• Dr Andy Raffles

My baby's head shape looks odd

Head shapes in baby are a frequent cause of anxiety, and rarely is there anything to worry about. Ventouse delivery is delivery with a suction cap applied to the scalp of the baby, so that a firm pull will deliver the head. The modern Ventouse has a soft rubber cup, and rarely causes any long-lasting damage. Usually the bruising and swelling of the scalp associated with this mode of delivery settles down over the first 3-7 days after birth. Any persisting head shape concerns at 6 to 12 months of age are very unlikely to be related to the Ventouse. Sometimes head shape problems in unborn babies lead to difficult deliveries, or deliveries more likely to require assistance with either forceps or Ventouse. The most common misshaping of the head is called plagiocephaly. In this condition the back of the head, or more usually one side or other, of the back of the head, is slightly flattened. As a result your baby will tend to lie on the flattened side and this leads to further flattening. The advice to keep babies on their backs whilst asleep for as long as you can, has also made this a very common cause for parental concern. However, as your baby develops in the first months, begins to roll over, then sit, this progressive flattening will stop, and the head will assume its normal shape. In addition hair growth will cover up the flattened portion of the scalp. In any case the condition gets progressively better from about 10 months onward, so there is no need to get too worried. There is no convincing evidence at all that any devices, now sold by a range of practitioners, and designed to improve head shape in this situation, do much to improve head shape other than the natural improvement expected over time. There is a very rare condition where the joints between the scull bones, called sutures, close too early. In this condition, called craniosynostosis, the premature closure of the sutures leads to progressive misshaping of the skull, which gets progressively worse from 10 months onward, or sometimes earlier. These rare conditions are relatively straight forward to diagnose, because of the progressive and significant head shape deformity, although treatment is complex and only available at specialist centres.

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