Can flat head syndrome delay baby development?

It’s not uncommon these days for young babies to developed a flattened or slightly slanted area at the back of their heads, typically towards one side. It’s called flat head syndrome (or, officially, plagiocephaly) and typically is related to the back-to-sleep position you place your baby in for naps and longer night-time sleeping.

What is flat head syndrome?

Flat head syndrome happens because a young baby’s skull is soft and malleable and is easily shaped if it spends an extended period of time in one position, or resting against a hard surface – such as a cot mattress, a play mat placed on the floor, or a baby car seat.

If your baby has brachycephaly, then when you look down on her from above you’ll see that her head is wider and flatter at the back and it may also be slightly higher towards the back of her skull too. If she has plagiocephaly, her skull will take on a slanted appearance at one side, with a slightly bulging forehead on the same side as the slant.

Could flat head syndrome cause developmental delays?

A recent U.S. study is suggested that flat head syndrome could affect baby development. In the study, researchers found that babies aged around six months of age who had flat head syndrome scored less well than babies without the condition when their cognitive and motor development was evaluated.

In the study, 472 babies ranging from four to 12 months old (average age six months) were screened for cognitive and motor development using standard tests that observe babies for basic cognitive, language and motor skill development. Researchers noted their responses to simple tasks that required problem-solving and memory, such as searching for a hidden toy, as well as the ability to imitate, vocalize, observe and respond to their environment. Infant motor skills like crawling, rolling from side to side, and being able to lift up from a tummy position also were observed and measured. Half of the babies in the study had exhibited and been diagnosed with some level of flat head syndrome, while half had not. ??Cranial images and measurements of each baby’s head shape and size were also obtained, and the study found that those babies who exhibited some degree of flatness at the back of the head were more likely to perform worse on the tests, with the most significant lower scores seen in large muscle motor functions, such as rolling from their backs to their sides.

This is the first controlled study to suggest that babies who have flattened areas on the back of their heads during the first year of life may be at risk for developmental delay and the researchers say their findings suggest that babies with flat head syndrome should be screened early in life for possible motor and cognitive delays. However, they also note that their study doesn’t necessarily indicate a direct link – in fact it may be that the babies had a pre-existing motor delay that meant they were more likely to develop flat head syndrome because they were moving less or remaining in the same position for long periods of time. It also is important to keep in mind that the study examined the babies at one particular point in time, and the observations may not hold true as the babies grow older (the researchers plan to check the babies again at 18 and 36 months of age).

Still vital to ensure your baby sleeps safe

It’s still very important to follow safe sleep advice and place your baby on her back in her cot, as it can help keep her safe from sudden infant death syndrome (SIDS). Be sure to follow this advice even if your baby appears to have a flatter area at the back of her head. ?

Tips to prevent flat head syndrome

If your baby has what appears to be flat head syndrome, speak to your doctor or health visitor about having her screened for developmental delays in both motor and cognitive skills.

Babies tend to face the same direction when they sleep, so if you do notice a flat area on one side of her head, try placing her at the opposite end of her cot so that she turns her head to the opposite side.
If you bottlefeed, switch the side you cradle her on for each feed.
Make sure your baby gets a few minutes of tummy time spread throughout the day to take the pressure off the back and sides of her skull. Always supervise her, and be prepared for her to protest – have plenty of toys and interesting objects to focus on to distract her from the fact she is in a new position.
Don’t leave your baby in her infant car seat or swing for extended periods of time – give her active play times and opportunities to move that don’t limit her to lying on her back all the time.
Encourage her to practice her motor skills – place toys just out of reach to encourage her to roll and reach out with her hands, and as her back muscles strengthen, sit her up inside a baby nest (supervised at all times) with interesting toys to hold in her hands and examine.
Develop her cognitive skills too – read and sing to her, make funny faces, imitae what she does and babble back to her in a pretend conversation.

The study was published online February 15, 2010, in the journal Pediatrics.

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.??

Last Modified: 28/02/2010