.pathwayscenter.org) and they CONSTANTLY see how the earlier you take action on something, the better. They give free evaluations and should be able to give you additional input on whether your baby might need therapy or a doc band. They often refer families to cranial technologies and highly recommend their services. Hope this helps and good luck!

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M.B.

answers from Chicago on

Some of the things we tried with my daughter included alternating which side of the crib we placed her head each nap and bedtime. We also alternated which side of the changing table we placed her head. Of course, tummy time, which you are doing is also helpful. You might also try using a toy and putting it in his peripheral vision forcing him to turn towards it -- on the side of the head that he does not favor. Ultimately, however we went with the Docband. Which is helmet like and forces the side of the head that is flat to round out. If you properly document what you do, have a prescription for the Docband from your pediatrician -- some insurances will cover part/most of it. There might be other things out there other than the Docband, but that is what we went with.

Good luck

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H.Q.

answers from Chicago on

I am by no means a medical professional, but it sounds like maybe he has a little case of torticollis! Both my daughters had it. We caught my 1st daughter's case when she was about 3 months... she HATED tummy time b/c she couldn't lift her head well when placed on the floor and she also favored one side when sleeping. We took her to the chiropractor (Whitney Chiropractic in Naperville) and she was better within a couple weeks (although it took her hair a little while to grow back on the spot she always slept on... ha,ha). My 2nd daughter (3 weeks) is currently being treated for torticollis and is doing really well! Good luck!

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J.J.

answers from Chicago on

My daughter had this but more on the back of her head. I was determined to get a helmet for her but our pediatrician talked me out of it, I started the process when she was 7 months old. I suppose it did get a little better on it's own and you can't tell now that she is older and has a lot of hair. Headbands don't really fit her right and I feel bad about that. From what I learned if you are going to go with a helmet the SOONER the better, the longer you wait the longer they will have to wear the helmet. I'm sorry you are going through this, it is horrible because you just want to do the right thing and don't want your child to have a misshapen head for their whole life! With my second child I would put him to sleep on his tummy sometimes when he got old enough to turn his head by himself (I know this is against the rules). We were so fanatical with my daughter about only putting her to sleep on her back, no blankets in the crib, etc. I feel like this contributed to her flat head and consequent sleep problems. I would go with your instincts, if his head if severely flat (which is not easy to admit!) I would make an appointment with a plagiocephaly specialist as soon as possible.

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L.M.

answers from Chicago on

Hello L. I'am a mother of 2 sarah and joshua I was a stay at home mom for 7 years there is nothing like it, it is a part of mold a child into whom they will become as a adult. I'am a ordained Rabbi who believes in Jesus I shall be praying for you and your son. I want to encourage you continue giving him the tommy time, and love, believing all is well with him. God new him before he was born and can use him to reach out to many others. When I became pregnant with my daughter sarah I knew this was the promised child from God, durring the 1st month I began to have pains on my lower side down by the uteris. I went in to get checked and they found a tumore the size of a lemon growing next to sarah, the doctor told me I would probably lose the baby, I left the doctors office knowing this was not true because God had promised this child to me. when I got home I began to do what I have always done and that is sing praises to the Lord and giving thanks to him, he spoke to my heart and said becaue I had not doubted his promise in 3 months I would be healed. 3 months later august 11,1998 I returned to the doctor's office they checked me and the tumor was completely gone, so I encourage you to keep loving and in the midst of that believe!!!!

Many blessing's
Rabbi L.
www.hamishkandavid.org

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S.T.

answers from Denver on

This is a huge topic in today's baby times. I am a daycare provider. Two of my last little guys had flat heads. Both of the boys got helmets before they were 6 months. From what I understand, this is the crucial time before which to get a helmet. One of my little guys had torticollis, and the other did not. There are also other things that can help also. Make sure you hold him in different positions while walking around and also while feeding. Extended periods of time in a bouncer, swing, and car seat can contribute to the head shape. Switching sleeping positions can also be good too. With one of my little boys, all of the tricks to correct the shape before the helmet did not work. He ended up and work the helmet for over 6 months. My other little guy, got his helmet earlier, and it was off in about 2 months. On another side note....one of my other families had a little boy with torticollis and a flat head. He is now almost 3. They sought intervention and his head is definitely oddly shaped. You have to do what you feel most comfortable with and what will work best for your child. I know that both of my families worked with MidWest Othopedics (sp?) and were very happy with service and pricing. Having a helmet on a baby was bothersome to one of my moms at first. After a short week, she was fine with it. Good luck!

