Why I Don't Recommend Baby Head Shaping Pillows

My kid has a flat head. What can I do about it?

This is a question I get asked all the time.  While a quick Google search will suggest head-shaping pillows, I'm here to tell you why I don't recommend baby head-shaping pillows. 

**Disclaimer: If you are being followed by a physical therapist or an occupational therapist and they have recommended you use these pillows intentionally as part of your therapy, this advice is not for you.

While I have never personally used or recommended head-shaping pillows in my practice, there are a handful of therapists who do use them. 

I am not here to tell you shouldn’t use them. What I am here to do is give you some information to think about if you have a baby or if you are considering a head-shaping pillow. 

Why Head-Shaping Pillows are Not Good for Newborns

Our babies come out of the womb with many different head shapes from the birthing process.

Over the first few months, their heads are so moldable, so we don’t want to restrict their movement.

Babies keep their heads round by having a lot of variety in their movement. We want our babies to spend time with their heads to the right, left, and in the middle.

Head-shaping pillows are designed to keep your baby's head in the middle. This will ultimately lead to a flat spot right in the middle on the back of your baby’s head.

Why Head-Shaping Pillows are Not Good for Sleep

Problem 1: Head-shaping pillows are not recommended by the AAP as being a component of safe sleep so they should not be in your baby’s crib to sleep.

Problem 2: Your baby should never have their head in one position to sleep. Whether it's in the middle, always to the right, or always to the left, sleeping in only one position is how they get a flat head.

If your baby naturally always likes to turn their head to the left and they have a little flat spot, putting their head dead straight in the middle with a head-shaping pillow will not reshape their head. Having the pressure right in the middle is not enough.

What you actually want to do is move their weight a little to the right side to help the reshaping and re-cranial molding.

This will be independent for each baby and the exact positioning you will need to help reshape your baby’s flat head is not going to be found with a head-shaping pillow.

You need to work with a therapist to help that cranial remolding and know the exact position to help shift the bones back.

Early Intervention is Key

If your baby has a flat spot many pediatricians will tell you to use a head-shaping pillow. However, that is not enough.

If you notice your baby has a preference for turning their head to one side or another and is getting a flat spot then that is your clue to talk to your pediatrician. Get a referral to see an OT or a PT who can give you simple exercises to do at home to get your baby's head round again.

If your baby is 4-5 months old and still has a flat spot do not wait. Make an appointment with a PT or OT that specializes in plagiocephaly or torticollis. The earlier you fix this, the faster it will go away.

While some babies will require a head-shaping helmet no matter what you do, you can typically avoid them if you can fix the problem early.  We want to avoid this intervention unnecessarily.

What to Do Instead

1. Don't use a head-shaping pillow

2. Alternate your baby's head position. Let them spend time to the right, to the left, in the middle, and on their tummy. You want as much variety as possible. This will help to keep their heads round.