does my baby need a helmet?

Have you noticed the development of a flat spot on your baby's head? Before you start down the rabbit hole of endless online research, rest assured that you are not alone. Flat head syndrome, also known as plagiocephaly or brachycephaly, occurs in nearly 40% of infants. In many cases, flat head syndrome resolves on its own with time and natural development.

To better understand how to prevent flat head syndrome and what to do if your baby has already developed a flat spot, we asked pediatric neurosurgery nurse practitioner, Stephanie Smith to answer the most asked questions about flat head syndrome.

what can I do to prevent my baby from getting a flat spot?

Limit the time your baby spends in reclined devices* such as swings and bouncer seats, as this can lead to flattening on the back of the head. Provide at least 60 minutes of tummy time each day as recommended by the American Academy of Pediatrics. When first starting tummy time, some babies may not enjoy it. The use of interactive tummy time playmats and placing toys in front of the baby may help them tolerate this position better. Tummy time can be broken up into five-to-ten-minute increments spread throughout the day. Without adequate tummy time, babies can be delayed in learning to roll and crawl.

*Please remember that although a car seat is a reclined device, your baby should always be secured in an appropriately sized car seat when your car is in motion.

what should I do if my baby has already developed a flat spot?

If using reclined devices for sleep or play, discontinue the use of these items immediately. Reposition your baby off the flat side of his or her head while awake. Do not place any pillows or repositioning devices in your baby's bed. Your baby should always be placed on their back for sleep; however, you can encourage your baby to turn their head to the non-flat side with toys and/or lights placed in their room nearby. You should not place any items in your baby's bed.

In babies who keep their head turned to one side, this often means that they have torticollis. Torticollis is a condition in which the neck muscles contract, causing the head to twist to one side. Contact your pediatrician to determine if your baby should be referred to neurosurgery and/or physical therapy to treat this condition.

how is flat head syndrome treated?

If the flattening of the head is determined to be moderate or severe, your baby may be placed in a helmet to help reshape the head. The helmets are worn for 23 hours per day and depending on the severity, helmets can be worn for up to six months. The average time in a helmet is approximately four to five months. To meet the eligibility for insurance companies to pay for helmet therapy, the following criteria must be met:

• Two months of repositioning out of swings and other reclined seating devices
• 60 minutes of tummy time per day
• If the baby has torticollis, two months of physical therapy or neck stretching exercises prescribed by the pediatrician or performed by the chiropractor that have resulted in effective treatment of the torticollis

why is flat head syndrome treated by neurosurgery at Dayton Children's?

Although rare, there can be other causes for flattening or mishappenings of the baby's head that may require surgical intervention. Neurosurgery providers are experts in evaluating the baby's head to determine the cause of the flattening and if needed, order the appropriate diagnostic work-up needed to rule out any potential surgical concern.

If you believe your baby has flat head syndrome, and would like an evaluation by our neurosurgery experts, schedule an appointment online.