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J.I.

answers from Chicago on

Sorry - Can't read all 40 responses you've gotten so far, but it looks like others are pointing you to torticollis as a possibility. From what I understand, it can just be from how the baby's head/neck was in the womb. If they were always turned a certain way, then they prefer it that way after they're born, and always turning/laying on that side will cause the muscles/ligaments to be shorter in that side & therefore the flattened head.

Seems that of people I've known with this, the doctors haven't been very good at finding it. Because I knew others whose babies had this, I was very aware & convinced our pediatrician to send us for a consult before my daughter was 3 months old. We only had to do phyisical therapy for 2 months, then we just did some exercises, etc at home. Her head is nearly perfectly round now, and she's almost two. My niece didn't get diagnosed & therapy until 6 months, and I think she needed at least 6 months of therapy. She's also fine now, and she's 3 1/2. Neither of them needed helmets, just physical therapy.

So... see if you can get your baby in for a consult from a physical therapist, and try to encourage your baby to turn it's head the other way. Good luck!

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M.K.

answers from Chicago on

This problem has been on the rise the last ten years. Our daughter was diagnosed with torticollis at her 2 month checkup. Her pediatrician noticed the flattening on one side & explained that she had torticollis or wry neck. Basically, they believe that it is caused by the way the child is positioned in the womb. Please do not dismiss this as your pediatrician has because we've now learned that many doctors aren't as knowledgable on the subject as they should be. Many children now have the flat head syndrome since the back to sleep campaign. The problem with children with torticollis is they have a tightened muscle in their neck which causes them to favor one side. This can lead to major skull mishaping & potentially to your child wearing a helmet. You HAVE TO start stretching this muscle asap. Start by laying him down, put slight pleasure on his shoulder & use your other arm to stretch his head towards the opposite side. Do this five times and at least 3-5 times a day. You can find information on how to do these stretch exercises simply by googling torticollis.

Secondly, you need to have your child visit with Dr. Frank Vicari with Children's Memorial. Dr. Vicari is the the director of the Head Shape Program there & he helped create something called the Star Scanner. It is a digital cranial scanner that will photograph your child's head in mere seconds. It will show the the severity of the problem & help plot a course of treatment. Dr Vicari is a wonderful physician & reknowned expert in this field. Here is a link to their website: http://www.childrensmemorial.org/depts/plasticsurgery/hea...

He has three office locations (one at the main Lincoln Park location, another in Westchester-where we took our daugther and a third in Glenview). Please do not wait too long to make your appt!!! The longer you wait, the more difficult it'll be to treat. Dr. Vicari will discuss a treatment plan which will likely include weekly physical therapy for your child. The focus of therapy is to teach you various tummy time exercises & other methods for helping your child to learn to use both sides. This is the key: your child needs to be able to learn new abilities using both sides. Children with torticollis tend to favor one side & may regress when they learn new things such a rolling over or sitting up. You have to be pretty vigilant about the exercises at home. If left untreated this could leave your son's head mishapen or pose problems with the way the baby's brain is shaped within the skull.

Our daughter had therapy for about 4-5 months & after 3 scans it was determined that she would not need to wear a helmet. A good friend of ours discovered this problem in her son at 6 months & he ended up being fitted with the helmet. Of course, the helmet isn't the end of the world because it'll help baby in the long run.

I'm sorry if I am sounding alarmist, but I just want you to have all the necessary info to combat this problem as quickly as possible. Please let me know if you have any other questions!

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C.S.

answers from Chicago on

My 3 month old daughter has the same thing & our pediatrician said just to switch how she sleeps each week (head at other end). My daughter gets tummy time too & I didn't have this with my older daughter either.

Good luck and congrats!

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J.T.

answers from Chicago on

At 4 months our son had a flattened head and the pediatrician sent us for a Doc Band (one of those plastic helmets). He wore it for about 3 months and it worked really well and his head is nice and round now! I would ask the pediatrician about one or go for a second opinion. And check with your insurance to see how much they cover.

