Plagiocephaly, otherwise known as “flat head syndrome” has become very common in young babies ever since we started putting babies to sleep on their backs. 

Thankfully, there are many steps you can take to prevent your little one from preventing a flat head.  In this week’s episode of the My Sleeping Baby Podcast, I spoke with Jennifer Barnard, Occupational Therapist and Founder of Baby Begin to discuss everything new parents need to know about plagiocephaly and flat head syndrome.  Have a listen!

Jennifer’s website-
Follow Baby Begin on Instagram-

Want to get your little one consistently sleeping 11-12 hours at night so you can be a functioning human?  Join my FREE training HERE:   

Eva: (00:04)
Hey there, you’re listening to the My Sleeping Baby podcast, which is all about baby and child sleep. I’m so excited to teach you how you can get your little ones sleeping so that you can sleep too and enjoy parenthood to its fullest. I’m Eva Klein, your resident’s sleep expert, mom of three, founder of the Sleep Bible online coaching program, and lover of all things sleep and motherhood. If you’re looking for tangible solutions for your little one sleep woes or you simply want to learn more, this podcast is for you. For more information, check out and you can follow me on Instagram and Facebook @mysleepingbaby.

Eva: (00:45)
All right, Jennifer. Thank you so much for coming on the, my sleeping baby podcast. I’m so happy to have you here.

Jennifer: (00:51)
Thank you for having me. It’s a question.

Eva: (00:54)
All right, amazing. So why don’t you tell everybody a little bit about yourself and, uh, what you do?

Jennifer: (00:59)
So, um, my name is Jennifer Barnard and I’m the founder of baby bien. And I found the baby in two eight mm-hmm about 14 years ago. And our primary purpose in life is to educate new parents about CEP or Flathead syndrome and try to help families avoid needing a helmet mm-hmm . So we like to get our babies young. We want parents to know about what causes flat head syndrome, how to prevent it, but then how to treat it without a helmet, if possible. So that’s our primary goal and we’ve treated about 9,000 babies so

Eva: (01:36)
Far. Amazing. Yeah. And so what’s your background? Like what is your clinical training that got you to this specialized niche?

Jennifer: (01:44)
Yeah, it’s very specialized. Um, so I’m a pediatric occupational therapist and I started in early intervention. So my focus was on birth the three year olds. And after doing that for many, many years, I went and worked for the helmet provider mm-hmm . So I spent eight years working for a very large helmet provider here in Dallas, and, um, got my training through them as far as with flat head syndrome, how to treat it, how to look it ahead, you know, what causes the flattening, all of that. After that I started, um, baby begin.

Eva: (02:18)
That’s amazing. And so, so how does, how do your services work? So you have a family that comes to you. They have a, a two month old baby who they’re seeing signs of their, you know, head flattening in, in one position, and then they reach out for preventative support.

Jennifer: (02:37)
Yes. So, um, we, we, we do a variety of things. We do courses. So we do online courses. We also, our main bread and butter is, um, in- therapy. So I have PTs and OTs that work with me. So we have, uh, clinicians in Dallas, Fort worth and Houston mm-hmm and then, and so we do private therapy in the, for those babies and those families, but then we also do virtual consultations for families all over the world. Right. We’re having families reach out to us from France and Germany and Cambodia and wow Australia that have babies with flood heads that need help because they can’t find the help that they need or the experts that they need to help them with the

Eva: (03:22)
Baby. Right.

Jennifer: (03:23)
Your example, a two month old is like our very favorite age to get started.

Eva: (03:28)
Yeah. Mm-hmm

Jennifer: (03:29)
so if you see that flattening at two months and you reach out, um, and get help, there’s so much you can do with those babies. Yeah. Uh, at two months old, so,

Eva: (03:39)
Right, right,

Jennifer: (03:40)
Right. Right. Is the better for sure. But we provide, we provide online and in

Eva: (03:46)
Amazing. So tell me what, what causes PGIs definitely. And what would you say are some of the main risk factors that contribute to that problem?

Jennifer: (03:57)
Sure. So, so flat head syndrome is caused really from back sleep. So since we started sleeping our babies on their backs, we’re getting, there was like a 300% increase in flat head syndrome. Right. And it’s very simple. It’s just, you know, you have a soft skull and the baby is sleeping on that soft skull for many, many years. If they’re working with you guys yeah. Many few hours a day. Right. And so the, if they’re in one position for a long time, that skull is gonna become shaping. Right. So that is the main risk factor is back sleeping, but there’s nothing we can do about that because we have to sleep our babies on their backs for safety.

Eva: (04:35)
Of course.

