DEAR DOCTOR K: I know it’s safer for my baby to sleep on his back, but I’m worried he’ll develop flat spots on the back of his head. What can I do to prevent this?
DEAR READER: Flat spots on the head are becoming more common in babies. As you suspect, that’s likely because more babies are sleeping on their backs than on their bellies.
We want babies to sleep on their backs to decrease the risk of sudden infant death syndrome. Since the “Back to Sleep” recommendation went into effect in 1994, the rate of SIDS has dropped by half.
But sleeping on the back does put pressure on the back of a baby’s head. Babies have soft, malleable skulls. This helps them get through the birth canal and allows for the rapid brain growth that happens during infancy. It also makes their skulls sensitive to pressure, especially when that pressure is always in the same place.
Flat spots don’t cause brain damage or affect brain function. They can, however, lead to teasing if the shape is very abnormal.
To prevent flat spots, change the position of your baby’s head throughout the day:
• Give your baby “tummy time” when he is awake and being watched. Do this for at least a few minutes a few times a day.
• Carry your baby in a sling or other baby carrier to take pressure off his head.
• Vary the position of your baby’s head when he is lying down. You may have to literally turn his head so he is facing the other way. If your baby prefers one side to another, position his seat or bassinet during the day so that the more interesting things to look at are on the less-preferred side.
Most flat spots are mild and go away once babies are a little older and spend less time lying down. In severe cases, your pediatrician can prescribe a soft helmet that shields the skull from pressure, allowing the head to grow naturally into a rounder shape.