Recent articles published by the American Academy of Pediatrics and the Food and Drug Administration (FDA) warn parents about the risks of using infant head-shaping pillows, stating that they can cause suffocation. 

Infant head flattening has been on the rise since the introduction of the Back to Sleep campaign in the mid-1990s which recommended infants sleep on their backs to reduce the risk of SIDS.  With one study suggesting up to 46% of infants will have some degree of head flattening. With flattening on the rise, parents have turned to the internet for solutions, often finding pillows claiming to either prevent flattening or improve head shape. A quick Amazon search will find you over ten pages of pillows marketed to concerned parents looking to round out their baby’s head. What these listings don’t mention is that head-shaping pillows are not FDA-approved and are not safe for sleep.

So, we asked Tinyhood expert, Board Certified Pediatric Physical Therapist, Brita DeStefano, for her take on the new guidelines and the risk that head-shaping pillows pose. Plus, how parents can help prevent flattening, and keep their little ones safe. See her answer below: 

As a professional, who specializes in treating head flattening, what is your take on these pillows? 

As a pediatric physical therapist who specializes in treating head flattening (also known as positional plagiocephaly), I caution parents to steer clear of these pillows for the above safety concerns and due to their ineffectiveness in treating or preventing plagiocephaly. 

In reality, head-shaping pillows can actually restrict a baby’s neck range of motion, often cause more deformation of the head, and potentially delay parents from seeking evaluation and treatment from a health care provider. 

How can parents prevent head flattening? 
Head flattening usually occurs within the first few months of life and in some cases can even begin in utero. Caregivers can decrease the likelihood of their child developing a flat head by prioritizing floor play over use of container devices such as bouncers, swings, or baby chairs. 

Other ways to potentially prevent flattening include varying the direction baby’s head faces when they sleep and integrating tummy time into their play routine from the very beginning. 

What should a parent do if they are concerned about their baby’s head shape? 
Many cases of head flattening are not preventable, however, so if a parent is concerned about their baby’s head shape, the best course of action is to bring it up with their pediatrician and seek out an evaluation from a physical therapist who specializes in treating infant head shape. 

Plagiocephaly is often associated with tightness in the child’s neck and body (called congenital muscular torticollis) and it is important that this condition is addressed as early as possible through physical therapy. Both positional plagiocephaly and torticollis have better treatment outcomes when physical therapy is initiated in the first month or two. The use of infant head-shaping pillows can contribute to parents waiting to seek treatment which in turn lengthens the duration of care required to improve their baby’s condition. 

How is head flattening treated? 
While they advise against the use of pillows, the FDA has approved devices to treat positional plagiocephaly called cranial remolding orthoses (or helmets). In cases of moderate to severe flattening, if conservative treatment has not been effective, some parents will decide to utilize a helmet. This consideration should be made between the child’s caregivers and healthcare providers as each situation is unique. 

If I purchased a head-shaping pillow, what should I do with it? 
If parents own an infant head shaping pillow, the FDA urges them to discontinue use and throw them away (do not donate or give them away). And remember, if you have concerns about your baby’s head shape reach out to your pediatrician or a pediatric physical therapist. 

To learn more about the dos and don’ts of sleep, according to our experts, check out this article. Plus, don’t forget to sign up for our free weekly newsletter to keep up with all the latest information new and expecting parents need to know.