Many parents notice that their baby has started to develop a flattening on one part of the back of the head and they seek advice on the use of pillows to correct this. We’re often asked about pillows for babies to sleep on and we follow the advice of the Lullaby Trust which does not recommend the use of pillows in the cot as they can increase the risk of SIDS. If you were thinking of using a pillow with your baby due to concerns around plagiocephaly (‘flat head syndrome’), there are techniques you can use instead which will not increase the risk of SIDS. For example, we advise that babies have plenty of supervised tummy time in their waking hours to minimise time spent on their back. You should also avoid letting babies sleep in harder contained sleep environments such as car seats and other travel systems.
Also, under the age of 4-5 months, the use of a shaped pillow during the day when the baby is awake and with a parent or carer can be used. Plagiocephaly (‘flat head syndrome’). Things to be looking out for are a flattening on one side or right across the back of the head, the ear and brow on the flattened side being further forward than the other side or the back of the head being very high. If by the age of 4 to 5 months, you’re not seeing any significant improvement you may want to speak to your health professional or seek corrective treatment.
When addressing flat head syndrome (positional plagiocephaly), both specialised pillows and helmets may be considered, depending on the severity of the condition. Here’s a comparison to help you evaluate your options:
Flat Head Shape Pillow:
Pros:
Non-Invasive: Pillows are a gentler, non-invasive option that can help redistribute pressure on the baby's head.
Comfort: Babies find pillows comfortable under their head during the day. They should not be used in the cot.
Ease of Use: Pillows can be easily integrated into the baby's daily routine.
Cons:
Limited Correction: Pillows may only provide a slight improvement and are only really effective in mild cases of flat head syndrome.
Suffocation Risk: It's crucial to use pillows in a supervised environment and that are specifically designed for infants. Standard pillows pose safety risks. Never use a pillow in the cot for sleeping on.
Helmets (Cranial Orthoses):
Pros:
Effective for Moderate to Severe Cases: Helmets are designed to mould the head and can be very effective in significantly correcting head shape.
Targeted Pressure Relief: They provide structured support and can direct growth away from flat areas of the skull.
Cons:
Wearing a helmet can be difficult for some parents to accept for their baby. However, the treatment length is short and the benefits are lifelong.
There is a financial cost to helmet treatment and is not covered in the UK by insurance or the NHS.
Conclusion:
The choice between a flat head shape pillow and a helmet largely depends on the severity of the flat head shape, which can be determined by how visually different from the normal the head shape is. In mild cases, a shaped pillow combined with repositioning strategies (like tummy time) may suffice if started early. In more severe cases, helmets may be necessary for effective correction.
