Head Shape/flat Spot

Updated on August 18, 2008
N.R. asks from Macomb, MI
32 answers

Just wondering what you all think!! My sister's baby is 9 mos old. He has a flat spot on the right back side of his head. She is very concerned about it. Her Ped said he thought it was minor and that helmeting is cruel, but she bugged him enough that he sent her to get a second opinion from a neurosurgeon. That Doc said no ones head is perfectly symmetrical and he thought the issue was minor also. My nephew has a very narrow head, so it may be more noticeable for that reason also. Wondering if anyone has any thoughts on the matter or any experience with this. Any advice would be greatly appreciated.

Thanks so much!!

N.

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S.S.

answers from Detroit on

My son's head was flat from being left in a crib for so long (he is adopted from Russia). He grew out of it. Hair helped! :)

S.

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J.N.

answers from Detroit on

If the doc says don't worry about it, don't worry about it. I just read that that is common. To help him, try keeping him upright as much as possible. Even letting him sit in a bouncer or swing, rather than lying flat on a crib mattress, can help. Good luck.

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M.B.

answers from Detroit on

A lot of babies will get flat spots on the backs of their heads because of spending a lot of time laying on their back. Tummy time and being propped up in sitting position can help this.

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W.M.

answers from Detroit on

My son wore a helmet for several months. I was apprehensive when the pediatric neurosurgeon said that he needed it, but it didn't bother my son at all, and I'm glad that we got it. However, if the neurosurgeon your nephew was taken to said he didn't need a helmet, then I would probably go with that advice. Head shape does correct itself a bit over time, so your nephew's head will most likely look better later on even if not treated.

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L.C.

answers from Grand Rapids on

Dear N. R.,

I knew a teenager in high school with a huge and noticeable flat spot on the back of his head that looked like a mountain slope with an extreme angle. It was so very noticeable that I think each person who saw him for the first time noticed it. But this young man was so intelligent that before long you would forget about his flat spot and get involved in his conversation with you. I don't know to this day what caused it, but I'm sure his mom wished she had turned him over more often as a very young baby or something similar to that. She had 9 or 10 children and they all seemed to be briliant intellectually.

I hope you hear some new ideas your sister can try on her son that will work without causing him any discomfort or pain or much cash out of pocket.

L. C.

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R.H.

answers from Cincinnati on

As already mentioned it could be from the way he sleeps, not enough tummy time (although at 9 months... I'm guessing he is sitting up on his own??) etc....

That being said...there is something to be said for 'mothers intuition'. I believe it is a God given thing to all mommies. There are times we just KNOW something is wrong ... even if the doctors tell us otherwise. If her mommy intuition is telling her this needs to be investigated, then I would go with that. No one knows our children better then we mommies.

I have heard of a woman who's son had this as well...same side. The dr. waved it off and did nothing. She pursued. She ended up with a therapist who noticed that her son was not crossing the midline with his development...which was indicative of where the flat spot was. She began therapy. Now, the flat spot is gone, he is crossing the midline and he is doing well.

So, if mommy thinks something is not right... then I would have her check it out. Get a second opinion if needed. Drs are not God. They do not know everything. They are limited by their schooling and experiences. These can not cover all possibilities.

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A.J.

answers from Lansing on

Wow, you've gotten some great responses! Our dr. noticed our daughter's "flat spot" at about the same age. He gave me a list of exercises that we could do with her and we did. Unfortunately, it didn't really help. We also saw the Neurosurgeon who recommended physical therapy first. We did that and the physical therapist told us about the cranial sacral therapy. We asked our Dr. about it and he made some calls to find out more about this type of therapy and decided it was a good option and referred us to MSU where she had this therapy. However - it was a DO that did it not an OT (which made me feel a little better).

The results? The physical therapy was great (Sparrow - they are the only ones in Lansing that deal with little ones) and I was pleased with the treatment she recieved at MSU (Clinical Center). I wish that I could remember the name of the Dr. over there but can't - she has an unusual last name and they call her Dr with her first name instead of the last. There is also a great support group on Yahoo groups - just look under tortecalous (sorry about the spelling) and you can sign up for it.

That group however, tends to support the helmet. I am of the opinion as most of the other Mommies that responded that it does grow out. My biggest concern was treating the tort. To me treating the cause (neck muscles) was more important than the flat spot. The only issue we have with Emma now is when I am trying to put her hair into pig tails and making sure that I have the right amount of hair in each one. But that could also be Mommy having technical difficulties! Good luck!

