Infant Flat Spots: When to Worry & What to Do
- Rachael Carreon PT, DPT
- Feb 24
- 4 min read
As a parent, you’ve probably heard about flat spots on babies’ heads—but did you know they’re incredibly common? Head shape conditions like plagiocephaly (a flat spot on one side of the head) and brachycephaly (a flat spot across the back of the head) affect about 50% of babies - Want to learn more about it? Check it out here.
If you’ve noticed a flat spot on your little one’s head, take a deep breath—you’re not alone, and there’s SO much you can do to help.
This guide will walk you through what causes flat spots, how you can address them, and when to seek extra support.
Why Do Babies Develop Flat Spots?
Babies’ skulls are incredibly soft and moldable when they’re born. This is nature’s way of helping them fit through the birth canal and allowing their brains to grow rapidly in the first year. However, this softness also makes their heads more susceptible to flattening. Here are some common causes:
1. Prolonged Time in Infant Containers
Spending lots of time lying on their back—whether it’s in a swing, car seat, or bouncer—can lead to uneven pressure on one area of the head. These devices aren't designed for safe sleep, so the comfy, cushiony containers often make it harder for baby to turn their head, unlike a firm play mat or bassinet mattress.
2. Torticollis (or a Preference to Look One Direction)
Some babies naturally prefer to look or turn their head to one side, often due to torticollis—tightness in the neck muscles. This consistent positioning puts extra pressure on the same spot, leading to asymmetry.
3. Body Tension
Tension in a baby’s body (from birth, oral ties, or other challenges) can make it harder for them to move their head freely or evenly distribute pressure on their head.
4. Limited Tummy Time
Tummy time isn’t just about building strength—it’s also about relieving constant pressure on the back of your baby’s head. Babies who don’t spend enough time on their tummies may be at a higher risk of developing flat spots.
5. Time Spent in the NICU
Babies in the NICU often spend extended periods in one position for medical reasons, which can contribute to head shape changes.
What You Can Do to Help
The good news? There are plenty of ways you can support your baby’s head shape and overall development at home. Small changes in your daily routine can make a big difference.
1. Increase Tummy Time
Tummy time is one of the most effective ways to prevent and improve flat spots. Start with a few minutes at a time and build up as your baby gets stronger. For younger babies, try chest-to-chest tummy time or elevate them slightly to make it more comfortable.
2. Incorporate Side-Lying Play
Place your baby on their side during playtime to relieve pressure on the back of their head. You can use a rolled-up blanket behind them for support and engage them with toys or your voice to encourage interaction.
3. Limit Time in Containers
While baby swings, bouncers, and car seats are helpful tools, try to minimize the amount of time your baby spends in them. aim for only 15-20 minutes at a time and no more than 2 hours a day. Instead, focus on floor play or baby-wearing to allow for natural movement and head position changes. As a guideline, for every minute your baby is in a container, try to provide double that time in floor play.
4. Find the Root Cause
If you’ve noticed your baby prefers one side or has difficulty turning their head, address the underlying issue. Sometimes, this might mean working on neck stretches, repositioning strategies, or consulting with a professional to release tension.
When to Seek Help
While many mild cases of flat spots resolve with these simple interventions, some babies benefit from additional support. Early intervention is key, so don’t hesitate to reach out if:
• You Notice a Flat Spot: The earlier you address it, the easier it is to correct (and the more likely you are to avoid a helmet). If the flat spot doesn’t improve by 2 months old, it’s time to consult a professional.
• Flat Spots Are Paired with Movement Restrictions: For example, if your baby struggles to turn their head or has torticollis, addressing both the head shape and movement restriction is crucial.
• You’re Unsure or Concerned: If something doesn’t feel right, trust your instincts. A pediatric physical therapist can evaluate your baby and provide personalized guidance.
Why Early Intervention Matters
Research shows that the sooner you start addressing head shape concerns, the faster and better they can be resolved. Early intervention can even minimize the need for a helmet, which is typically recommended for more severe cases.
Working with a pediatric physical therapist ensures a whole-body approach—because flat spots are often connected to muscle imbalances or tension. By improving your baby’s strength, mobility, and alignment, you’ll not only support their head shape but also set the stage for other important milestones like rolling, sitting, and crawling.
As a parent, you’re doing an amazing job just by being proactive and seeking out information. Flat spots can feel overwhelming at first, but with the right tools and support, you’ll be able to help your baby thrive.
If you’re unsure where to start or want expert guidance, I’m here to help. Together, we’ll create a plan that works for your baby and your family—because every baby deserves to grow, develop, and move comfortably. Let’s get started!
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