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

Why do Preemies Have Flat Heads?

How many parents of NICU babies had to take a hospital burp rag and roll it up, tape the ends together, and place it under their baby’s head to keep their baby’s head from being too flat?  How many had to buy a helmet after leaving the NICU, to continue rounding out their preemie’s head?

It’s very common for babies who spend much time in the NICU to develop positional plagiocephaly or flat head syndrome.  This simply means that the baby’s head has a flat spot or is assymetrical because of outside pressure (see http://www.helium.com/items/1607973-plagiocephaly-and-craniosynostosis-flat-head-syndrome-in-infants).

Any parent who has been in the NICU with their baby knows how hard those cribs are.  They’re pretty solid!  Those tiny preemies get repositioned every 3 hours or so during their “cares”, but most of their time is spent lying motionless in their isolette or crib, with their head lying to one side or the other.  They’re way too tiny to have the strength to change positions on their own.  The older and healthier they get the more they can get off their heads during bottle-feeding or kangaroo care, or just to be held by parents or nurses.

I used the “rolled-up burp rag” method to help my preemie’s head round out, but I think it still took a few months at home when she was bigger and stronger before her head didn’t appear flat anymore.  Some parents have to buy helmets for their babies to wear to round out their heads at home.  Whatever it takes!  Also, some preemies who spend many months or even a year in the NICU due to extreme prematurity or sickness may have a flat head for years, or permanently.  Thankfully, hair growth can disguise the fact for some, but survival is the most important factor and having a flat head really doesn’t matter.

Interesting, eh?

Afton Mower About Afton Mower

After Mower (UT) lost her firstborn son at 21 weeks.  Her daughter was born a year and a half later at 27 weeks.  The NICU was overwhelming and isolating and it was through those two experiences she was led to found this social hub for parents to find the support they needed. Afton also gave birth to another daughter, born two days overdue after four months of strict bedrest. She believes it is a tender experience to hold a special baby in your arms when his spirit returns to his heavenly home, a miracle to watch tiny babies survive the risks of prematurity and a blessing to hold a healthy full-term baby after months of difficulty and sacrifices.


  1. I was worried about my little one because both sides of her face appeared flat while we were in the NICU. I finally asked a nurse and was told that they call it “toaster head” and that if that was the only thing I had to worry about, I should be happy.

    My little one has been at home for almost four months now and her face is completely round now, but I have noticed she has a flat spot in the back where she laid on it quite a bit.

    I wish I had known about the rolled-up burp rag. I would have been sure to use that technique.

  2. We used what’s called a Nestie Noggin in the NICU, pretty much the same concept of the towel. My son still has a flat side but that is because he prefers to sleep on that side of his head. I think that with time it will round out!

  3. Fed the nurses cheese cake to rotate his head more often… We have a perfectly round head!!

  4. rotate the head.

  5. its only flat in the beginning… then rounds on its own, but yeah stay on them nurses

  6. Having a wonderful primary nurse that rotated the head often.


  1. […] in February, Afton wrote a great post about premature babies having flat heads.  The official term for “flat head syndrome” is […]

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