The same “Back to Sleep” campaign that has dramatically decreased the rate of SIDS has also resulted in an increasing number of babies with flat skull areas, usually on one side of the back of the head. The benefits of sleeping on the back far outweigh the often-preventable short-term cosmetic issues.

The AAP has issued July 2003 recommendations for preventing these flat areas (plagiocephaly or positional skull deformities) while still sleeping on the back. The ideas are simple.

First, try to decrease the amount of time that babies spend on their backs or leaning on the backs of their heads when they are awake. Building the habit of “Tummy Time” is one great way to do this.

Second, try to alternate which side of the head is down when babies sleep. This may often be accomplished by changing which way a babies would look to see the door when they sleep.

If a change in skull shape occurs, this will usually improve on its own, or with minor treatment, once the baby is sitting on his own through much of the day and beyond the highest risk period for SIDS.