20/02/2025
The baby flat head pillow: A closer look at its efficacy and safety
In recent years, many parents have turned to baby flat head pillows to address or prevent flat spots on their babies' heads. Marketed as a solution to correct positional skull deformities , these pillows are designed with a hole in the center, supposedly allowing the baby's head to rest comfortably while relieving pressure on the skull. Promises of a rounder, more symmetrical head shape are often coupled with claims of preventing further flattening. However, a closer examination, especially from the perspective of pediatric physiotherapists, raises concerns about both the safety and effectiveness of these pillows.
Illustration of a baby with a flat head.
The safety concerns
Despite the promise of a solution for flat heads, there are important safety concerns associated with the use of these pillows. Most notably, the US Food and Drug Administration (FDA) has issued warnings about the use of pillows for infants, specifically noting the risks of suffocation and sudden infant death syndrome (SIDS). The FDA and the American Academy of Pediatrics (AAP) advise against the use of pillows in cribs or basinets for young babies, particularly those under the age of one, as they pose a significant safety hazard.
The AAP's guidelines emphasize that babies should sleep on a firm, flat surface without any soft bedding, including pillows, stuffed animals, or blankets. These soft materials can obstruct a baby's airway, leading to dangerous situations like suffocation or restricted breathing. Therefore, the use of a baby flat-head pillow during sleep, even if it's marketed for head-shape improvement, is not recommended by health professionals due to the safety risks it presents.
The physiotherapist's perspective: No benefit, and potential harm
As a pediatric physiotherapist, I've seen firsthand the development of motor skills in infants and the importance of allowing babies to move their heads freely. Movement is a key component in building strength and developing healthy motor patterns. When babies are awake, they should be encouraged to move their heads in various directions to avoid prolonged pressure on any one part of the skull. This movement not only helps to relieve pressure but also strengthens neck muscles and promotes the development of healthy movement patterns.
However, the design of the baby flathead pillow can hinder this natural process. The hole in the center of the pillow, while intended to reduce pressure on the flattened side of the skull, restricts the baby's ability to move their head freely. By being positioned on the pillow, the baby may not have the same opportunity to turn their head or shift their weight as they would when lying on a flat surface. This restriction can potentially slow down the recovery process for plagiocephaly and may even contribute to the development of brachycephaly, another type of head flattening where the entire back of the head becomes flattened, rather than just one side.
When babies spend time on a pillow with a hole in the center, they are less likely to shift their weight or engage their neck muscles in the same way they would on a flat surface. In essence, the pillow may encourage a more rigid head position, slowing down the natural recovery of positional plagiocephaly. Therefore, using the pillow as a corrective measure may be counterproductive.
Other types of pillows
In addition to the baby flat head pillow, other types of pillows are used to promote a more natural and symmetrical head shape. Among these are therapeutic or corrective head-shaping pillows, which feature more complex designs with multiple layers or adjustable features. These pillows are marketed as solutions for both plagiocephaly (flat head syndrome) and brachycephaly (wide, flattened skull), providing comprehensive support for babies with more severe flattening. While they are designed to reduce pressure on the head, the American Academy of Pediatrics (AAP) does not recommend these pillows during sleep due to safety concerns.
Another type of pillow is the side-lying pillow, which encourages babies to sleep in a position other than on their backs. By promoting side sleeping, these pillows reduce the risk of developing flat spots by varying the pressure on the baby's head. These pillows are placed around the baby to encourage side-lying or to alternate between sides while resting. However, they must only be used under close supervision to avoid suffocation risks or rolling into an unsafe position. Additionally, some babies may not tolerate the side-lying position, which can make this method less effective.
While these pillows may offer benefits, safety and proper supervision are crucial, especially when using them for sleep. Always consult a pediatrician before using any type of pillow for flat head syndrome treatment.
Conclusion
While the baby flat head pillow is marketed as a solution for correcting flat head syndrome, both safety concerns and professional experience suggest that it may not be the effective or safe choice that many parents hope for. The FDA's warnings and the AAP's guidelines caution against the use of pillows for young infants, particularly during sleep, due to the risks of suffocation. Moreover, from a physiotherapist's perspective, the pillow may limit the baby's natural ability to move and strengthen their neck muscles, potentially slowing down the recovery from plagiocephaly. Ultimately, parents should prioritize safe sleep practices and engage in activities like tummy time and letting the baby play on the side (under supervision) to promote healthy development. While the promise of a quick fix through a baby flat-head pillow can be appealing, there are safer and more effective alternatives available to support the baby's growth and well-being.
