Normal newborn head shape

Newborn Head Shape – What is Normal?

Posted on July 15, 2018 by Sydney West Physio - Paediatric Physiotherapy

It’s very common for a newborn’s head to be elongated or have an odd shape. Babies may have an uneven head shape at birth, however this should remould to a normal, more symmetrical shape within 6 weeks after birth.

When babies are born, the bones of their skull are thin and flexible, meaning the head is soft and may change shape easily. All babies should have two soft areas at the top of their head (fontanelles). These fontanelles allow for your baby’s rapidly growing brain during infancy and usually closes around 12 months of age.

Positional plagiocephaly describes a condition where your baby’s head is not symmetrical but the fontanelle remains open. Positional plagiocephaly does not affect the development of your baby’s brain however; it may alter your baby’s physical appearance as it can cause uneven growth of their head or face. Positional plagiocephaly is a relatively common condition occurring in an estimated 10-50% of newborns.

Flattening of your baby’s head can occur when constant pressure is applied to one part of a baby’s head.

Studies have found babies to be more likely to have positional plagiocephaly if they have the following characteristics:

First born
Premature
Male
Difficult or assisted birth
Breech positioning during the last trimester
Other neck problems e.g. congenital muscular torticollis
Lack of supervised tummy time when awake i.e. less than 3 times per day
Always positioned to the same side when feeding or sleeping

If your baby has positional plagiocephaly, it is important to determine if the fontanelles have closed too early. This is a condition called craniosynostosis. It is estimated to occur in 1 /2500 live births and should be reviewed by a doctor.

Positional plagiocephaly: What can you do?

For the majority of children, positional plagiocephaly is a correctable condition. For most babies, regular repositioning of your baby’s head before they are 4 months old will result in optimal outcomes. If your baby has a flat spot, alternating their head position can improve this.

Tummy Time:

Provide supervised “tummy time” when you baby is awake
“Tummy time” promotes normal shaping of the back the head, it also helps babies to strengthen their neck muscles and learn to push up on their arms, which helps develop the muscles needed for crawling and sitting up.
Looking around from a new perspective encourages your baby’s learning and discovery of the world. Move toys around to keep your baby active and stimulated.

Side Positioning for Play:

When awake and you are supervising them, place your baby on their side to play

Hold your baby more often or consider an appropriate sling

Pick up and hold your baby in an upright position. This will take pressure off the head and may help with development of neck muscle strength and head control. By reducing the amount of time your child spends lying in a position where the head is resting against a flat surface (such as in car seats, strollers, swings and bouncy seats). For instance, if your baby has fallen asleep in a car seat during travel, take your baby out of the seat when you get home rather than leaving your little one snoozing in the seat.

Sleeping Position

Sleeping on the back is the best position for babies to reduce the risk of SIDS. There has been an 80 per cent reduction in SIDS deaths since the introduction of prevention campaigns in 1997 that encouraged parents to place sleeping infants on their back.
Although your baby is on their back try to alternate your baby’s head position for each sleep: for one sleep turn your baby’s head to their left side and then the next sleep turn your baby’s head to their right side.
Whichever side of your infant’s head is flattened, you will want to position your baby to encourage active turning of the head to the other side.
Scientific evidence and SIDS do NOT approve of wedge pillows and other devices to keep your baby in one position as per the guidelines athttps://rednose.com.au/article/pillow-use
The Australian government states it is safer not to use a pillow at all for children under two¹⁵.
More information on SIDS guidelines can be found at https://rednose.com.au/section/safe-sleeping

Corrective Helmet

Sometimes when the uneven head shape is more severe or where counter positioning did not work, a cranial remodelling helmetmay help. For children where this treatment is necessary, it is important to see a craniofacial specialist team through your local Childrens Hospital. Treatment is provided by a team specialising in this service, helmets are custom made and adjusted by the orthotist every one to two weeks and treatment usually takes between two to six months.
Neverpurchase or use any helmet or head shaping devices without first having your child seen by a doctor. Only a small percentage of babies wear helmets. The decision to use helmet therapy is made on an individual assessment and case-by-case basis by the team and child’s family.

Key Points to Remember

Babies may have an uneven head shape at birth however this should remould to a normal more symmetrical shape within 6 weeks after birth.
Positional plagiocephaly will not affect the development of your baby’s brain.
If you are concerned about your baby’s head shape, talk to your Child Health Nurse, GP, paediatrician or paediatric physiotherapist.
A paediatric physiotherapist can assess your child and assist with planning a home program which may include specific exercises, stretches and promotion of a variety of positions during awake, sleep and play time.
Few baby’s require helmet therapy.

