'To use or Not to use the Pillow, that is the Question!'
Motherhood is a beautiful journey filled with countless experiences, advice, and recommendations. Cultures worldwide have unique beliefs surrounding newborn well-being and care, often passed down through generations. One common piece of advice new mothers receive is to use a pillow for their baby throughout infancy and beyond.
Dr. Madhavi Bharadwaj, a consultant pediatrician at LifeTree healthcare, shares in her reel that she has had patients who have given her some pillow talk on the benefits of using a pillow for newborns. Mostly asking her what type of pillow she'd use for an infant a 'rye pillow' or a 'cotton pillow?'
The market is overflowing with infant pillows, from tube-shaped head supports to dimple-bottomed cushions. They all claim to maintain a uniform, rounder shape of head in the newborn. But do the claims stand true? or is this another myth?
Dr. Madhavi debunks the common misconception that using a pillow is essential for ensuring a baby's head develops a proper and uniform shape. Flattening of head in infants is possible irrespective of the use of pillows, resulting in a condition called positional plagiocephaly (play-jee-oh-SEF-uh-lee).
Dr. Madhavi who also goes by the name 'baccho_ki_doctor', speaks about "the need of pillow for infants!"
She explains that, an adult needs a pillow to support the head by filling in the space between head, neck and shoulder while lying down on back or sideways for proper sleeping spinal alignment. However, this space is not developed yet in infanthood and thus use of pillow is not recommended.
She also speaks on 'Pillow or No Pillow' dilemma in new parents and emphasizes that children do not need pillow through the first year of our life, while some may argue that pillow is needed for maintaining proper roundness and shape of head. Although studies have shown that infants who slept on pillow throughout the first year of life also suffered form the flat head syndrome.
Ever noticed a baby with a slightly lopsided head? That might be flathead syndrome, also known as plagiocephaly. Plagiocephaly or Flat Head Syndrome is caused due to infants sleep position, lying on one one side most of the time.1 This causes a flat spot on the head and leads to unevenness in the shape of head.
Prolonged lying on back: Infants spend many hours sleeping through day and night and usually on their back during their first year, which can lead to pressure on the back of the head. This may lead to flattening of the back off the head.
Multiple births: Babies from multiple births may have plagiocephaly due to pressure from adjacent twin.
Tight neck muscles: Stiff neck muscles can hinder a baby's ability to move their head, and lead to one sided positioning of the head leading to flattening of the head.
'While plagiocephaly, or flathead syndrome, can be concerning for parents, it's important to understand that it typically doesn't affect a baby's brain development.' says the doctor. She also tells that the skull is still malleable during infancy, and the flatness is often cosmetic. One might notice unevenness of the face or head and rarely vision impairments may be seen.
However, in some cases, severe plagiocephaly can be associated with conditions that indicate brain development. These conditions include craniosynostosis, where the skull's bones fuse too early, and torticollis, a condition that causes neck stiffness.2
If you're concerned about your baby's head shape or suspect an underlying condition, it is better to consult a pediatrician. Early diagnosis and treatment can help address any potential issues and ensure your baby's optimal development and growth.
Flattened head syndrome usually is easy for parents to notice:
Back of the baby's head is flatter on one side when looked from above.
Baby may has less hair on the flattened part of the head due to friction.
When looking down at the baby's head, the ear on the flattened side may look pushed forward.
Physical examination:
The simplest way to check the severity of plagiocephaly is to use a diagonal caliper to measure the difference between the length on each side of the head. This is however done by a pediatrician to examine proper and uniform growth of head.
Dr. Madhavi says that plagiocephaly is usually nothing to be concerned about and is easily treatable in the early ages of life. However, it is always better to take precaution and prevent it by taking necessary measures.
Plagiocephaly can be prevented by:
Encouraging Tummy time: Encourage your baby to spend time lying on their tummy during awake hours. This helps strengthen neck muscles and prevent flatness. This will also help them gain strength for crawling. Tummy time may vary according to comfort of the child and can be gradually increased over time.
Changing the Position: Frequently change your baby's position in the crib to prevent prolonged pressure on one side. Avoid using a pillow or wedge to keep baby lying on one side. Place the baby in positions that will encourage them to turn their head to the other side.
Limit time in restrictive devices: Minimize the amount of time your baby spends in car seats, strollers, and swings, as these can restrict head movement. These tools also provide a flat surface against and leaving the kid in such restrictive devices for long hours can lead to flat head.
Treatment of Flat Head Syndrome include:
Physical therapy: For babies with tensed neck muscles, physical therapy can help improve range of motion and reduce head flatness.
Orthotic Helmets: In severe cases, a specially designed helmet may be recommended to reshape the head. This device provides space in the flat spot, to allow normal growth of the head on the side into normal rounder shape.3
However, the use of helmets should always be under the supervision of an expert to avoid complications.
Massage Therapy: Gentle massage using light touch to help release tension around the back and neck muscles of the child can help with the flattening of head.4 These massages should be carried out only under professional supervision.
In most cases, flathead syndrome doesn't require treatment. However, if it's severe or caused by an underlying condition, a helmet may be recommended. But in anyways a pillow is definitely not recommended for use in infants. It is however important to consult with your pediatrician if you're concerned about your baby's head shape. While flat head syndrome is often harmless, early diagnosis and treatment can address any underlying issues.
References:
1. Park, Hyun-Suk, Mo-Yeol Kang, Chi-Whan Choi, Jung-Wan Koo, and Yeon-Gyu Jeong. "The Relationship Between Postural Torticollis Abnormalities and Plagiocephaly on the Early Motor Development Milestones of Lying and Rolling Activities in Infants: A Retrospective Study." Developmental Neurorehabilitation 27, no. 5-6 (2024): 179-185.
2. Santiago, Gaia S., Chiara N. Santiago, Emily S. Chwa, and Chad A. Purnell. "Positional plagiocephaly and craniosynostosis." Pediatric Annals 52, no. 1 (2023): e10-e17.
3. Blanco-Diaz, Maria, Maria Marcos-Alvarez, Isabel Escobio-Prieto, Marta De la Fuente-Costa, Borja Perez-Dominguez, Elena Pinero-Pinto, and Alvaro Manuel Rodriguez-Rodriguez. "Effectiveness of Conservative Treatments in Positional Plagiocephaly in Infants: A Systematic Review." Children 10, no. 7 (2023): 1184.
4. Jung, Bok Ki, and In Sik Yun. "Diagnosis and treatment of positional plagiocephaly." Archives of craniofacial surgery 21, no. 2 (2020): 80.