Jennifer: (04:36)
So that’s a risk factor. Another risk factor is because they’re on their back so much. They’re really not on their tummys very much mm-hmm . So we like to say back to sleep tummy, to play, but a lot of families are uncomfortable with tummy time. A lot of babies are uncomfortable with tummy time, so parents tend to not do it. Right. So we have lack of tummy time. Another thing is containers like our, uh, marketing to new parents for all of these gadgets, for new families, swings, bouncy seeds, DACA, tots, snooze, all of these things that contain a baby and restrict their movement can really do a number on their head shapes.

Eva: (05:17)
Right. Is that because they’re sitting in that, you know, bucket seat or, you know, container of some kind and they just, they get their comfortable position, whether it’s the head turn to the left or the head turn to the right. And, and then it becomes a downward spiral from there because then that part of the head softens making it that much more attempting to continue to keep their head on that side.

Jennifer: (05:39)
Exactly, exactly. Right. So it causes a restriction in neck mobility. Mm-hmm client container, or like the DACA top with cuz it’s so snug around the baby, it restricts their movement. Cause we don’t wanna restrict baby’s movement. Cause that’s what flattens the head. Right. Is that, is that increased pressure for long periods of time.

Eva: (06:00)

Jennifer: (06:00)
So containers are not your best friend, the first, you know, three or four months of life. Yeah. I would tell families if you can avoid using those up until four months, you’re out of the woods with the head shape. And so then you can start using them if you want mm-hmm although I would rather no one used them, but I know that’s not feasible.

Eva: (06:18)
Yeah, of course.

Jennifer: (06:20)
So, um, yeah. I mean, we have to use them at times, but you don’t want your baby sleeping in them. You don’t want ’em in them for long periods of time. Mm-hmm you want that baby to be on a flat surface as much as possible.

Eva: (06:30)
Right, right, right, right. Yeah. My, my son, my youngest had very clear flat head syndrome when he was two months. And um, and it was it’s funny because the, it wasn’t, it almost wasn’t surprising to me because he was such a great sleeper. You see, he was my first baby that I had as a sleep consultant. So my middle child was the one she’s now eight and a half, almost nine. She got me into this business cuz she was the one that was waking me every 90 minutes, all night long spoiler alert. She had a beautifully round head but was waking me every 90 minutes throughout the night. So then of course, when I knew what I was doing the third time around, because I’d been doing this for a number of years already, I had my son sleeping eight hour stretches in his Basse from the time that he was six weeks of age.

Eva: (07:21)
And even when he was younger than that, he was still giving me, you know, really large stretches for that age range. But then of course the side effect of him sleeping like a champ was that he developed a preference for sleeping, you know, on his back in the Bassett. But his head, you know, twit, I think it was this way. I think it was, it, it was that way if I recall. And um, and it’s funny because I saw it right away. I saw it emerge and we of course had our two month checkup. He needed his two month shots. And our pediatrician, I mean was, was my husband’s pediatrician. He’s very, very experienced and actually very well known for his diagnostic abilities. And so, um, my husband was like, Eva, when you go to Dr. G don’t mention anything about the head, like let him mention it because my husband in his mind was like, if you tell him then maybe it’ll make him think that he’ll it’ll make him go, oh, look at that.

Eva: (08:19)
And I’m going. I said to my husband, I was like, do you think, do you think I can fool Dr. G? Like, is that what you really honestly think like this is so my son’s head, it looked like a diagonal. Like that’s how apparent it was. But I said, okay, you know what? I’ll do it. My husband I’ll give my husband this one. So I go into the office and, and he says to me any concerns what’s going on? I was like, Nope, absolutely nothing, no concerns at all. And then he looks at him for literally two and a half seconds. Oh, he has plagiocephaly and I’m going really you don’t say, um, because it was so abundantly clear. Um, and so I’m curious, you know, cuz then I’ll, I’ll, I’ll tell you, I mean, spoiler alert, my son did not need a helmet. We were able to, uh, intervene and prevent that. But you know, you said that for the two month olds, which is, I suppose, when you be really begin to see that Flathead syndrome emerge, um, what are some of the interventions that you can do to prevent the need for a helmet later on?

Jennifer: (09:27)
They just definitely like with your son, he had a turn preference. Yes. And so if you notice that your baby has a turn preference, that means that they have a neck muscle imbalance. Mm-hmm the one side of the neck is tighter than the other and it causes the baby to always turn in, in the same direction. So some families I hear say, oh, he doesn’t have very good head control. So he just likes to turn that way. Mm-hmm a baby with no muscle restriction with no muscle restriction will turn their head equally to both sides. Even if they don’t have very good head control, if they’re nice and loose on both sides, they’re gonna equally go there. Okay. Yeah. So, so don’t, don’t fool yourself into thinking, oh, he just likes that side. Yeah. Um, if your baby clearly has a turn preference that needs to be addressed as soon as possible.

