Q & A

Q

I have heard that babies can develop a flat head from sleeping on their back, yet this is recommended by SIDS. How can I make sure that my baby’s head shape is OK?

A

All babies are born with soft mouldable heads to allow for adaptation during the birthing process. The skull bones have not fused together and may even overlap a little during birth. The newborn baby tends to be floppy and is unable to control his head in a midline position. He will therefore allow it to roll to one side or the other. After as little as four hours of sleeping there will be a tendency for the under side of the head to be a little flatter than the upper side.

There is no doubt that the incidence of SIDS has been lowered significantly since the introduction of Safe Sleeping Education. We must ensure that the baby sleeps on his back, but there is evidence to suggest that we should make sure that the baby lies with his head turned to alternate sides after each feed, or at least in the morning and the afternoon. This practice can be started from birth.

As the baby develops he will tend to turn his head to see bright objects, light, or the approach of the carer. Positioning the cot and toys to make use of this voluntary turning of the head is a very good practice. Some people find it easier to sleep the baby at alternate ends of the cot.

Placing the baby on his tummy when awake and supervised is also important. Playing or dressing and undressing with gentle stroking, can be soothing for a baby and teach him that tummy time is pleasant and fun. This is important for his future development.

If you have any doubt about the shape of your baby’s head, it can be checked by a paediatric physiotherapist and you can get further advice about handling and encouraging good development in your baby. There is also a brochure outlining the techniques to help in maintaining good head shape of your baby, available from your APA paediatric physiotherapist or through the National Office of the Australian Physiotherapy Association.