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D.F.

answers from Detroit on

My niece was born with a little tiny skinny head, I do have to say she did look different as a baby, she is now nine years old and her head has grown into a regular size head.

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D.N.

answers from Detroit on

How much tummy time has the baby been getting? Can/does he roll over on his tummy to sleep or is he still sleeping on his back most of the time (without rolling over). Does he have hair.

If your sister wants to give him a helmet, that is her choice. It seems though that you are hesitant because you don't think the spot is as big as your sister seems to. Why don't you give her suggestions to increase tummy time, encourage rolling over during play and a deadline (by X months if it doesn't look better) for the helmet.

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K.R.

answers from Detroit on

My son had this problem as well, I think for a similar reason as the mom who mentioned her son also had reflux. He's 2 and a half now, with a round head, so I don't think it's much to worry about to be honest, at least at this age.

If she's not tried laying him with his head facing another direction, that may help, but I know from experience 9 months is a difficult age to keep a child in any position other than the one they choose! My doc recommended utilizing any (safe) activity, holding position etc that kept his head off the ground to help with that. We used an activity station for that purpose, since Tummy time was only torture in long intervals (He still has Reflux, and is almost 3)... Good luck to your sister!

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A.H.

answers from Detroit on

Our dr. saw my little girls. It was hardly noticeable, well, obviously since I didn't see it. Anyways, he suggested that I switch the side of the bed that is the "head". Babies tend to turn their heads to where ever the noise or stimulus is coming from so if she just lays him down differently it will give some relief to the side he is always laying on and things will move back. :o)

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M.C.

answers from Grand Rapids on

My son had a minor flat spot on his head, too. I made sure that when he slept, he turned his head the other way. Once he was not laying down all the time (like when he started sitting up and crawling) it got a lot better. I can still tell that it is a little flat, but only because I know to look for it. His hair helps to hide it, too.

Your nephew's flat spot will likely get better, especially if two Doctor's say that it is minor.

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J.M.

answers from Saginaw on

He'll grow out of it. I think all baby's have a flat spot at some time or another, as the skull closes on top and the bones grow and get harder, it'll go away.

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G.B.

answers from Detroit on

Babies these days get these more from sleeping on their backs. Getting him upright and on his belly to play whenever he's awake should help. He's growing too so it should improve.

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J.S.

answers from Detroit on

Hi, My daughter had a flat spot and torticolis which means she favored one side of her head because of poor neck muscles. Her neck muscles are fine now from stretches we did at home and we ended up with a helmet for her head. It is NOT cruel. She could care less about it. From day one she never cried or pulled on it. She is the same with it on or off so that should not be a concern. I am not sure who her doctor is but if she is really concerned please go to another pediatrician. There is a sharp rise in this problem due to all children sleeping on thier backs. My daughter has had the helmet for two months and her head has made a 120% improvement. No more flat spot and she had no issues with the helmet. She is now almost done wearing it. It went by very fast and the resulst were very quick. I also worred about how it would feel to her and if it was necisary but now I am so happy we did it.:) So my advice is to look for another pediatrician who is more informed. AND to do it quickly because in a childs first year they grow the most and it will give her faster results. The older the child the longer it will take and the longer the baby will have to wear the helmet. My daughter is now 6 months and is almost done. It was a hard decision I wish you lotts of luck. Just dont feel bad for your child if they have to wear a helmet they adjust so quickly it is much harder on the parent:)

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L.R.

answers from Detroit on

My daughter had a similar problem. Because she preferred sleeping/laying with her head turned in one direction, she developed a flat spot on right side of her head. We discussed our concern with our doctor and he also said no one has a perfectly round head and that as she grows it should work itself out. If not, then they would consider other options. We also made sure to give her more time on stomach and work with her turning her head in the other direction. She is now 1 year and her flat spot has gone almost completly away. Not sure if that helps but it was my experience with it!

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K.D.

answers from Detroit on

My niece had a flat spot on her head when she was little from the way she slept on it when she was first born. Her Dr. said not to worry about it as it would round out as she started turning and moving in her sleep. She is now 15 and you would never know she had a flat spot at all. I now have a nephew who is about 11mos. and has a flat spot from the way he sleeps, his Dr. has said the same thing - don't worry about it. It was worse when he was yonger but it is now starting round out as he is now moving in his sleep.
So my advice is don't worry about it as the Dr.s called it with both of my sisters' kids
It just takes time.

