Newborn Head Shape

Overview

Many newborn babies’ heads are slightly misshapen. Newborns’ skulls are soft and flexible because the skull bones haven’t yet grown together. The pressures of passing through the birth canal may cause your newborn’s head to look pointy or oval. 

Babies born by cesarean section tend to have rounder heads at birth, because they didn’t pass through the birth canal.

The soft spots between a newborn’s skull bones are called fontanelles. Your baby’s brain grows rapidly after birth. Eventually the fontanelles close, as your baby’s brain grows toward full size.

In the first months after birth, your baby’s head shape can be affected by lying in the same position for too long. This is called positional molding (plagiocephaly). One side of the head may flatten. Molding can begin before birth, depending on a baby’s position in the uterus.

Fortunately, young babies’ head shape problems are not dangerous and can almost always be corrected. You can help by:

  • Changing your baby’s position 
  • Encouraging neck movement
  • Placing your baby in “tummy time” each day

As babies get better at lifting and supporting their heads, their heads usually become rounded.

If your baby’s head shape doesn’t improve in a few months, you may need to see a specialist.

Causes

Babies should always be placed on their backs to sleep. This reduces the risk of sudden infant death syndrome (SIDS). This sleep position also increases the chance of your baby’s head developing a flat spot in back. Your baby’s safety is more important than a temporary flat spot.

Some babies develop flattened or misshapen heads because they have tight neck muscles (torticollis). These babies may not be strong enough to turn their heads from side to side. They typically lie on only one side.

Premature babies are more likely to develop positional molding. They usually lie on their backs during the weeks or months when they receive medical care.

Less commonly, abnormal head shape can be caused by: 

  • The skull bones growing together too early (craniosynostosis). 
  • Fluid or blood collecting in or beneath the baby’s scalp during delivery. This usually goes away on its own a few days after birth.
  • An unusually large head (macrocephaly) or small head (microcephaly) at birth. 

We may order tests to find out whether your baby has one of these conditions.

Diagnosis

Usually, we diagnose the cause of a baby’s abnormal head shape by:

  • Viewing and feeling the skull.
  • Asking about your baby’s regular sleep position. 
  • Measuring the baby’s head, in some cases.

If the cause isn’t clear, we may consult with a specialist in infant head growth.

Prevention

Use these suggestions to prevent and improve flat spots.

Keep your baby from lying on any firm surface for too long. This includes on a mattress, in a car seat, or on the floor.

Change your baby’s sleeping position. Babies should always be placed on their backs to sleep, for safety. Place your baby’s head at opposite ends of the crib on alternate nights. This encourages your baby to turn the head to each side when responding to your voice.

Carry your baby often, in your arms, a sling, or another carrier.

Place your baby in tummy time each day. Tummy time is important for:

  • Preventing flat spots by relieving pressure on the back of the head.
  • Strengthening your baby’s neck, tummy and back muscles.
  • Promoting skills like rolling over, sitting, and crawling.

Use these tummy-time tips:

  • Begin on the day your baby comes home from the hospital.
  • Choose times when your baby is awake and not hungry.
  • Place your baby on a towel or mat on a firm surface, such as a floor or crib. 
  • Get down to your baby’s eye level, offer a toy, and engage him or her in play.

Babies should always be placed on their backs to sleep to help prevent sudden infant death syndrome (SIDS).

Home Treatment

If your baby has a flat spot, use these tips (along with the Prevention tips) to encourage your baby to turn away from the flat side:

  • Alternate the arm you use to hold your baby each time you breastfeed or bottle feed. This places your baby’s head in different positions.
  • Place mobiles and other toys so your baby must turn to see them. 
  • Move your baby’s crib so that one side faces a window or another light source. Even very young babies will try to turn their heads toward a light.

If your baby sleeps in your room, set up the bassinet or crib so that your baby must turn to see you.

Avoid using:

  • Any kind of support or device that restricts your baby’s head movement. 
  • Wedges or sleep positioning pillows, which can be unsafe.

Other Treatment

If neck muscle tightness (torticollis) makes it difficult for your baby to turn the head in one direction, we may recommend physical therapy. You’ll learn exercises to do at home with your baby. These exercises:

  • Involve gently stretching your baby’s neck muscles.
  • Should be done exactly as your therapist shows you, to benefit your baby.

When to Call Us

Please call us to schedule an appointment if:

  • Your baby’s flat spot or abnormal head shape is significant.
  • You notice bulging on the side opposite the flattened area.

Most babies get better with home treatment. Please talk with us about any questions or concerns during your next well-baby visit (checkup).


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.