Flat Head?

[KbabyM]

New to the forum and couldn't find a thread about this, but I am concerned about my baby's flat head and now recently I have become concerned about her small head.

Our baby is almost 5 months old and she is in the 80th percentile for her height, 40th for her weight. I was not at her last appt but my husband told me that her head just caught but to just below average. Our ped is not concerned about her weight, she just said she has my genes, tall and skinny. My husband tends to not tell me everything so that I don't worry, so I really don't know if the doctor said anything about her head, but I am concerned about her head...most babies have a large head as their heads are growing rapidly at this age,and to me her head is looks small. I don't think she has microcephaly but I am concerned that her head is on the small side. Has anyone's baby had a below average head size? Did it catch up eventually? Did it not catch up? Were there any learning problems? So far I don't see anything strange about her, she is very responsive, tracks with her eyes, coos and laughs in response to things, holds her head up and turns her head very well, hasn't started crawling yet but tries. I am worried about the future though and what may develop later on down the line?

What I am also worried about her flat had. Again our ped isn't worried and just said to move her head to the side when she sleeps, and give her plenty of time off her back. We caught it at around 2.5 to 3 months and we have been moving her head, giving her tummy time, carrying her, etc... and I don't see it rounding out. My husband has a flat head, but not like my baby's... my baby's is dramatic and tilts inward at the top while my husband's is just a straight line back there. She does not have misaligned ears though and does not have anything else misaligned. Has anyone experienced this? Did it eventually correct itself? When? Did you need to use a band or helmet? How did you deal with family or other parents seeing the baby in the gear? This is something I feel horrible about because it was preventable. She wasn't born with a flat head and then by 2.5 months she had one. I read boards about adults dealing with plagiocephaly and I don't want my baby to go through that now or in the future.

[RiverSky]

Our pediatric chiropractor with a specialty of cranial sacral therapy said that she could fix my nephew's flat head in 2 - 3 sessions. My husband and I were so concerned with my nephew's head shape (caused by a fairly negligent, alcoholic and drug addicted mother) that we offered to pay for those three sessions, but the mother refused to let us. His head is still pretty misshapen at the age of 4. Sigh... Supposedly, his pediatrician wasn't overly concerned, either. No, it didn't just pop back, btw.

Anyway, good for you for noticing and for wanting to avoid any worsening of the condition and hoping that you can avoid a helmet.

I suggest finding a good pediatric chiropractor (holistically minded) via suggestions from friends and such and interviewing them to see how you feel about their skills. Perhaps you can ask for recommendations from people with infants who have had success with improvements in skull shape?

Meanwhile, try to limit infant car seat time, baby swing time, laying down too often time, and utilize slings and other baby carriers as much as possible, even during naps. If your baby's head isn't laying flat anywhere, but is instead supposed in a softer fashion, it can't get worse, right?

good luck!

[Dmitrizmom]

If you are worried that you didn't get all the information about the ped visit from your dh, call the doctors office to schedule a visit to discuss options. If you feel that the plagiocephaly issues is significant enough to warrant intervention and that your ped isn't responsive, get a second opinion to either confirm your gut feeling or confirm that your ped is right.

(*disclaimer* I am a chiropractor and am thus biased toward chiro/alternative care modalities) If my child had a flat spot, I would find a chiro or a craniosacral specialist to work on her skull sutures. It is much less invasive and more gentle than banding/helmeting an infant, IMO.

to you mama. Hope you can get some peace on this challenge.

[raqi]

Just wanted to third the chiro suggestion. My LO had a pretty significant ridge on her head from her birth (her head was stuck pushing down on my pubic bone) and it's basically much gone after four sessions. If you decide to do it, though, the sooner is the better since their little skulls get less maleable as time goes on.

[beebalmmama]

My ds's head now at 7 months is rounding out a bit more now that he is sitting up a lot more. We took him in at about 5 months because it looked a little flat on his left side. The doctor wasn't too concerned but did want to see him in a couple of months. I've noticed it has rounded out a bit, but still has another slight flat spot on the back right side.

I might look into the cranial sacral though like others here have mentioned.

[sunnygir1]

My daughter had a flat head when she was a baby. At 3 it is still pretty flat on the back, but her hair covers it up.

Our family doctor was never worried about it, and neither were our chiropractor or cranio-sacral therapist. I took her for regular care to all three. She is totally fine and smart and healthy. I don't know how pronounced your baby's flat spot is compared to mine, but it is possible that it really is nothing to worry about.

I'm all for cranio-sacral therapy, which is very gentle, and chiropractic as well...it can't hurt.