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S.F.

answers from Chicago on

Our son had assymmetry with some flattening of his head (it's called plagiocephaly) and we made the decision to do a consulation with Cranial Technologies. They were really helpful--several free consultations before we needed to commit to the therapy with the DOC band (aka helmet). They gave us exercises and taught us about sleep positioning precisely so we might not need to go the route of the band--there was no pressure. But in the end we chose the band and were very pleased with the results in his head shape and facial symmetry. The time in the band flew by and it didn't seem to bother the baby at all. If you look around you see more and more parents making the same choice--and putting cute and fun stickers on the band to get into the spirit of it. I really recommend Cranial Technologies whether your child ends up needing the Doc Band or not. What they offer along the way to making that decision is really wonderful support. (The consultations are free. The band is not. Our insurance covered it no problem with a physician's referral, but some make you fight for it. Straighten all of that out up front so you don't end up frustrated or broke!) If your son does wear a band for a few months, I'm here to tell you that from one mom's perspective it's not as big of a deal in the end as it surely feels like at the beginning! Good luck and good for you for being proactive about what you are seeing. The earlier you do the intervention, the better the results!

(Oh, and don't give too much credence to the folks who say "I never see adults with flat heads!" We don't see them because the "back to sleep" rules for preventing crib death are new and so babies now spend way more time on their backs than ever before. And when you do see "flat heads" they are often on people who come from cultures or infant environments where they lay babies on their backs for long periods of time.)

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A.B.

answers from Chicago on

My first daughter was the same way. I realized I was always holding her with the same arm and laying her in the same direction in the crib/on the floor-- since this was the case she was always turning her head the same direction towards whatever was interesting (i.e. us!). So all I did was started making sure I changed things up a bit. She started sitting up a little before 5 months so that helped a ton as well. Good luck!

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E.A.

answers from Chicago on

I turned my son around in his crib so his head was at the opposite end. I found that he was leaning to one side so he could look at the door. It worked itself out and by the time he was sitting up the flat part was gone. Good luck!

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J.K.

answers from Chicago on

Dear L.,

We had this with my youngest. Fortunately, we realized the problem when he was just 8 weeks old so we were able to take steps quickly and avoid any sort of helmet. I would suggest the following: avoid the bouncy chair/swing if at all possible. It is too easy for their head to tilt in the preferred direction and then rest on the flat spot, which makes the problem worse. If you must use these, then roll up a receiving blanket and make a prop for his head so that he cant turn to the flat spot. If you bottle-feet, switch the hand that you hold the bottle. This will feel strange at first, but I don't think you should even alternate sides, just go to the side you haven't been using. The idea is to get pressure off the flat spot as much as possible. If you hold the bottle in the other hand, your baby will need to turn off the flat spot to face you and drink. Also, when you change his diaper, you probably put his head down on the same side. This is normal -- this is how most people change diapers. You should try to change this so that you put his head down on the other side all of the time. Lastly, I would recommend rolling up some towels or receiving blankets and using them as a wedge while he is sleeping. If you can keep him turned away from the flat spot in the crib that works very well. Since babies want to see us, they will turn to face the door of the room a lot, so it helps if you put his head down at the opposite end of the crib from the one he is usually at. If you make all of these changes at once, and do them consistently, you will probably see good results. The head is still very soft and pliable at this stage so if you take pressure off the flat spot and put it on the opposite side it should start to sort itself out.

You can look into the bumbo seat, available at Target, for playtime. It is a molded rubber seat that allows babies to sit upright with nothing touching his head.

Although your Dr. is right that this isn't a big deal now, if it isn't corrected it will get worse on its own. Your baby's head grows a ton in the next few months, so try to capitalize on that natural growth to reshape his head. You can also search the children's website for their doctor who specializes in this condition. We saw him, around age 5 months, but by that time we had corrected the problem on our own doing the things above. Good luck!

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J.C.

answers from Chicago on

When we picked up our daughter, Olivia from China she was almost 11 months old. The back of her head was flat as a board, she had no muscle tone, etc. Her Dr. told us her head will continue to grow and will change. We also she a chiropractor who does adjustments. She is now 4 years old the back of her head is much, much better. Not perfect. She is full of energy - she climbs and jumps everywhere. She is in ballet and gymnastics. My advice is if you are worried, then get a second opinion.

All the best
J.

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R.V.

answers from Chicago on

I am 62 and my kid brother is 52. My brother had a flat head which he outgrew - because he definitely does not have it now. And I do not remember someone ever rubbing his head to reshape it - but it seems like a good idea. I witnessed the birth of my 19 year old granson and he was born with a cone-shaped head. Did that scare me. The obstretician rubbed his head to shape it and he has one of the best-shaped heads. Friends and family would always comment about his beautifully-shaped head. So I feel the doctor knows what he is talking about - but do rub his head - it definitely couldn't hurt. God bless and may you get peace of mind.

