Babies’ Head Shapes: 5 Things to Know

Babies come in different shapes and sizes, but what’s the deal with babies’ head shapes? Many parents know newborn heads are soft and pliable, therefore it’s crucial to support the baby’s head until it fully forms. But why do some babies have rounded heads, while others have more of a cone, asymmetrical or flat shape?

Connecticut Children’s Neurosurgery Nurse Practitioner, Bethany Simonetti, addresses babies’ head shapes and 5 things parents should know.

1. It’s common for a baby’s head to appear uneven or flat—and most of the time the head shape resolves itself.

Here are some questions to consider about your baby’s head shape:

Was your baby delivered naturally, or via c-section?
Were they born prematurely?
How did they position themselves while in the whom? (We know, you wouldn’t know that!)
Do they favor one side while sleeping or looking at something?
Do they spend a lot of time flat on their backs? And yes, for safe sleep, back is always, always a must according to the American Academy of Pediatrics.

The above factors contribute to how your baby’s head is shaped. For example, it’s normal for babies to have a slightly flattened spot on the back of their head simply from lying down. In most cases, this resolves itself. But, keep watch, of course.

2. Your pediatrician may refer you to a pediatric neurosurgeon if they suspect your baby has an abnormally shaped head.

How do you know if your baby’s head might be misshapen?

At a milestone visit, your pediatrician will look for:

Large, flat spots that aren’t improving, especially by 4 months old.
Flat, rather than curved, back of head.
Classic parallelogram shape, meaning the forehead looks pushed forward and the back of baby’s head is flat. This is plagiocephaly.
Long- and narrow-shaped head. This is doliocephaly.
Generalized flatness across the back of the head. This is brachycephaly.

3. Your baby may benefit from a cranial remolding helmet if they are anywhere between 4 and 12 months old (but sometimes up to 18 months), when skull bones are still malleable.

Baby cranial remolding helmets are custom designed for your baby and work by relieving pressure on the flatter parts of the head as it continues to grow.

Your baby should not feel any pain or discomfort from wearing them, though the decision to get a helmet for your baby is a personal one. If you decide to pursue a cranial remodeling helmet for your baby’s head shape, Connecticut Children’s pediatric neurosurgery team is here to connect you with the resources to make it happen.

4. Most of the time, surgery is not necessary to correct baby head shape. But sometimes, it can help for a condition called craniosynostosis.

Unlike misshapen baby heads that are caused by birth or lifestyle factors, craniosynostosis is a birth defect. It happens when the bones in a baby’s skull fuse together too early, well before the baby’s brain fully forms. The skull can become misshapen as the baby’s brain grows, causing unnecessary pressure, but this is completely fixable thanks to advances in pediatric neurosurgery.

5. There are ways to help shape your baby’s head naturally, but check with your pediatric neurosurgeon or pediatric occupational therapist first.

Here are some things you can do—and might already be doing!—to help encourage a healthy baby head shape:

Tummy time—place your baby on their stomach while awake, and always have an adult supervise them. Tummy time is an early exercise with important developmental benefits for the muscles, bones and nervous system. Start doing tummy time correctly from day one.
Carrying or “wearing” baby more often—if you are able, try to spend more time during baby’s first few months carrying them so they are not constantly on their backs, which we know can lead to slightly flattened heads.
Change the position of baby’s “eye candy”—does your baby have a favorite toy, mobile or design they like to gawk over? Move it! Subtle changes in positions can help encourage a healthy head shape as baby matures.