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Tummy Time and Why So Many Babies Need Helmets

January 20, 2022

baby with plagiocephaly wearing helmet

On the playground or at daycare, you may have noticed more and more babies sporting helmets. These foam-filled helmets aren’t to protect babies from falls. Instead, they are helping babies with flat head syndrome or positional skull deformities grow rounder, well-shaped skulls.

How Babies Get Flat Head Syndrome [Positional Plagiocephaly]

Baby’s heads are made to grow fast — which means they must be flexible. And while their flexible skull protects their quick-growing brain, it is also vulnerable to pressure. If one part of your child’s head is under pressure often, it can start to flatten.

Flat head syndrome or positional plagiocephaly affects up to 40 percent of babies. There’s been a big increase in the number of babies with flat head syndrome since 1992 — but it’s for a good reason.

Starting in 1992, the American Academy of Pediatrics (AAP) began educating parents about reducing their child’s risk of sudden infant death syndrome (SIDS). The “Back to Sleep” campaign taught parents how important it is to place infants on their backs while sleeping.

Since this campaign started, the number of SIDS deaths each year has decreased 50%. Thousands of lives are saved every year by helping babies sleep safely. But it did have an unintended consequence. Suddenly, babies were lying on the back of their heads for 14 hours a day or more as they slept. Many babies began developing a flat spot on the back of their heads and needed a helmet to fix it.

Premature babies are more susceptible to flat head syndrome because their skulls are soft and they spend a lot of time on their backs during their stay in the NICU.

Margaret Grell, MD, Cleft and Craniofacial Program

But you can help your baby sleep safely and keep their beautiful round head with tummy time.

What is Tummy Time?

Tummy time is time your baby spends playing while lying on their stomach. It gives their head a break, reducing their risk for flat head syndrome.

The AAP recommends that even babies just a day or two old start tummy time at home. You can place your baby on their stomach for just 3 to 5 minutes a few times a day. It’s best to do it when they are alert, such as after a diaper change, and they should always be supervised by an adult. 

How to Help Your Baby Love Tummy Time

Some babies aren’t as happy on their tummies as others. But you can do a few things to get them interested in tummy time. You can try:

  • Placing age appropriate toys around your baby to hold their interest
  • Doing tummy time in different places so they have new things to look at
  • Giving your baby a massage while they are on their tummy
  • Lying down on your back with your baby tummy down on your chest
  • Lying down next to your baby while they are in tummy time
  • Placing a baby-safe mirror close to their face

As babies get older and stronger, they start to enjoy tummy time more and more.

Talk to Your Baby’s Pediatrician

Some babies will develop flat head syndrome even with plenty of tummy time. For instance, a baby with torticollis (tight neck muscles) often develops flat head syndrome because their neck muscles repeatedly pull their head into the same position.

If you are concerned your child’s head is an odd shape, you should talk to your pediatrician. Starting therapy early can help your baby avoid a helmet or wear a helmet for just a few weeks, instead of months.

At Joe DiMaggio Children’s Hospital, our experienced pediatric physical therapists can help your child complete exercises to improve their head shape. They can also fit your child with a helmet, if necessary, and teach you how to incorporate tummy time into your child’s day. Learn more about our physical therapy services.