Uneven Baby Head Shape: Causes, Treatment And Concerns

Some cases do not need treatment, while some can be cured with equipment, such as helmets, at home.

Medically reviewed by Dr. Dur Afshar Agha, MS Dr. Dur Afshar Agha Dr. Dur Afshar AghaMS facebook_iconinsta_icon Specialty: Masters of Tropical PediatricsExperience: 26 years
Written by Dr Bisny T. Joseph
Last Updated on
Baby Head Shape What Affects It And When To Worry

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A baby’s head shape changes after birth and takes a few weeks to get a round shape. Generally, babies are born with uneven head shapes due to flexible head bones. Applying even gentle pressure on these malleable bones may distort the head’s shape. However, in most cases, the shape gets normal. But if it doesn’t, the baby may require specific homecare or interventions, such as helmets, to get the head shape back to normal. Thankfully, uneven head shapes don’t interfere with the baby’s brain growth and development.

Keep reading to learn the types, causes, and treatments of uneven head shapes in babies.

Types Of Uneven Head Shapes In Babies

Babies can have various uneven head shapes during the newborn period and infancy.

  • Conehead: Babies may have conehead after vaginal delivery due to head molding. This is normal and resolves within weeks, and does not affect the brain’s normal development (1).
  • Flathead or positional plagiocephaly: Pressure on a part of the head due to various reasons can cause a flat head in babies. Although the shape of the skull is not round, this condition does not affect brain growth (2).
  • Craniosynostosis: This is the early fusion of cranial sutures causing abnormal head shapes due to a rapidly growing brain. Craniosynostosis requires surgical correction to avoid brain damage (3).

Causes Of Uneven Head Shapes In Babies

The following factors may cause uneven head shape in babies (4).

  • Vaginal delivery: Babies head is molded in the birth canal during the delivery process. This may result in uneven head shape, such as conehead, in some babies.
  • Intrauterine position: Some positions in the uterus may put pressure on the baby’s head.
  • Multiple births: More than one baby in the womb may cause flat heads due to lack of space in the womb.
  • Torticollis: This is a condition where a muscle on one side of the neck tightens, tilting the head to one side. Babies can have flat heads due to torticollis since they cannot turn their heads to another position.
  • Sleeping positions: Laying on the back for long periods without changing position may result in flat heads in babies.
  • Genetic causes: Changes in one or two genes may contribute to craniosynostosis in some babies. However, the cause is unknown in most cases.

Babies born through cesarean section may not have a misshapen head shape since they are not passing through the birth canal. An increase in the number of C-sections and awareness among caregivers or parents has resulted in the reduction of conehead and flathead babies.

Is It A Cause For Worry?

Not all cases of uneven head shape in babies are the cause for concern. Flat spots (plagiocephaly) due to pressure may not cause brain damage or issues with brain development in babies (5).

Abnormal head shapes due to craniosynostosis may interfere with a baby’s normal development. This may also increase the risk of seizures, cognitive impairment, or blindness due to increased intracranial pressure. Therefore, it requires prompt treatment.

Treatment For Uneven Head Shapes In Babies

Pediatricians can make the diagnosis of positional plagiocephaly on physical examination. Cranial ultrasound, MRI, or CT scan is done to diagnose craniosynostosis in babies. The following steps are recommended for the management of uneven head shapes in babies.

1. No treatment

Newborns with an uneven head shape, such as conehead due to the birth process, may not require treatment. Bump and swelling may resolve within a week or two in most babies, and they could eventually have a normal head shape.

2. Home treatment

Doctors may suggest the following homecare measures for babies with positional plagiocephaly (4).

  • Change the direction of the head while the baby sleeps on their back. This may help to reduce the pressure on one part of the head.
  • Hold the baby with alternate arms and change the feeding positions. It may reduce pressure on the baby’s head during nursing.
  • Reduce the amount of time the baby spends sitting in infant seats, carriers, and swings to prevent excess pressure on a part of the head.
  • Provide adequate tummy time to the baby since it may also help to avoid pressure on the head. You may ensure that your baby always has tummy time on a firm surface with adult supervision to prevent the risk of sudden infant death syndrome (SIDS).

These interventions may help bring the baby’s head to a normal shape in most cases. Pediatricians may recommend interventions only after trying out the home measures.

3. Helmets

Custom-made helmets are usually prescribed if the uneven head shape is not improved with homecare measures for six months. These molded helmets reduce the pressure on the flattened side of the head.

Helmet therapy is effective from four months to one year of age. This is when the skull bones are not fully fused.

4. Other treatments

Uneven head shape due to craniosynostosis may require surgical treatment in infancy. Surgical separation of fused bones lets the brain grow and develop normally (3).

When To See A Doctor?

If you notice an uneven head shape in your baby, you may contact the pediatrician to know the necessary measures to prevent it. Flathead and coneheads are not a cause for worry since this may not impact the normal growth and development of the brain tissues.

Fontanelles or soft spots are soft membranous gaps (sutures) between cranial bones seen in a baby’s head. These spots let the baby’s skull expand according to the brain growth during infancy. If you notice a lack of soft spots, seek pediatric care as soon as possible.

Frequently Asked Questions

1. Is it common for babies to have an uneven head?

It is common for babies to be born with uneven heads as their skull bones are not fused until birth. Therefore, their head may lack a definitive round shape (6).

2. Do pillows help with a baby’s flat head?

According to the American Association of Pediatrics guidelines, using pillows to treat your baby’s flat head is unsafe as pillows pose a substantial suffocation risk (7).

A baby’s head shape is usually uneven at birth, caused due to the type of delivery, intrauterine positions, or other factors. While conehead in newborns normally resolves after one or two weeks of birth, and flathead resolves without affecting the baby’s brain growth, craniosynostosis in babies may necessitate particular treatments and correction surgery to avoid brain damage. Some home treatments, including adjusting a baby’s sleeping posture, getting enough tummy time, and wearing custom-made helmets, can help rectify the uneven head.

Key Pointers

  • Babies can have various uneven head shapes during birth and infancy.
  • Causes of uneven head shapes in babies include vaginal delivery, intrauterine position, multiple births,
    and torticollis.
  • Flat spots (plagiocephaly) due to pressure may not cause brain damage or issues with brain development in babies.

References

1. Newborn Head Shape; Mid-Atlantic Permanente Medical Group
2. Is Your Baby’s Head Misshapen?; St. Louis Children’s Hospital
3. Uneven Head Shape in Babies: Causes and Treatment of Craniosynostosis; American Academy of Pediatrics
4. Baby’s Head Shape: Should You Be Concerned?; Nationwide Children’s Hospital
5. Baby’s head shape: What’s normal?; St. Clair Health
6. Uneven Head Shape in Babies: Causes and Treatment of Craniosynostosis; American Academy Of Pediatrics
7. Why Your Baby Doesn’t Need a Head-Shaping Pillow; Consumer Reports
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Dr. Dur Afshar Agha
Dr. Dur Afshar AghaMS
Dr. Dur Afshar Agha is a consultant pediatrician with around 26 years of experience in various medical facilities both in Pakistan and Saudi Arabia. She has headed the Department of Preventive Pediatrics at the prestigious, Children’s Hospital and Institute of Child Health in Pakistan and is a life member of the Pakistan Paediatric Association.

Read full bio of Dr. Dur Afshar Agha
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