By Camilla Ejsing, Child Occupational Therapist with +5 years of experience in young children's sensorimotor development.
April 2021/ @boerneergoen
Flat or crooked back of head? The primary cause of a crooked or flat back of the head is restricted or reduced movement around the neck. There can be various reasons for this.
Since the recommendation is that children sleep lying on their backs on a firm surface, there has been an increase in flat backs of heads, simply because babies spend many hours of the day lying on their backs, where there is therefore a strain on the back part of it soft skulls that babies have. However, it is still the recommendation, as it is known that it has the important purpose of preventing cot death.
Your baby is also welcome to nap on its side, in a carrier or lying on your stomach, but here is the recommendation that this is done under your supervision. This can help prevent/relieve a flat back of the head.
When babies sleep in a swing cradle, it is a good idea to put a bracing mattress in. It gives the child's neck more opportunities to move, as it gives a little more space around the baby down in the cradle. I have written about how the movements in a sling cradle can help calm your baby's nervous system in a previous post.
Pay attention to whether your baby always turns his head to the same side when they sleep or when they lie down - also if they always turn their head at an angle so that one ear points down towards the shoulder when they lie down. It can be a sign that they may have a favorite side/torticollis/tensions, which means that there may be restricted range of motion around the neck, which reinforces a unilateral movement pattern. It may also be that your baby often lies with the whole body shaped like a C or a banana.
"Keep an eye out if the back of the baby's head starts to become crooked so that the ears, when you look from above, do not sit straight against each other, if there is a bald flat spot on one side of the back of the head and the like, these are also signals that your child may have a problem with the movement of the neck."
Here I would recommend that you contact your health nurse to find out if she might be able to refer you to a child therapist in your municipality's PPR. If you contact a practitioner yourself, you must find one with experience and further training in babies with crooked or flat back heads. Here it is my professional opinion that a purely manual treatment is not preferable, i.e. a form of treatment where your baby is only touched and you are then sent home, without further notice than a new time for the next treatment, which should also include exercises and points of attention for how you can best remedy and handle the baby's problems in everyday life. For example, that you remember to turn the baby's head towards the non-preferred side when they are in a carrier, that you place the baby's play mat so that they will automatically orient themselves towards the non-preferred side, that you are aware that you do not always only carry your baby on your right arm, as well as how you can best position the baby when they are on the floor, etc.
Moreover, you should not let your baby lie on or sleep with one of the small baby head pillows with a hole in it. This further restricts the neck's movements and can therefore, in the worst case, help to reinforce the problem.
