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Does Your Baby Have a Flat Spot?

Photograph by Getty Images

A recent study out of Canada suggests that up to half of all healthy babies now suffer from at least a mild form of positional plagiocephaly, or a flat spot on the side or back of the head.

The condition—it’s believed—is caused by pressure due to babies spending too much time with their heads on firm surfaces: crib mattresses, baby swings, bouncy seats and infant car seats.

And lo, with a single headline, a brand new mommy war was born.

On one side, the baby wearers: “WEAR YOUR BABIES!” They screamed from comment sections. “Quit carrying them around in those awful baby buckets!”

The other side quietly defended itself. “I have twins/my baby was premature/that Moby gave me claustrophobia,” they whispered. “Put yourself in my shoes.”

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Let’s step back for a minute and look at the facts.

In 1992 the American Academy of Pediatrics kicked off its “Back to Sleep” campaign, urging parents to put babies to sleep on their backs, much to the chagrin of grandmothers everywhere. (The campaign is now called “Safe to Sleep” and includes information on general sleep safety not related to SIDS, for those of you who are interested.) That simple move reduced SIDS deaths by half, but as early as 1996 pediatricians noted an uptick in positional plagiocephaly.

Parents, doctors and early interventionists noticed another unsurprising trend. Babies were slower to support their heads, roll and sit up on their own than babies of earlier generations. Turns out all that tummy sleeping also went a long way toward building core strength. Babies were quickly schooled in Tummy Time 101 and parents were admonished to provide it several times a day.

So to sum it up: Back-sleeping reduces SIDS cases by 50 percent, but may come with some troubling consequences. What is a parent to do?

The general advice is stuff you’re probably already doing:

  • Hold your baby whenever you can to reduce time spent flat on his back.

  • Place your baby (on his back) at opposite ends of the crib each time you lay him down. Chances are he turns his head a certain way to look out into the room or at a crib toy. Not only will this decrease the chances of forming a flat spot, but his neck muscles will also get equal opportunity to exercise. Strong neck muscles mean that baby is able to turn and lift his head at will, which will also reduce risk of developing a flat spot.

  • Likewise, if you bottle feed, alternate sides with each feeding. If you breast-feed, this will happen naturally.

  • Tummy time, tummy time, tummy time. If your baby hates tummy time, try propping her over your leg or a rolled up blanket for extra support, or lay her on your chest.

  • Don’t panic: Most mild flat spots will resolve themselves as babies get stronger and are able to move around more. More severe flat spots need treatment before the age of 6 months, but are reversible with a specialized helmet.

And now, my own personal anecdote:

Way back before my now 10-year-old daughter was born, an occupational therapist I worked with told me to avoid keeping her in an infant car seat. (She did not smugly call it a baby bucket.) Her reasoning was that babies who are held have proper flexion, which improves feeding and breathing, and that being held improves core strength. I followed her advice and didn’t even buy an infant carrier-type seat. I carried my firstborn everywhere I went. (I was unable to “wear” either of my babies due to a large chest that made it awkward and uncomfortable for both of us.) It was not a convenient choice, but I was a stay-at-home mom of one, and it worked for us.

RELATED: Floor Time & The Developing Child

Then, my now 8-year-old daughter was born, and I instantly understood why people love their baby buckets and their “baby neglecters” (swings). She spent plenty of time in both, though I still held her at every opportunity. We all just do our best, you know what I mean? She went on to roll, sit up and crawl months earlier than her older sis, so maybe all that “neglect” was good for something.

Did your baby develop a flat spot in his first three months? Share your story with us in comments below.

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