Babies have soft spots or fontanels on their skulls heads to facilitate birth by pressing through the narrow birth canal. That is why, newborn baby’s head looks weirdly pointed right after her birth. A premature baby may get more misshaped head while struggling for birth because of lesser-developed bones than a full term baby. Twins also have a higher probability of getting born with odd heads because they share the womb and space may be an issue for changing positions inside the uterus. Low amniotic fluid during pregnancy is another reason as it provides less protective cushion and restricts the fetus activity inside the womb. Lying at one position applies pressure on soft spots and results in an irregular head shape of the unborn fetus.
Soft spots or gaps remain open later in young babies to adjust the growing brain. Fontanels are fragile but are covered with tough membranes. Day to day massage and touching while bathing, dressing and holding the baby does not cause harm to them. Gradually, the bones in the baby’s skull get enough mineral deposits to entirely fuse together and fill these gaps. As your baby grows, you will observe that the back fontanel, small one will close first anywhere around 6 weeks to 4 months of age. The second fontanel, which is larger is present on the front portion of baby’s head and takes at least 18 months to close normally. The odd shape of head due to birth evens out on its own as these gaps closes.
Sometimes, the baby’s head looks perfect earlier but becomes flat or misshape later during the first year, due to baby sleeping and feeding continuously in the same position. When the back of her head becomes flat, the disorder is called brachycephaly and if flat area is observed on one side of head, the medical term given is plagiocephaly. Both are positional cephalic disorders. Frequent repositioning the baby while sleeping and lying stimulates the pressed or flattened areas of baby’s head to come back to shape naturally. Baby pillows are specially filled with loose mustard seeds filling in India to provide maneuverable base for head while sleeping. Pillows with depression in center also work great to ease the pressure on the resting head.
Babies should always be put on their back to sleep to avoid the risk of Sudden Infant Death Syndrome (SIDS). During the first 5 months, baby is mostly on her back, even while playing. If you find one side of baby’s head flat, change the position of mirrors and toys, your baby loves to look at, to encourage him to keep the head on alternate side. Keep changing her position while feeding also. Sling can be tried to make the little one sleep to relieve the pressure points on delicate head. Baby bouncers and rockers with colorful toys can also be used to provide the alternate playing and feeding position to your honey bun. Supervised tummy time should be encouraged sufficiently from beginning in life to ensure proper physical and motor growth of infants. Monitoring and alternating the everyday habits of your baby can simply prevent this problem altogether. Re-positioning has a great deal of positive effect to even out the odd flat areas of baby’s head. If you observe that your efforts are not paying well to make your baby’s head appear round till the age of 6 months, consult your child’s doctor immediately. Timely medical intervention till first 2 years of life can cure the problem completely.
Positional Plagiocephaly is a very common occurrence. 1 in every 2 infant suffers from it and about 1 in 10 need the medical treatment for it. Thankfully, it does not affect the brain and neurological growth of the child. If left untreated, it might spoil the appearance of your little angel for life. Custom fit cranial helmets are made according to your baby’s head size to allow enough room for growing skull. Wearing the soft Helmet for 23 hours a day ensures the presence of a corrective external force on the baby’s growing skull at all times to promote rounding of the flattened shape. However, this therapy is a viable option only before the child turns 2. Earlier the therapy is started, faster you can expect good results. Doctors advise to start this treatment as early as 4 months.
In some cases, misshape of head occurs due to a birth defect, Craniosynostosis. In this, one or more of the joints between the bones of baby’s skull close or fuse prematurely (before 2 years) and does not allow the full growth of brain. Its treatment involves cranial surgery to separate the fused bones. After surgery, if another abnormality is not there, brain is expected to grow properly. Helmets may be advised to the child post surgery for support. An experienced doctor diagnoses this defect as a result of physical exam. Symptoms which distinguish it from positional cephalic disorders includes absence of a soft spot at birth, early disappearance of fontanels, seizures, bulging eyes, raised hard ridges on skull, unusual head circumference and shape, visible scalp veins, slower head growth, irritability, excessive crying, vomiting, poor feeding habits and developmental delays. The symptoms are milder sometimes and the disease can go undiagnosed for several years till complications like blurred vision and feeling of increased pressure on head develops.
Whatever may be the reason of your baby’s odd head, it is treatable when you act timely. Talk to your baby’s pediatrician about your concerns.