References:

http://www.essentialbaby.com.au/baby/baby-sleep/sids-safe-sleeping-guidelines-20081201-6oek#ixzz4hOfggbXn
Australian Competition and Consumer Commission. (2007) Cots. Safety Alert Brochure. Retrieved from http://bit.ly/RpYpA1.
https://rednose.com.au/section/safe-sleeping
https://www.physiotherapy.asn.au/APAWCM/Physio_and_You/Infants.aspx
http://www.rch.org.au/kidsinfo/fact_sheets/Plagiocephaly_misshapen_head/
https://www.schn.health.nsw.gov.au/parents-and-carers/our-services/craniofacial/chw
http://www.mayoclinic.org/diseases-conditions/craniosynostosis/symptoms-causes/dxc-20256926

Tags: Baby Brain, Newborn Head Shape, Paediatrics

Plagiocephaly, Brachycephaly, Scaphocephal Baby Head Shape

Sometimes known as “flat head syndrome,” plagiocephaly (pronounced play-jee-oh-sef-uh-lee) is a relatively common condition where an infant develops a flat spot on the back or backside of the head. Many factors can cause flat spots. A baby’s skull is very soft and pressure from everyday surfaces, such as beds or car seats, can cause flattening.

No two cases of plagiocephaly are alike.

What is Normal?

Parents spend so much time with their baby, recognizing an abnormal head shape can sometimes be difficult. We’ve found it can be helpful to see examples of a normal head shape before looking at abnormal ones. Normally, the head is about 1/3 longer than it is wide and rounded at the back. Below are some examples of a normal head shape at three months, six months and nine months old.

Head Shape Comparisons

Normal Head Shape– 3 month old

Normal Head Shape– 6 month old

Normal Head Shape– 9 month old

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What does plagiocephaly look like?

Plagiocephaly means “oblique head” (from Greek “plagio” meaning oblique and “cephale” meaning head). The baby’s head shape resembles a parallelogram from above. Parents and medical professionals can look for these characteristics:

Head is flat on one side
One ear is more forward than the other
One eye is smaller than the other
One cheek is fuller than the other
Top of the head is not level
Head shape resembles a parallelogram from above

Plagiocephaly head shapes, ranging from normal to severe.

What does brachycephaly look like?

Brachycephaly is rooted in Latin, “brachy” meaning short and “cephaly” meaning head. The back of the head becomes flat, causing an abnormally wide, tall head shape. Parents and medical professionals should look for these characteristics:

Head is wider than normal
Head is abnormally tall
Back of head is flat rather than curved
Face appears small relative to the size of the head
Widest part of the head is just above the ears
Tips of ears protrude
Head shape resembles a trapezoid from above

Brachycephaly head shapes, ranging from normal to severe.

What does brachycephaly with plagiocephaly look like?

As you might expect, babies with brachycephaly and plagiocephaly share characteristics of both head shapes. In these cases, the head is abnormally tall and wide and resembles a distorted trapezoid from above. These are the traits parents and doctors can look for:

A combination of plagiocephaly and brachycephaly traits
Head is wider and taller than normal
Forehead is sloped
Ears and eyes appear misaligned
Head shape resembles a distorted trapezoid from above

Brachycephaly with plagiocephaly head shapes, ranging from normal to severe.

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Head shape in a newborn: what options are considered normal loose (they will have to completely harden in the first year), and the seams between them have not yet had time to overgrow. During childbirth, the bones overlap each other, allowing the baby to move out more easily. That is why, after natural childbirth, the shape of the head is slightly elongated, while in small "caesareans" it is even and rounded.

Due to the ups and downs of traveling through the birth canal, a baby may be born with an asymmetrical head, and sometimes also with a bump (cephalohematoma) or edema (the so-called generic). nine0003

Mothers often wonder: why do babies have such a large head? Relative to the size of the body, it is indeed much larger than in adults - at birth, the baby's head in a circumference is about 2 cm larger than the chest. But it happens that these dimensions increase even more: this happens if cerebrospinal fluid accumulates in the cranial cavity. Then doctors talk about hydrocephalus. This problem can occur if a woman has a severe infection during pregnancy. And it happens the other way around - the head of the newborn is too small (microcephaly). Fortunately, in many cases, the reason for its unusual shape or size is much simpler: a child can inherit all these features from their parents. nine0003

In newborns, the following head shapes are considered normal:

Dolichocephalic - in this case, the skull is slightly flattened, elongated from the chin to the back of the head, and has an elongated diagonal shape.
Bracheocephalic - the transverse diameter of the head is greater than the longitudinal one, the skull is elongated from the forehead to the back of the head, slightly flattened.
Tower - the skull is elongated vertically, the reason is the rapid healing of the sutures of the skull bones. nine0003

When will the baby's head become the correct shape? It begins to level off already in the first days after childbirth, and in total this process can last up to a year. How can you help your baby get back to normal?