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M.H.

answers from Chicago on

Hello,
my baby had a flat on the back of his head and someone suggested a pillow from boppy pillow called noggin nest I believe, I purchased it online from babiesrus and has help tremendously,now it's more rounder,he still uses it, so maybe that will help,Good Luck!!! heres a link to the product

http://www.toysrus.com/product/index.jsp?productId=2507966

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S.S.

answers from Chicago on

I remember the flat head problem. I assure you, neither of my children have flat heads anymore. They are full with brains! The mom's who are telling you to just switch sides- situations are correct. Perhaps in a bouncy seat, etc. Seriously how many adults do you see with flat heads? I can't think of any. Once baby is more mobile it will change also which will probably be in a short while. It seems scarey, but on the bright side it sounds like you have a good sleeper.

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L.K.

answers from Chicago on

Hi L.- I am also a L.! I will be curious to hear what other people say about this, because I too have a son- 3 months old- with the same issue. My husband is very worried, and I haven't had a chance to talk to his doc yet. Hope some helpful mothers respond- L. and I will appreciate your advice!

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A.F.

answers from Chicago on

My son was developing a flat spot on his head too.....My ped. had suggested that we increase our "tummy time" and to do some neck stretches.....
Once he started spending more time upright it didn't seem to be that big of a deal anymore.....as well that he started to grow more hair to cover it. :)
Now, he is an almost two year old with just a little bump that isn't noticable.....unless of course he decides to shave his head one day. HA

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N.K.

answers from Chicago on

My daughter had the same thing. It was difficult but we just made sure whenever someone was holding her they had the stuck out side against their arm. Also when shewas sleeping we set her on her side and used whatever we could find to keep her in that position. We had the bumpers but also had to support the bumber with rolled up blankets wedged in there and whatever creative thing you can find to keep them stuck in that positon. And then once it starts to reshape we would alternate sides. Of course this only worked until she started rolling.

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J.A.

answers from Chicago on

I work with this as a pediatric chiropractor. Occasionally cranial work is needed to assist in creating an even round head. Check out www.icpa4kids.org to find someone near you if you would like a second opinion.
Feel free to call the office with questions.
Dr. J.
###-###-####

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J.N.

answers from Chicago on

Dear L.,

We have a 4 month old who has just been through exactly the same issue. Our doctor recommended us to North Shore Pediatric Therapy - they have several locations in and around Chicago ###-###-####).

I think a lot of the work we did at home helped much more than the therapy though - I really went there for the advice.

First of all we made sure the crib, the chairs and the baby changing units were all promoting him to look in the opposite direction. We then ensured we gave him plenty of tummy time - even if it was lying on one of our chests for at least 30 minutes a day. The answer to all your issues is supervised tummy time and make sure he doesn't spend too much time on his back in cribs, chairs and strollers. The therapist also gave us some excellent exercises to do with him to help his neck muscles - if you can't get your insurance to cover the therapist, I'm sure I could get a copy of the exercises for you by scanning them into email. If you're interested, let me have your email address.

The therapist isn't cheap - so you'd need to get a referral from the doctor and ask your health insurance to cover it - they aren't normally in network.

Good luck.

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C.R.

answers from Chicago on

We had the same problem with my now 22 month old daughter. We realized at a month old that she was developing a flat spot on the back of her head and immediately saw her doctor. The doctor suggested propping her on her side while she was sleeping and more tummy time, but I felt we needed to be more proactive. I don't know if this is your case, but we also realized at the same time that my daughter almost always had her head turned to the right and when she did look the other direction that it appeared to be difficult and her head would almost snap back into position. I ended up taking my daughter to a chiropractor. We went a couple times a week for a few months and by the time she was 6 months old the flat spot was almost completely gone and she didn't constantly look to the right. If you want to see a chiropractor, check out the International Chiropractic Pediatric Association website at icpa4kids.org. They offer a doctor search, so you can find someone with a pediatric specialty in your area.

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S.E.

answers from Chicago on

I got a little memory foam (or just foam?) wedge at Babies R Us that helped my daughter sleep better and prevented any flattening. It seems a lot more comfortable than sleeping flat on your back on a hard crib mattress. It also made it easy to move her from bed to bed when visiting relatives etc. since the wedge could easily go with us. This may be a good first step to see if it helps him try other sleeping positions and relieve the pressure on that one side. Good luck!

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