Does your baby need a little more tummy time?
Babies have very malleable noggins. The bones of the skull are not fused in infancy, which allows passage through the birth canal and rapid growth of the brain in the first year.
This also means how we position infants affects how these bones align, grow, and fuse. When sleeping, you absolutely should place baby on her back and in her own sleep space to reduce the risk of sudden infant death syndrome (SIDS).
However, too much time on the back of the head or lying on one side can cause flattening or uneven head shapes, and babies spend A LOT of time on their backs.
Think about it, they sleep for 12 to 19 hours a day and when they are awake we put them in car seats, strollers, bouncers and so on.
Changes in head shape caused by positioning is the most common cause of flat or uneven heads. Depending on the shape it is called either positional plagiocephaly or positional brachycephaly (i.e., flat on one side vs, entire back of the head is flat). It can occur with or without restriction in neck turning called torticollis. We consider torticollis if a baby prefers to look in one direction or has trouble turning her head both directions.
The other reason babies may have odd head shapes is more rare. Sometimes skull bones fuse together before they are supposed to. This is called crainosynostosis and requires surgery to correct. Pediatricians can look for clues during routine exams to determine if the head shape is because of positional issues or premature fusion.
So what can you do? If you have concerns, talk with your child’s doctor. For positional causes, the doctor may suggest changes in positioning, physical therapy, or may consider helmet therapy if there is a severe deformity (such as the ear and eye being pushed forward on one side). Doing images like a CT scan is not useful unless your doctor is concerned about the bones fusing too soon.
Here are some tips to try at home to help prevent flattening:
Do it multiple times every day. For example, do tummy time for a few minutes after every diaper change and slowly increase the amount of time spent.
Get down on the floor with your baby, talk to them, and touch them. Very little ones especially love your face so it is comforting and good motivation for them.
There is no rule that tummy time has to be on a special mat on the ground. You can recline back and place baby’s tummy down on your chest. This is especially good for newborns who haven’t lost their umbilical cord yet.
Give the baby support by placing a rolled up towel under the chest.
Make it entertaining! Place bright toys or prop up a board book to look at.
Encourage baby to look in all directions
Alternate the head of the crib, the car seat location, and the side you change diapers on.
Move mobiles or mirrors to different places the crib.
Feed on the other side or try different feeding holds.
Spend as little time on the back as possible
Don’t keep babies in car seats unless on a car ride.
Use a baby carrier instead of a stroller when you can.
Limit time in bouncers, swings, etc.
As a bonus, tummy time is not only great for head shape, it also helps with motor development like head control, neck control, rolling, crawling, and sitting. So, try getting your little love a little more tummy time.
Leah Brandon D.O., MSA, FAAP, is a pediatrician at Mercy Central Pediatrics Clinic, located at 330 Laurel St., Suite 2100 in Des Moines. To schedule an appointment with Dr. Brandon, please call (515) 643-8611.
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This is the 11th installment in a healthcare series from Mercy Des Moines. Find the rest of the posts below: