Head Molding

If the infant sleeps on its back with the head turned one direction most of the time, then the back of the head will mold and the skull will become misshapen.  One night sleep the infant on their right side with a blanket rolled beneath the shoulder so the head is at an angle to the side.  Then the next night sleep the baby with the head and back flat on the bed.  Then the next night angled to the left and keep rotating each night.  Also, one night place the baby with head to the left in the crib, and then next time head toward the other direction.   The infant tends to look to the light, window or door that the parent comes through.  Or place interesting objects that the baby likes to look at to different sides on different nights.

The babies with severe head molding tend to be babies that have a sore neck. It frequently is caused by sore muscles that were stretched at delivery or positional in the uterus. Then the baby tends to keep it's head only to one side and not want to turn it to the other side because it stretches the sore muscles and hurts.  The muscles can tighten up and even get a knot it in called Torticolis.  Then the head really stays to one side and the back of the head can be severely deformed. Pressure on any bone will distort that bone architecture.  That is why babies are born with bowed legs from being wrapped up inside the wound.  As an aside, when we slept the babies years ago on their stomachs, they folded their legs underneath them. That caused the legs to become severely twisted and caused pigeon toed babies by 6 months. (A condition called tibial torsion.)   Then we had to put them in derotation bars between their feet at 1 year old.   I have not had to put one baby in the bar since we started sleeping the babies on their backs.   We fixed two conditions when we started sleeping them on their back: SIDS and Tibial Torsion.  But the side effect of back sleeping is that they can develop misshapen heads.  So it is either misshaped heads or legs.  At least on their backs there is a big decrease in SIDS.   Any way, back to the discussion.  Notice if the baby turns it's head both ways and let the doctor know at the 2 week checkup if they do not.  If the neck is stiff and the baby cries when the head is turned one way, it is a sign of the trouble.  When the infant does have the sore neck problem, the parent should exercise the neck several times a day.  Lay the infant flat on it's back and then hold the infants head with your hand.  Then turn the head both directions to touch it's chin to both of it's shoulders.  As if one is looking straight to one's left and right.  Then touch the ears to each shoulder.  The baby cries at first but in a few weeks they can turn it easily both directions.  Then stop exercising the neck and watch the baby to be sure it is turning it's head both directions.  This may sound kind of mean but important for the infant.  If you are not clear of this, talk to the doctor about showing you how to do the exercises in the office. 

 

If a minor molding of the head develops, put the infant on the other side 80% of the time to reform the head back toward normal shape.  If there is a minor difference at 2-4 months, then keep working on it.   IF there is a significant difference at 4 months or 6 months old, then we will refer the baby for a head band.

Dr. Knapp