Caring care. If the baby lies on his back in one position for a long time, his head may become flat. That is why the child's head must be turned from time to time to the left, then to the right, lay the baby on its side, and if necessary, put a roller. nine0003
Proper nutrition. The shape of the child's head may change due to rickets, in which calcium metabolism is disturbed in the body. In this situation, the baby will need the help of a doctor; he will advise the mother to monitor her diet (for example, eat more dairy products) if she is breastfeeding the baby, and he will prescribe a suitable mixture for the little “artist”.
Orthopedic pillows for newborns. These pillows are prescribed by a doctor to correct the shape of the baby's head and prevent deformities in the back of the head and neck. nine0003

More interesting and useful materials for expectant mothers - in our channel on Yandex.Zen.

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shape, size, fontanel.

Everything is good? Shape and size of a baby's head

What can the shape and size of a newborn's head tell parents? What "signals" about the state of the baby does a large fontanel give? We dispel the fears and doubts of mothers.

What should a newborn's fontanel be like

A small dimple on the baby's crown - a fontanel - performs an important task during the birth of a baby. And after birth, she is given a serious role, and along with this, special attention of mothers and doctors. nine0003

Fontanelles are areas at the junctions of cranial bones, covered with soft elastic membranes instead of bone tissue. Thanks to them, the baby's head is plastic and during childbirth can adapt to the curves of the mother's pelvis. The volume and size of the baby's head decrease at the time of birth, which helps protect both the baby's brain and the mother's organs from damage.

There are six fontanels in total, but in full-term babies, by the time of birth, as a rule, only one remains open, in the region of the crown, the so-called large fontanel. Normally, its size is from 0.5 to 3 cm, and the shape resembles a rhombus. After birth, it helps the baby to adapt to the changing external environment: maintain body temperature, regulate fluctuations in intracranial pressure. nine0003

We have been trying to get around this big spring for a whole year when we stroke the child’s head, take off his hat, and comb it. Just under the skin, thin and shiny, is a strong but elastic membrane, which will later be replaced by bone, and under it a rather large vein pulsates. It is she who swells, transmitting the vibrations of the arteries and the heart, when the baby cries, screams or takes a deep breath.

The large fontanel grows gradually and finally closes between 6 and 18 months. When exactly this happens depends primarily on the characteristics of the baby's body. Although too slow or, conversely, rapid overgrowth of the fontanel is a sign of illness, but not in itself, but along with other symptoms. So, most often the "dent" is tightened too slowly due to rickets. It also happens that the fontanel disappears already in the first six months of a baby's life - the reason for this is a violation of the metabolism of calcium and phosphorus in the body. nine0003

The dimple is low maintenance. You can touch the fontanel with both your hand and a comb - although, of course, you should not put much pressure on it, as, indeed, on any other part of the child's body.

By the appearance of the fontanel, you can assess the condition of the baby. Normally, it should neither swell nor sink; touching the fontanel with your fingers, it is easy to feel the pulsation.

It is worth consulting a doctor if the fontanel becomes hard to the touch, there is no pulsation inside it, it swells or sinks, and the baby is worried or, on the contrary, looks lethargic (normally, the fontanel can swell when the baby cries, but then quickly returns to its previous form). When the fontanel is pulled inward, this may indicate severe dehydration of the child: it must be urgently shown to the doctor. nine0003

The speed of overgrowth of a large fontanel is different for each baby - this is normal if the head circumference increases both smoothly and on time. This phenomenon can be explained as follows: if, due to some kind of stress received during childbirth, the child’s brain “lives” better in the conditions of a “spacious” skull, it will retain a large fontanelle and open sutures for a long time, and if mobility harms the brain, the wise the body will overgrow it in 3 months.

Newborn head shape and size

The shape of the head in newborn babies can be not only round, but also elongated, flattened, ovoid - and all these options are considered the norm. Why it happens?

By the time of birth, the bones of the skull in babies are not yet too dense (they will have to completely harden during the first year of life), and the seams between them have not yet managed to heal. During childbirth, the bones overlap each other, allowing the baby to move out more easily. That is why, after natural childbirth, the shape of the head, as a rule, is slightly elongated, while in small "cesareans" it is even and rounded. Due to the ups and downs of traveling through the birth canal, a baby may be born with an asymmetrical head, and sometimes also with a bump (cephalohematoma) or edema (the so-called generic). nine0003

At birth, the baby's head is approximately 2 cm larger than the chest. But it happens that these dimensions increase even more: this happens if cerebrospinal fluid accumulates in the cranial cavity. Then the upper part becomes larger than the lower one, a heavy forehead hangs over the eyes and nose, and doctors talk about hydrocephalus. This problem can occur if, during pregnancy, a woman suffered a severe infection that affected the unborn baby. In this case, doctors will immediately start treating the child, and after a few months, his head may approach normal size. nine0003

A more serious situation is when a newborn, on the contrary, has a too small head (microcephaly).