Babies today spend much more time on their backs, since the American Academy of Pediatrics began recommending in the 1990s that all infants sleep on their backs to decrease the risk of sudden infant death syndrome. Because they spend less time on their bellies, more babies develop "positional plagiocephaly," the medical term for a flattened area on the back of the head. You can prevent your baby from having a flat head by keeping him off his back as much as possible during his awake times.
Start tummy time early. Put your baby on his belly on the floor while he's awake, even when he's only a few days old. You can also lie down and hold your baby on your abdomen or chest, face-to-face with you, or place him over your lap, face-down. Wait around 20 minutes after his feeding, so he doesn't spit up. Begin with short amounts of time, five minutes or so, three or four times a day and increase up to 20 minutes at a time as your baby tolerates it. Tummy time not only helps keep your baby's head round, but it also strengthens his shoulders, back and neck muscles.
Pick your baby up and carry or hold him, rather than keeping him in his car seat, stroller or swing for long periods during the day. All these devices -- although sometimes necessary for today's busy parents -- keep your baby's head at an angle that presses it against the back of the seat, which contributes to developing a flat head.
Change your baby's orientation frequently. If your baby keeps his head turned in the same direction most of the time, he's at greater risk for developing a flat head. Place his head at the foot of his crib sometimes, so he has to turn his head in the opposite direction to see into the room. Move his swing to different parts of the room, so he has to turn his head to the left sometimes and the right at other times to see what's going on.
Tips & Warnings
- Once your baby can sit up, his plagiocephaly generally won't get any worse. Only a small percentage of babies need to wear a corrective band or helmet to improve head shape.
- Premature babies have softer skulls, which increases their risk of developing plagiocephaly.
- Don't place pillows or wedges behind your baby's back to tilt him to one side; such devices can pose a smothering risk.
- Tummy time should be done only when your baby is awake and you're supervising.
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