Baby head shapes

Worried about your baby's head shape? Dr Yehudi Gordon has the answers

Extract taken from Mother and Baby Health: The A-Z of pregnancy, birth and beyond (Ebury)

Nature prepares your baby for the pressures of the birth by ensuring skull bones can easily slide over one another. As a consequence, the head may mould into an alarming shape. The moulding will smooth out within a few days, but two areas known as fontanelles remain soft for longer. They are a part of the skull structure, enabling it to expand as the brain enlarges. The average head circumference of a newborn is about 32cm (13in).

Each fontanelle consists of a sheet of tough fibrous material that bridges the gap between growing bones. This area is no more sensitive than any other area of the skull and is immensely strong. When your baby is quiet you may be able to see or feel his pulse here.

The posterior (back) fontanelle marks where the skull bones at the back of the head join. It cannot usually be felt beyond the fourth month, although being unable to feel the posterior frontanelle before this is not abnormal, nor is it uncommon. Very rarely, the posterior fontanelle may be closed, when the bones have fused too early, usually before the thrid month.

This is usually linked with an unusually shaped or small head. The larger fontanelle at the front of the head (the anterior - 'front' - fontanelle) remains obvious until it closes around 18 months. Early or late closure of the anterior fontanelle is not usually cause for concern.

The fontanelles do rise and fall with normal breathing, and this is of no concern. If they appear sunken, accompanied by a dry mouth and perhaps sunken eyes, this may be a sign of dehydration. If they appear to bulge it may indicate meningitis or hydrocephalus, when there is swelling within the brain. If your baby's fontanelles appear shrunken or swollen, visit your doctor.

Flattened head (Plagiocephaly)
If your baby's head appears flattened on one side behind the ear, this is most likely due to his sleeping postion as he habitually turns his head to one side. You could alter your baby's head postition from night to night to cure this. Otherwise it will right itself when your baby begins to sit. Typically, flattening improves at around four to eight months, and is usually gone by 2-2.5 years of age.

Recently a range of helmet has been offered (at a cost), with the claim that hey speed up what is a naturally occurring healing process, but their usefulness is highly questionable. The flattening is likely to disappear naturally, and you can help your baby by ensuring he has lots of playtime on his tummy and is carried in a sling by you or other adults. Some professionals suggest that flattening may arise when babies are left lying on their backs, or sitting in a car seat or rocker chair for excessive amounts of time. This is referred to as 'positional plagiocephaly'.

Rarely, a flattened hea may be a sign of Wry Neck, where there is tightness or tearing in one of the strap muscles. This can be treated with physiotherapy or osteopathy.