As far as head size goes, it sounds like she is 80th percentile for length, and about 50th for head size, is that right? I guess I'm not sure that is a problem; I'd have to look, but I'm pretty sure my ds was kind of like that...now (9 months) his head has caught up to his length in terms of percentile. You could ask your husband what the doctor said or call the doctor to see if s/he is concerned about it.

You asked if people have had babies with below average head size...of course about half of us have. My dd's head was always big, and ds's is more normal sized, but both were below the 50th percentile for a while.

[KbabyM]

Thanks for the QUICK responses everyone! I would love to hear more from parents who have been dealing with this too. My baby's next appt this week and and regardless of what she says I am going to see a specialist. I've been wanting to since her last appt. What kind of doctor specializes in this?

beebalmmama, did you do anything special to help round it out and when did you start?

Sunny, at what age did you start therapy? I'll post some pictures and let me know what you think.

I feel pretty horrible about it, I didnt even know about flat head syndrome when she was born. I didn't read about it in any book or in our prenatal classes... I wish I knew to prevent this!!!!!!!!! I worry so much about it. Parents dealing with this has anyone made any comments, does your child get teased?

[Nicole730]

On the head size - my daughter is 50th percentile for height and weight, but 25th for head and has been since birth. I would think if your daughter is maintaining her percentile and not dropping, you are probably fine. Everyone comes in different shapes and sizes

[1blueheron]

we have a big body (75/80 percentile for length/height) little-headed girl (35 % for head). Our ped said not to worry as she is consistent and usually they worry more about overlarge heads/malnutrition ("brain-sparing" growth pattern).

i think our girl is cute as a button. so far so good on responsiveness, imitating sounds etc.

dunno about the plagiocephaly. do you have a picture?

[KbabyM]

I am still at the office i need to look and see if there is a pic I have that shows it on my office computer. If I don't I will post tomorrow.

Thank goodness about the head size issue, very comforting.

I just looked and I don't have any profile shots, I will post tomorrow. I'll also post an overhead shoot you can see the shape that way too.

In the meantime I'd love to keep hearing from everyone!

[askew]

My DD is 90th for height, 40th for weight and 10th for head. Nothing to worry about as long as it stays on it's curve. I have a very small head. Same size as my 3 year old DS who takes after his Dad. FWIW- I have several advanced degrees and have always been considered "gifted".

As for the flat head, we took DD to the neurosurgeon as we were concerned about it and though hers was pretty bad. Totally expected a helmut or surgery. He told us it wasn't that bad at all and she would grow out of it as she spent less time on her back... he was right... it keeps getting better. I am glad I got a second opinion though. We also see a cranio sacral therapist.

[Alisse]

Our son has been in the 95th percentile for length and weight since birth, but 33rd for head circumference. We were really concerned in the earlier months but aren't anymore as he's been meeting all milestones on time (and seems to be turning into a sneaky little bugger). Our doctor said that it wasn't anything to worry about in our case because head circumference is so variable.

I was very conscious of flathead syndrome from birth and so had my son lying on my chest a lot in the earlier months so that he would be lying on his front so to speak, and would alternate his head position every so often. The flatness on the back of the head can become permanent so i'd do something about it ASAP.

[sunnygir1]

Originally Posted by Alisse

The flatness on the back of the head can become permanent so i'd do something about it ASAP.

Do you mean do something because it is dangerous or detrimental in some way, or just that it is unattractive? It seems to me that head shape in and of itself doesn't warrant aggressive action, unless there is something wrong with the baby. It sounds like the op is doing something by changing sleeping positions and considering seeing a specialist.

[bender]

If your child's head is developing a flat spot and moving her around isn't fixing it, I woulc get an appointment with a specialist in that field. There is such a small window to fix the flatness effectively, that it would be unfortunate to miss learning about the options out there.

My friend's son had this problem, and their ped shrugged it off. They ended up getting a helmet for their child because he would never have been able to wear glasses or hats properly. They got the treatment at a later age, so his head is roundish, but not perfect. He'll never be able to get a buzzed haircut without looking kinda weird.

[marsupial-mom]

A smaller than average head shouldn't be a reason to worry unless either it's below the 5th percentile or if it's not keeping up the growth pace (example: goes from 60th percentile to 20th).

Small heads can be a sign of drug, alcohol, or cigarette use during pregnancy.. Or they can just be small heads. I wouldn't worry about your baby's small head unless she's not developing normally.

About a flat head: do what the doctor says and give her lots of time during the day when she's not lying on her back. It takes a while to round out. Our baby's head was sort of flat on one side for a while because he'd always turn that direction in his sleep. But now that he's older it flattened out and he rolls his head both ways.

If you're really worried though, go see the doctor.

