Chances are that at birth (and for a few weeks after), your beloved baby’s head won’t look like the charming cue ball you’d imagined. In fact, it may be downright pointy or mysteriously misshapen. Or it may sport a soft spot that pulses with every heartbeat. (All this and you’ll still think he’s adorable.)
Here’s a rundown on how your baby’s head shape may change in those first months of life.
What causes changes to a baby’s head shape?
Several different factors can affect your baby’s head shape, which may appear cone-shaped, asymmetrical or have a flat spot on one side:
Birth
At birth, a baby’s head has an average circumference of 13.8 inches and makes up about a quarter of the length of his body. (Imagine that ratio on a grown-up!) So how does a baby’s huge noggin make it through the birth canal? You can thank the fontanelles, or soft spots, on your newborn’s head.
Fontanelles are the membrane-covered gaps between several bony plates making up the skull. They helped your infant’s head to shift and mold so it could fit through the birth canal. And if you’ve had a vaginal delivery — especially one in which you had to push for a long time — that head may appear pointy or cone-shaped, thanks to the time spent squeezing through.
The fontanelles also give your baby’s brain room to grow (very!) rapidly during his first year. The largest soft spot is on top of your newborn’s head, called the anterior fontanelle, can measure up to 2 inches across. It’ll start to close when your baby is about 6 months old and close completely (forming a solid skull) by the time he reaches 18 months.
Positioning
Placing babies on their backs to sleep is one of the most effective ways to reduce the risk of sudden infant death syndrome (SIDS). The not-so-nice by-product of the “back to sleep” campaign: flat spots that appear on baby’s head if he always rests in the same position — a condition known as positional plagiocephaly, to get technical.
Read This Next
Spending lots of time lying flat in a car seat, stroller or rocker can similarly lead to a flat spot on part of the head. And babies who experienced extra cramped conditions in the womb (often twins or multiples) may be born with a flat spot on the head too.
Congenital torticollis
Sometimes an asymmetrical baby head shape (flattening on one side of the head) is due to congenital torticollis, a normally mild condition characterized by limited neck mobility. Tight conditions in the womb, like if your baby is in the breech position, can affect the way the neck muscles develop.
Babies with torticollis have a difficult time moving their head to one side. That means that baby’s head shape may become more asymmetrical over time if your baby usually sleeps or rests with his head facing his preferred side.
Should you worry about baby’s head shape?
In nearly all cases (and especially with treatment), your baby’s head shape will eventually become a non-issue. Here’s what you should keep an eye out for:
- Soft spots. Your baby’s soft spots are totally normal and much less fragile than they seem, since they’re covered by strong membranes that safeguard the brain. Two (rare) signs of trouble: A sunken fontanelle could signal dehydration, and a constantly bulging one could indicate pressure on the brain. In either case, contact your baby’s doctor. Also let your doctor know if your baby’s fontanelles haven’t started to shrink within one year.
- Conehead. You can expect your baby’s head to round out within a few days to weeks of birth. If you’re concerned, ask your doctor, who can rule out other potential (rare) causes and recommend treatment if necessary to help your baby’s head take a rounder shape.
- Flat spots. Almost all flattened areas are minor and disappear by the time a child is 2 years old, especially if you carefully follow your doctor’s recommendations.
- Congenital torticollis. Your pediatrician will likely diagnose your baby within the first few weeks and suggest special exercises and maybe physical therapy. In the rare case that your baby’s head shape is still severely asymmetrical after a year, a special muscle-release surgery may help.
Treatments for baby’s head shape
If your newborn’s head is misshapen from his journey down the birth canal, your doctor may very well take a wait-and-see approach, as a cone shape will likely go away on its own without any treatment within a couple of weeks.
Otherwise, the treatment for baby’s head shape depends on the cause. It may involve:
Tummy time
One of the best ways to prevent and treat a misshapen head is to make sure your baby gets plenty of supervised tummy time when he’s awake. Working your way up to 15 minutes (or more) of tummy time per day helps to strengthen your baby’s neck muscles, as well as develop motor skills that will one day help your baby learn to crawl.
Switching up baby’s sleep position
You should always place your baby to sleep on his back to help prevent SIDS. But it’s a good idea to vary his sleep position (laying him down with his head at alternate ends of the crib) — especially if he has a misshapen head for any reason. This ensures he doesn’t always rest in the same position, which helps keep one side of his head from flattening.
Holding your baby
When your baby is awake, try to keep him out of the bouncer, stroller, car seat or carrier as much as possible and carry him in your arms instead, to relieve pressure on his head.
Helmets or bands
If your child has a flat spot or cone-shaped head that doesn’t resolve on its own, your doctor may recommend that he wears a special medical helmet or band and refer you to someone properly trained to measure and fit one. These devices apply gentle pressure to redirect the skull’s growth.
Your doctor will likely recommend that your baby sport the helmet all day and night long, taking it off only for bathing. For most babies with flat spots, therapy ideally starts at around 5 or 6 months of age (and before 12 months) and usually lasts for about three months.
Stretching exercises and physical therapy
If your little one has an asymmetrical head shape due to congenital torticollis, your doctor may show you some stretching and strengthening exercises to help lengthen and loosen your baby’s neck muscles, and you may see a physical therapist for more guidance.
When does baby’s head shape become permanent?
Your baby’s largest fontanelle should close by around 18 months of age, and your child’s head will reach about 90 percent of its adult size by his second year! That means most abnormalities in a baby’s head shape should disappear by the time a child is 2 years old.
Between cradle cap and a cone-shaped head, you wouldn’t be the first parent to think your child looks a little alien when he’s first born. Rest assured, nearly all of these quirks resolve within the first days to weeks after birth — and certainly within the first year or two. Still, don’t hesitate to bring up any concerns with your baby’s doctor. Your pediatrician can ensure you’re taking all the steps to help ensure your baby’s noggin takes on the round shape you expect.
Yes 
No 
Trending On What to Expect
