I had to attend a mandatory inservice on this topic last night, for work, and I found it really interesting. I apologize if this is information you've all heard, but I know I've had a few friends go through it with their children lately. And I figured if I'm a neonatal nurse, and a mom, and I can still learn from it, than hopefully some of you can as well! So this is info, in my own words, but taken from a lecture given by Vicki Caine, a Physical Therapist from Pediatric Rehab.
Since the "Back to Sleep" campaign, there has been a large increase in infants with flat spots on the backs, and sides of the back of the head. It can range in severity, and in the most severe cases you may have seen these babies wearing helmets. There can be other medical causes, but back sleeping is the largest contributor. What really made this stand out to me was when Vicki pointed out that the newborn brain is literally growing 24/7. If the head is lying against something, the brain can't push the skull out in that area, so it pushes it out in the areas that aren't lying against a flat surface instead. When you put that into perspective with how much a newborn sleeps in a 24 hour period, and that most of them lay in the same position when sleeping, all of a sudden it makes perfect sense why flat spots are so common.
Research has shown that sleeping on the back is safest. So what can we do about it? You can encourage your baby to look to both sides by switching up what sides you give care from. (Most of us tend to always change diapers, bottle feed, etc. from a certain side.) Don't always lay them with their head at a specific end of the crib, changing table, etc. Also, limit time in bouncy seats, infant carriers, and swings, as they are still putting pressure on the back of the infant's head. When you are holding your baby, try to snuggle them upright, or at least so their bellies are against you. It's okay for your baby to sleep on their belly if you are right there! One suggestion she made was to carry your baby around in a sling against you, in an upright position sometimes instead of always putting them in a bouncy seat or swing. Last but not least, we all know the importance of tummy time! Don't give up, even if your baby hates it. Try to make it a fun time, by getting on the floor with them, putting toys and a mirror in front of them, etc.
Sorry if that seemed like common sense, but I thought it was a good reminder! My little one wasn't a baby that was content to lie still for long anyway, but I will definitely use these tips with the next one!
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It's funny that you would post this today. I just had a physical therapist out to my house (like she left 5 minutes ago) to work with my three month old who is developing a flat spot on the back of his head. His is forming on the left side because of a condition called torticollis, which I had never heard of before, but the doctor noticed at his two month check-up that he almost always looks to the left. Anyway, she said one thing you can do with infants that can't sit up on their own yet, it to drape a blanket over a laundry basket and prop them up in the corner with a boppy pillow in front for them to lean on. The earlier they learn to sit up, the better as far as avoiding flat spots is concerned. I asked her if using a bumbo seat would work and she freaked out. She does not like bumbo seats - I was so glad I didn't have one sitting out in the room! She said it encourages children to slump forward or something.
i was going to add the torticollis piece but bethany beat me to it!
tummy time! tummy time! tummy time! even if they hate it, get down on their level with them and help them develop those muscles!!! my OT friends are always telling me that not only the flat head and torticollis but they're developing their neck muscles in general and motor skills slower because they're not on their tummies!!
Perfect time for me to read this. It is interesting to read about the 24/7 brain growth.
Wow this is way helpful. I will definitly be using some of the techniques mentioned and it great to be more aware!
Our son also has a preference towards his right side and we have been working constantly to try and round out his flat spot. Our doctor threatened the helmet many times if the flat spot didn't round out. We have literally not let him spend any time on his back the last few months unless he is sleeping or in his carseat. It's been a challenge to not rely on swings, playmats, etc., but his head is getting better.
Some more ideas that were suggested to us to help with plagiocephaly (especially if your baby has a preference to one side or torticollis) are:
-Always face the flat side of the head towards the "boring" side of the room. So, basically, put the flat side towards the wall so he wants to look the other way, both in his crib and when he is awake. When you change him, have the flat side towards the wall. When you play or talk to him, have him look at you from he side that uses less.
-Roll up a small receiving blanket to prop under the side of his body while he is asleep. This allows him to turn his head the other way especially if he always sleeps in the same position (I know there may be some controversy about this because of having a blanket in the crib). We tried it for awhile and it worked until our son got more mobile and scooted off of the blanket and turned his head back the way he wanted.
-Tummy time, of course. Our doctor actually recommended a bumbo, so who knows what the effects are. Our son doesn't really love it anyway.
-Limited time on his back while he is awake!
At first I didn't know why it was such a big deal to have a little flat spot. Hair will cover it up later in life, right? But it can be pretty serious if it doesn't get fixed. Everything can shift forward, including his ear, jaw, forehead, and cheekbone. This can cause the brain to not develop properly.
We are still waiting to hear whether or not he needs a helmet, but I do think that each pediatrician varies in how seriously he or she treats this issue. We recently switched doctors and the new one doesn't nearly as concerned. Good luck to all those who are dealing with this same issue!
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