Hand to Hold's Official Blog: Written by Parents for Parents

Why Do Preemies Have Flat Heads? (Part 2)

Back in February, Afton wrote a great post about premature babies having flat heads.  The official term for “flat head syndrome” is plagiocephaly.  Preemies usually have positional plagiocephaly due to lying in one position for a long period of time during their NICU stay.

If you notice that your child has a flat spot on their head, there are many different tips and tricks, including (as Afton suggested in February), rolling up a burp rag to create a “halo” for your child to rest their head on.

Our pediatrician allowed us to put Addie to sleep on her side once she was released from the hospital.  Every time we put her down for nap or bedtime, we alternated the side to keep things even.  (Speak with your health care provider before doing this with your own child—we fully support the “Back to Sleep” Campaign, especially since we lost a nephew to SIDS this year.)

Addie also spent a LOT of time on her tummy!

Despite all of our attempts, our little preemie did end up with a permanent flat spot.  I did a lot of research on plagiocephaly around the time of her first birthday, speaking with therapists, doctors, and other parents who had helmeted their children due to flat spots.

Our pediatrician told us that Addie’s flat spot is purely cosmetic.  He checked her out for torticollis (wryneck) and facial asymmetry, both excellent reasons to consider putting your preemie in a helmet.  Most insurance companies don’t cover helmeting and Addie was already over a year—most doctors recommend helmet therapy before a child reaches 12 months.

We decided not to put Addie in a helmet and hope that eventually her head would become a little more round.  One year later, the flat spot is definitely not as noticeable as it once was!

If I had known then what I know now, there are a few additional things I would have done differently when Addie was first released from the hospital.

I would have purchased a convertible car seat right from the get-go and NOT used the traditional “bucket” infant car seat.  It was very convenient, but I’m sure that the time Addie spent in her car seat while in the grocery store or at church contributed to her already flat spot.

Similarly, I would not have used the comfy papasan bouncy chair around the house.  I would have tried babywearing or put her on her tummy even more to keep her off the back of her head.

These are just a few suggestions—what else did you do to fight plagiocephaly once your preemie came home from the hospital?





  1. Samantha says:

    When Roxy was in the NICU, we had the same problem. Roxy laid with her head to one side so one side of her face was flat. It was her preference and as much as the nurses tried to keep her head the other way, she managed to turn it back. I asked at one point why her head was flat on one side and the nurse told me they referred to it as “toaster head.” Looking back now, it is funny, but at the time, I didn’t find the name very amusing.

    We are very fortunate that Roxy’s “toaster head” has gone away and she has a very full, round face now.

    Glad to know there is a name for this other than what was told to me 🙂

  2. When our little babe came home I was PARANOID about her ending up in a helmet or her getting torticollis , so I was pretty OCD about changing positions frequently and giving her tummy time. I would make sure when we put her down on the floor to play or in her crib to sleep we were taking turns with each side of her head. She is 8 months old without a flat spot!

  3. Great post Melissa! Your girl’s head looks just fine with her hair grown over it. 🙂 I definitely rotated my preemie every night after we brought her home and made sure she had tummy time and I held her a lot. My favorite thing in the world was to just hold her for hours. Now that I think about it, that probably helped with rounding out her head.

  4. When my son was in the NICU they moved him from side to side but never put him on his back, he had as you called it “toaster head”, I called it “alien head”. It was so bad he couldn’t lay flat because his head would fall to one side. We had to put rolled towels and balance his head in the middle. Took us a long time reshaping it but we did it without a helmet.

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