Post NICU – Flat Head?

Plagiocephaly in other words, which is apparently commonly seen in premature babies.

In our very first session right before our discharge from the NICU, hospital physiotherapist checked D.'s head for possible complications which could be observed in preemies.

One of the things she checked was whether she had a flattening in her head due to sleeping positions in the incubator. In NICU, babies are placed in a different position every 4 hours so their muscles develop properly.

Neck pillow. I used for 2 minutes only. Did not like how her neck is positioned above her shoulders.

In NICU, we did observe that D. had a preferred side. She, very often, turned her head to the right during her sleep. Our physiotherapist said, "It does not have an impact on the head shape yet and as her neck muscles get stronger, preference should disappear." She also added "You need to watch out and make sure she turns her head to the other side as well." She gave us a few tips as well.

Then we got discharged and went on with our daily routine. We did not really put her into positions, we instead let her be. After a month, we realized she turned her head constantly to her right side. Considering they only eat, sleep, poo for a few months, it had taken a toll on her head. We could see a slight flattening on her right side.

Our physiotheraphy session was not due for a few months (first session was scheduled for 2 months corrected age – 5 months chronological age) so we mentioned the flattening situation during our visit with her pediatrician, who was her NICU doctor. (Her NICU doctor was our main point of contact for a year as he had all the history and details about her health)

He observed a little flattening. He checked whether she was able turn her head to both sides to make sure her left neck muscles were not stiff. D. was able to use her neck muscles, left and right. She was just more comfortable with her head leaning to the right side. Her doctor was not worried but he gave us two tips to avoid it from getting worse:

1- Sleeping on the back: It was very important that when she slept her head stayed in the middle. He suggested to place something to her right side of her head so her head stayed in the middle.

2- He said to practice lots of tummy time to strengthen her neck muscles. As her neck muscles become stronger equally for both sides, she might grow out of the habit of turning it to one side.

Initially, instead of applying the first tip doctor gave me, I went on and immediately purchased a baby pillow (head shaper). It looks very cute and comfortable in the pictures. However, I did not find it very useful for her. It is a pillow with a little bit height to it. I knew that her neck was supposed to be flat during sleeping. The head shaper on the other hand, made her neck a little bit higher than her body, which is not ideal for babies. I did not want to break one thing while fixing another. After one use, I got rid of it and just went with the doctor’s recommendation.

Over time, she grew out of the habit of turning her head to the right side only. When she was 9 months old chronologically, flattening on her right side of her head disappeared and her head shape was perfectly normal.

Having said that, if you have doubts about the head shape of your baby or if you observe repeated movements only to one side, before taking any action, it is best to check with your doctor. Doctors check things from a very different perspective, a perspective that we do not have😊