Pediatrician

By Dr. Denis Leduc

: I know that the best way to prevent SIDS (Sudden Infant Death Syndrome) is to put my baby on his back to sleep. But recently someone told me that babies who always sleep on their backs may end up having a flat head (or flat back of the head). Is this true? And how can I prevent it from happening? 

: You are absolutely correct that the best way to reduce the risk of SIDS (when a baby dies suddenly and unexpectedly for no clear reason) is to place your baby to sleep on his back. 

However, it’s also true that babies’ skulls are very soft and the bones can be affected by pressure. Because their neck muscles are weak, babies tend to turn their head to one side when placed on their back. If the baby always turns his head to the same side, the skull may flatten. This is known as “flat head.” The medical term for this is positional plagiocephaly. A little bit of flattening will go away on its own. More serious flattening might not improve completely, but it will not affect a baby’s brain or development.

A simple way to prevent your baby from getting a flat head is to change the position of the baby’s head each day. Because they like to have something interesting to look at, babies tend to turn their head so that they can see the room rather than the wall. This way they can also see you as you come and go.

Here’s how to change the position of your baby’s head while still giving him the same “view”:

• One day, place your baby with his head at the head of the crib. 

• The next day, place your baby with his head at the foot of the crib.

• Each day, alternate your baby’s position in the crib.

• Check to make sure that your baby is always looking out into the room.

• You might also put a mobile on one side of the crib to encourage your baby to look that way.

“Tummy time” is beneficial
Babies should also have supervised “tummy time” several times a day when they are awake. Not only will tummy time help prevent flat spots on your baby’s head, but it will help develop your baby’s neck and arm muscles. If your baby still develops flat spots, talk to your pediatrician or family physician.

Because parents often have worries about SIDS, here are guidelines caregivers should follow:

• The safest place for your baby to sleep is in a crib close to your bed. Use a firm, flat surface for sleep. Car seats and infant carriers should not replace the crib for your baby’s sleep. 

• Keep soft materials such as quilts, comforters, bumper pads, stuffed animals, pillows and other pillow-like items out of your baby’s sleep environment. 

• Be sure your baby’s crib meets Health Canada’s most current safety standards. For more details, visit the Health Canada website, www.hc-sc.gc.ca, or contact the nearest Consumer Product Safety Office, listed in the blue pages of your phone book. 

• Make sure your baby is not too warm. Use only a light blanket, or dress your baby in sleepers if the room is cool. 

• Keep your baby away from cigarette smoke. Babies whose mothers smoked during pregnancy and babies who are exposed to smoke after birth are at an increased risk of SIDS. 

• Breastfeed your baby. Research has demonstrated a decreased risk of SIDS in breastfed babies. 

Dr. Denis Leduc is a general pediatrician in the Montreal area. He is the Past-President of the 
Canadian Pediatric Society.  For more information on your child’s growth and development, visit the Canadian Pediatric Society’s website at www.caringforkids.cps.ca or www.soinsdenosenfants.cps.ca.