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M.S.

answers from Detroit on

Hi N.,
I completely understand your sister's concern. I have been there, done that! My son's head was starting to get flat at three months. I asked my ped about it then. He (who I really like, mind you) told me it was minor and of no concern. But it just didn't look right to me. I asked again at 4, 5, and 6 months. All with the same reply and telling me how "horrible" helmets are. At 7 months I was firm. As a reply the dr told me "well his head is never going to be round!" I was livid and demanded a referral. My son's case was bad enough that above his right eye, the forehead started to bulge out. I read everything online (stating that the earlier the better the outcome) and was kicking myself that I wasn't demanding the helmet sooner. My son was evaluated at children's hospital in detroit by a neurosurgeon who said we didn't need surgery (much to our relief) and confirmed he indeed needed a helmet. We were sent to wright and filippis. THEY WERE AWESOME!! So gentle, so kind to him, and so helpful for us. Ben took exactly ONE DAY to get used to his helmet. That was it. No crying whining, nothing. In fact, he started using it as a tool and found he could head butt things and it didn't hurt. It was, in a strange way, a relief when he was learning to walk to have it on as we knew "well at least his head is protected." Thanks to the helmet, bens forehead has leveled out for the most part and as he grows, his head gets rounder and rounder. So as for your sister, it was good of her to push her ped as I really think there is a misconception out there about helmets. If you weigh the options: Ben doesn't remember his helmet at all, but I think there could have been lasting damage to his emotions if his head/forehead was ridiculed at school. Having said that, I would trust the neurosurgeon, they are very particular and really look at all the possible angles (plus they generally seem less concerned about your child's comfort, so they tell you the truth). But if your sister feels it in her gut that something is wrong, have her see another neurosurgeon to give her peace of mind. I do know for a fact most flat spots are just that, a small imperfection that hair usually covers up nicely. So hopefully it is just that. I have pictures of ben's head if you or your sister would like to compare what a helmet case looks like. Good luck!!

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K.V.

answers from Grand Rapids on

I too bugged my son's doctor to refer him to a specialist because of a very flat head. She told me visit after visit that it wasn't necessary and it would round out. At 8 months old I finally called Mary Free Bed (Grand Rapids) and asked them if they would see him without the doctor's ok. They said they would do an evaluation and if he needed a helmet then we would need the doctor's ok. We did the scan which estimates how badly the flatness is. If it said 95% or greater it meant he would benefit from a helmet. It did. They did molds for a helmet and sent a letter to the doctor saying it was medically necessary. The doctor wrote a prescription for the helmet and he wore it for several months. The orthodist at Mary Free Bed said evaluations for helmets should be done at 4 months old to receive the most benefit.

A helmet is NOT cruel. Babies adapt to it very quickly. It's only for a few months. A lot of kids like it when they start to walk because it protects their head and makes them feel quite daring since they won't get hurt. Especially for boys who have short hair that can't hide the flatness I'd do it.

K.

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T.R.

answers from Kalamazoo on

Check into cranial sacral therapy. An occupational therapist does it. I'm not exactly sure how it's done, but a friend of mine is an OT and was discussing it with another friend.

Good luck,
T.

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H.C.

answers from Detroit on

I'm a pediatrician and recently went to a conference on head shape. The neurosurgeon said that almost all heads round out by the age of two whether they get a helmet or not. I have seen a lot of flat heads and it's true that they get much better as time goes by. I think the results are only faster with a helmet.

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V.G.

answers from Grand Rapids on

Could it be that he is spending a lot of time on that side of his head, sleeping or during floor time. You, or your sister, might want to try adjusting the amount of time he spends on that side of his head. See if that helps level it out some. My daughters both had flat spots, that as they started moving more and playing their heads started to round out better.

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A.L.

answers from Detroit on

I started to notice my son's head becoming increasingly flat at about a month and a half or so. When I took him to his Ped, he said "If it were my son, I wouldn't get him the helmet, you can correct it but you have to start now". He said kids have to be fitted for the helmet and have to wear them a minimum of 23 hours a day for the first couple of weeks. He suggested that I try to keep him from laying flat on his back and instead, prop him on his side in his swing and even at night time and of course do as much tummy time as possible. Amazingly enough, my son, who was a pretty good sleeper at night, went from being pretty good to pretty great! He seems to sleep better on his side. So I just rotate him from one side to the other every other night. My husband and I can tell a difference and it's only been a couple weeks.