[Jane91]

"Do you mean do something because it is dangerous or detrimental in some way, or just that it is unattractive? It seems to me that head shape in and of itself doesn't warrant aggressive action, unless there is something wrong with the baby. It sounds like the op is doing something by changing sleeping positions and considering seeing a specialist

We are struggling with this issue with one of our girls right now, and the issues beyond the aesthetics of the head are, as I understand them: (1) misaligned eye placement, resulting in vision issues, (2) misaligned ear placement, resulting in hearing issues and (3) jaw problems (such as TMJ).

[ErinYay]

V has a very round head, but it's also very small. She's always been on the low end of the charts, weight-wise, mid-range for hight, and way, way low for head-size. I was worried at her 2 month that her head was so tiny, but our ped assured us that she's fine- it's growing on its own curve, and DH and I both have remarkably small heads (we're both also tall and thin, and gifted- we just have little heads.)

My MIL calmed me down, too, after telling me my husband wasn't even ON the charts as a kiddo, and in fact needed a weight waiver to enlist in the Army at 22 because he was so thin. But he's strong and healthy- he couldn't have done two tours (Iraq and Afghanistan) in the Airborne brigade otherwise!

Our ped told us that it's the growth charts don't mean all that much; they want to see babies growing properly according to their own curve, and the charts exist mostly to detect sudden spikes or drops in growth. As long as there IS growth, and it's steady, no worries.

[nextcommercial]

I don't know much about head size. I usually get the big head girls in my daycare. We have to cut a slit in the neck opening to get the shirts over their heads.

I have had many, many kids with oddly shaped heads. None of them have gone back to a normal shape. One boy had the helmet for several months, and his is perfectly normal now. In fact, by 12 months, I couldn't even see where it had been misshapen. (he was born with a flat head, and a shortened neck muscle)

With the kids I notice getting flat heads, I usually will move them from one side to the other at each nap time. But, that's not incredibly helpful since they only sleep a few hours here. I haven't seen a big improvement either way. Hair usually covers it up just fine. I doubt any of us have perfectly shaped heads as adults, and we all slept on our stomachs and many of us didn't have carseats or any of the nifty contraptions babies have now.

I don't know that you can reverse it, but you are already doing things to keep it from getting flatter. She's also five months now. So, she will be spending more time in saucer seats or those jumping seats. (those jumping seats are awesome btw... they have saved my sanity....I worship ours a little)

Then after the sitting up in loud jumping contraptions for a few months, she'll be crawling soon. She'll spend much less time on her back soon, which helps a great deal.

[Jane91]

My understanding from our PT is that we will be helmeting one of our girls (currently 4 months) at around the 5 to 5.5 month mark, since "self-correction" of the flatness by re-positioning rarely occurs in any significant way after that point in time. I also understand we are starting at that point because the helmet is most effective when begun before 6 months.

From the OP's description, it sounds like her child may not have plagiocephaly (which is flatness along one side of the head and is ususally associated with torticollis) but rather brachycephaly (not sure of spelling), which is not an uneven flatness, but rather a straight flatness across the back of the head. I believe that can create jaw issues, but am not sure that the vision/hearing issues which may arise with plagiocephaly are the same.

At our parenting group meeting of 11 infants, I saw 2 or 3 that looked like the pictures of brachycephaly that I have seen on the web to varying degrees, so this is clearly very common.

The cranialtech.com website (which sells the DOC bands) had some good pictures for identifying the issue and severity. However, my PT does not recommend their band as it is not (in her view) a completely passive system but rather a helmet designed by the University of Michigan (can't recall the name off-hand since we don't have the helmet yet).

Don't listen to your ped on this issue. I had brought my child in at the 3 month mark, when we were noticing the issue (though looking back, I think it arose as early as 6-8 weeks after birth). I was told to just hold her differently when feeding which was a completely inadequate response (really rising to the level of malpractice I think). We should have been advised to seek out physical therapy, maximize even more her tummy time, completely stop all use of the swing, and position her on her side for sleeping. Basically, the peds seem so terrified that you'll move your baby to sleep on her front to avoid flat-head that they totally down-play the flat head syndrome when it presents itself and under diagnose and make inadequate recommendations.

After this experience (and some other negative medical ones I've had as an adult) I've decided to assume the medical professionals I interact with are incompetent unless they actually demonstrate otherwise. We now have two peds (so I can get second opinions easily, as I feel necessary) and are in process of getting our second opinion on the helmeting issue from a pediatric cranial specialist. I now research what specialists and additional resources I think my girls need, and I go in with the goal of obtaining the references and prescriptions I think are needed to make sure no balls are dropped.