Newborn care | Caring for your baby’s head

Your new baby’s skull may not be perfectly round after birth. Here’s why, and how you should care for it. By Sister Philippa Hime

Caring for your newborn's head

Your newborn may have an odd-shaped head after birth – especially if you have given birth naturally. The heads of babies born via C-section tend to be round and, generally, less misshapen than those born vaginally. But what’s normal, and when should you be concerned?

What’s different about your baby’s skull?

In order for your baby to pass through the birth canal during delivery, the foetal skull is a little different to that of an adult’s. Like an adult’s, it’s made up of six bones, however, these aren’t fused together. Rather, they lie like a loose jigsaw puzzle over your baby’s brain, held together by spaces called cranial sutures. The skull bones are also malleable, so they can be manipulated to fit through your pelvis during delivery.
Your baby’s head and brain undergo rapid growth between birth and the toddler years, so the soft skull bones and spaces allow for this.

Moulding and delivery

The changing shape of your baby’s skull during vaginal delivery is known as moulding, and his head may appear cone-like and have ridges. It can take anything from a few hours to days to settle back into a round shape.

Swelling and bruising

As well as ridges on your baby’s head, there may be some swelling and even bruising, which is caused by your baby passing through your bony pelvis. It’s especially obvious if your baby’s delivery was assisted in any way – for example, with forceps or a vacuum. The bruising and swelling usually subsides within a few days after birth.

ALSO SEE: 9 assisted birth methods explained

Fontanelles

Your baby’s head will have a few soft spots – especially at the top and back of the head – where the skull bones have not yet fused together. These are known as fontanelles. The front, or anterior, fontanelle is the easiest to spot as it is usually wide and diamond-shaped. It will slowly get smaller as your baby’s head grows and the skull bones fuse and harden. This usually happens between 12 and 18 months and will be completely closed by the time your child is three.

Although it’s normal for a fontanelle to appear flat from time to time, a sunken or depressed fontanelle can indicate that your baby is dehydrated. Consider whether your baby has been unwell with vomiting or diarrhoea.
If a fontanelle is raised or bulging, it could indicate that there is pressure in your baby’s head.
Avoid putting pressure on your baby’s head – especially on the soft areas. Always support your baby’s head, as the neck muscles are still weak at birth. These start to strengthen at about six weeks, while head control will develop between four and six months.
If you are concerned about your baby’s fontanelles, visit your local clinic for advice.

ALSO SEE: Caring for your baby’s fontanelle/soft spot

Flat head syndrome

Your baby’s head shape beyond birth may also change.

Here’s why this can happen, how to prevent it and when to worry.

  • You have probably been told repeatedly to put your baby to sleep on his back. This is to lessen the chance of sudden infant death syndrome (SIDS), and many parents put their babies directly onto their backs as a result. Because babies spend the majority of time during the early days sleeping, this means there is constant pressure on the back of your baby’s head. As the bones in the skull are malleable, this sometimes results in the skull becoming flat at the back.
  • To prevent this from happening, turn your baby slightly when putting him down to sleep, using foam wedges to keep him in place. This will rotate the pressure and prevent a flat area from developing.
  • Another precaution is to ensure that when you put your baby down to play, he spends as much time as possible on his tummy. This is also important for the development of his upper body.

ALSO SEE: Tummy time – why it’s important for your baby and when to start

Craniosynostosis

This is a rare condition in which a baby is born with the bones of his skull already fused together. As a result, his head can become misshapen as he grows, and there’s not enough room for the brain to grow. Pressure may also be applied to the brain, resulting in damage.
A baby with craniosynostosis is monitored closely, and if it appears that the brain is being restricted, the fused bones will need to be surgically separated. In less severe cases, a helmet can be worn to reshape the skull.

Hair today, gone tomorrow

Your baby may be born with a full mop of hair, or without a single strand – which is normal. Your baby’s beautiful crown of locks may fall out shortly after birth or wear out in patches, especially on the back of the head, leaving your little one looking like a bald, old man. This is largely due to hormonal changes in your baby (as a new mom, you may notice that your hair also sheds after the birth). Don’t be surprised if your baby’s hair grows back a different colour.


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