I hope we can correct this, it's mid july and WAY TOO HOT to have a baby wearing a helmet!!

A.

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A.J.

answers from Grand Rapids on

That story sounds all too familar! My son who is 9 mths old as well had the exact same issue. I asked EVERY time I went to the doctor and the he said that it was fine. His flat spot was also on the right back side and would not go away with repositioning. After much research and seeing a doctor in a specialist hospital, we learned that children can develop some serious issues like speech problems and swallowing issues due to the jaw pushed slightly forward, and hearing and vision issues due to the eyes and ears not being alligned. The doctor also gave us studies that found that 40% of special education students have mis-shapened heads. After evaluations, my son's head was not that bad (on a scale of 1 to 5; his being a 2.5) but we decided to do it anyways. He wears it 23 hours a day without ANY fussing, and after only a month we have noticed a difference. I believe it is worth it and if you feel that strongly about it....DO IT. I would drop that doctor! I hope this helps.

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A.V.

answers from Jackson on

He will probably out grow it - but she could consider taking him to a pediatrician who is also a D.O. They are often trained to do some gentle body manipulation with their hands that is both safe and effective.

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C.M.

answers from Detroit on

When my girls were little, the sleeping position was side or belly. Now that this has changed, I think there are alot of babies out there who have a flat spot somewhere on the back of the head because they always sleep on their backs. Babies heads are very soft and the rotation of sleeping positions keeps little heads round. Why the position change is beyond me...babies have been side and belly sleeping for centuries.

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N.W.

answers from Detroit on

My son (now 4) had and still to a certain extent has a flat spot. My ped followed and said it really wasn't a big deal. I can't really notice it...and it didn't affect brain or other development.

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S.P.

answers from Grand Rapids on

My son had a flattened spot on the back of his head (known as plagiocephaly) and also muscle tightening on one side of his neck (known as torticollis) which kept his head turned to one side which contributes to the flat spot. I noticed the flat spot at 3 mos and brought it to the attention of his doctor and we started physical therapy for stretching the neck and some manual manipulative therapy to help manually shift the skull bone (done over many sessions). When he was 6 mos old he was fitted with a helmet to mold his head. It worked wonders and he only had to wear it 3 mos. Now his head is very near perfect and he will be 2 in August. If she really feels strongly that he needs treatment I would keep pushing. It may resolve as he grows if he has good movement in his neck. I would definitely recommend that she encourage him to sleep and lay on the non flattened side as much as possible (not easy in a 9 month old). It was a lot of work but I am glad that I went through it. It was well worth it. Let me know if she would like any more information.

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M.C.

answers from Detroit on

The helmet does help in getting rid of the flat spot. My friend's 7 month old just got rid of her helmet last month. She wore it for 2 months and it worked. The baby was suppose to have it for longer than 2 months, but the helmet worked so well so she didn't have to wear it for long. She had to go for an adjustment every 3 weeks to make sure it fit properly and it only took the baby a few days to get used to wearing it. Her doctor told her the sooner the better when getting a helmet. The doctors at U of M Ann Arbor gave her baby a cute little pink helmet with butterflys. The only drag was cleaning the helmet because she had to do it every couple of days and clean it with rubbing alcohol.

Hope this helps!

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L.E.

answers from Detroit on

My daughters head was a little flat on one side she grew out of it though.

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A.U.

answers from Detroit on

My daughter had the same issue, and hers was from a mild case of torticollis. It evened out eventually and is perfect now. But, at the time I thought it wouldn't and was asking the doctor about a helmet also, I was told the same thing that it wasn't that bad and it would "fill out" where needed. Her's was even affecting her facial features some(one cheek was more chubby that the other, making even her eyes look different!), it freaked me out.. But she is 4 now and looks absolutely perfect :)

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A.H.

answers from Grand Rapids on

My son's head was very flat on the back because he had a very bad case of reflux when he was little and I always had him propped on an incline to help him as much as possible. I don't think that he was able to move as freely and was kind of 'stuck' in the same position quite a bit. I was also concerned about the shape of his head, but after some research found out that there may be some connection between the helmets and migraines later in life. This was NOT a problem that I wanted to give him, so I chose not to do it. He is now 16 months old and his flat spot is barely noticable.

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