Your Baby’s Head – Soft Spots and Flat Areas?
Most babies aren’t born with nice round-shaped heads. Rather than looking like the cartoon characters Boss Baby or Jack Jack, real babies have skulls with lumps, bumps, and soft spots. It can look a bit concerning if you don’t know what you are looking at!
A newborn’s skull is not a solid globe; instead, it has bony plates that move, overlap, and compress to allow them to pass through the birth canal. This flexibility also allows the brain to grow during infancy. Later, these plates will join together and form a solid skull. Until then, you may notice a few things on your baby’s skull:
A cone shape. During birth, a baby’s head often becomes molded to the shape of the birth canal. This cone shape goes away over the first several weeks of life.
Ridges and lumps. The molding from birth can also create ridges or raised areas on the skull where the bones overlap. These usually disappear quickly. You may still feel raised or uneven spots on older kids’ heads. These are usually normal and represent areas where the bones of the skull have joined together.
Soft spots. You may feel 1 or 2 soft areas (fontanelles) on your baby’s skull. There’s one in the front that’s easy to find and one in the back that’s a little harder to feel. These are spaces between the bones that also allow for brain growth. These areas aren’t covered with bone, but they’re still well protected. You don’t have to worry about hurting them! You may see them pulsing at times, and this is nothing to worry about; it just shows blood flowing with their heartbeat.
Swollen or bruised areas. Right after birth, there may be swollen or squishy areas where fluid or blood collected in or beneath the scalp during delivery. These go away on their own in the first few days or weeks of life.
Flat spots. Areas of flattening are caused by pressure placed on one part of the skull, which is called deformational or positional plagiocephaly. Some babies are born with flat spots as a result of how they were positioned inside the womb. Others develop flat spots later on caused by lying in one position too often or having asymmetrical neck muscles that cause them to turn in only one direction. These flat areas usually improve over time and don’t harm the brain.
You can help round out your baby’s head by taking a few simple steps:
Switch up the direction they face when sleeping. Babies should always sleep face up in a firm, bare crib. While this reduces the risk of Sudden Infant Death Syndrome (SIDS), it does tend to create flat spots. You can help prevent this by placing them in the crib with their head at a different end each night to encourage them to turn their head in a different direction to see what is in their room (mobiles, light, window.) Don’t use positioning devices that are sold to keep the head in a specific position. It’s safest for a baby to have nothing in their crib.
Pay attention to daytime habits. During the day, be sure your baby spends as little time as possible with pressure on the back of their head. Avoid long periods in a baby seat, swing, or car seat. Instead, carry them in a front carrier or sling. And most important, make sure they have lots of tummy time.
Alternate arms when holding and feeding. This encourages them to turn and look in a different direction with every feed. You can also alternate the direction you place them when you change their diaper.
If you notice any flat areas on your baby’s head, please start by talking with their pediatrician to rule out more serious problems. If your baby’s head has a flat spot because of a tight neck muscle (torticollis), you may be referred to work with a physical therapist.
Less commonly, a baby’s head shape may require medical care to correct. If a flat area doesn’t improve over time and the above steps, some babies may need to wear a helmet to help mold the head. Rarely, babies can have a head that’s too large or too small head (macrocephaly or microcephaly.) Craniosynostosis is another rare condition which causes the bones to grow together too early. Your pediatrician will diagnose these conditions after an examination and suggest appropriate care.
Usually, when a baby becomes more mobile, turns and holds up their head, rolls over, and starts to crawl, the flat spots will round out on their own. Then your baby will look more like the cartoon ideals of round-headed babies – but hopefully, behave much better!
Resources for Parents
American Academy of Pediatrics
When a Baby’s Head is Misshapen: Positional Skull Deformities
My Doctor Online
About the Author
Disclaimer: If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.