Jennifer: (10:16)
Yeah. And that does not go to YouTube and find baby neck stretches. It is find a pediatric therapist in your area to help you with that. Mm-hmm some pediatricians show the next stretches. Although I don’t know if they do a great job at it, um, because it’s just really not their specialty and they have 15 seconds to show it to you. Of course. Um, I really recommend the pediatric physical or occupational therapist to help you with those stretches. Sometimes you need one visit. They show you the stretches. You do ’em at home, you reposition the baby and then you’re able to, to correct it. Mm-hmm so that would be my first, if you’re noticing a term preference, you need to get that baby into therapy as soon as possible. Mm-hmm um, the other thing is when, when a doctor says just reposition the head, just turn the head the other way. That will be a lot easier when you get the neck loosen up

Eva: (11:08)

Jennifer: (11:09)
So if the neck is loose, then you can turn, what’s your son’s name?

Eva: (11:14)
Uh, his, uh, JJ,

Jennifer: (11:15)
JJ. So you can turn JJ to the left and he’ll stay there now because his head, I mean, because his neck is looser. Yes. So, so that’s one thing therapy. I would strongly recommend that in a two month old is the perfect candidate. So don’t feel like, oh, we’re gonna wait a couple months just to see how it plays out. Yeah, no, no, no. Do not wait.

Eva: (11:34)
No, no. Our pediatrician made it very, very clear to me cuz he doesn’t beat around the Bush. He said, he said flat out, he goes, if we don’t intervene, he will need a helmet by five months. Right. No question about it.

Jennifer: (11:48)
Yeah. Yeah. He’s just gonna stay on that side. So yes. He’s gonna need a helmet because you can imagine if he’s now laying on that side for three more months, how flat is gonna get yes. So you have to, um, so you have to intervene right away. So the other things that I would recommend is increasing your tummy time. If you have trouble with tummy time or if your baby doesn’t like it, then you need it with a professional to help you with that. The other thing is really look at your container usage. If is your baby spending a lot of time in containers? Mm-hmm and a lot of time I would say is more than two hours a day.

Eva: (12:24)
Yeah. So

Jennifer: (12:25)
That in includes your car seat. So if you’re taking a nice walk, which all you knew, mamas need to be taken a walk outside every day, get outside and get some fresh air, but that is included in your container time.

Eva: (12:37)
Right. Does, uh, does the bassinet attachment to a stroller? Like does that count as a container

Jennifer: (12:44)
That does not,

Eva: (12:44)
That’s not. Cause that’s technically

Jennifer: (12:46)
A safe, more like the car seat and also a carrier in front where you’re wearing the baby. Yeah. That is not considered a container

Eva: (12:56)
Ego. Right. Because the baby, because the baby is not lying. Is it the incline of these containers specifically that is problematic for flat heads?

Jennifer: (13:07)
It is. It is. But the DACA to is flat. Uh, but it’s also a risk factor too. Cause it’s very risk.

Eva: (13:14)
Oh, so the dog Todd is problematic because it makes it more challenging for the baby to move their head, you know, different directions.

Jennifer: (13:22)
Yes. Because if that baby, like if AJ was put in the, and he had a right turn reference, he’s probably gonna stay there majority of the time. Cause it’s so SN around the baby. Um, he’ll have a hard time getting past midline and over to

Eva: (13:37)
The left side. Right, right. It’s interesting because you know, when I, I mean he’s now three and a half, but when I, when I look back, um, we never used the, the DACA tots, um, at all here, here, in fact in Canada, it was, it was actually recalled. So it’s, it’s not even totally. Yeah. It’s not even available. You gotta go on the black market. If you wanna get, if you wanna get yourself a DACA tot here, um, he would nap sometimes in, you know, either a swing or, you know, a bouncy chair, but it actually happens to be that the majority of the time he would sleep in his bassinets. But he developed that he must have developed that turn preference very early on where that was his sleep position in, in the bassinet. And I remember my doctor asking the pediatrician, asking, does he always sleep, you know, with his head to the right or head to the left.

Eva: (14:28)
And, and I said, oh yeah, absolutely. That’s the only way, um, that he sleeps. So, you know, what are your thoughts? I know there’s a lot of products on the market. Like positioners, um, positioners for sleep positioners for, um, not even necessarily tummy time, but you know, um, like I know, uh, a friend of mine gave me this, this thing, it wasn’t meant what, what was it called? It was this mat for his head. It wasn’t meant to be for sleep, but when I would have him, um, on the play mat, um, it sort of, you know, allowed his, I guess I don’t, I, I can’t even remember exactly what it did, but it was supposed to, it was, it was one of these higher end products that was supposed to help encourage, you know, the head to move back and forth. Um, are any of those products or positioners encouraging them to move to the other side? Are any of those effective?

Jennifer: (15:22)
I can’t say I can’t speak for what you’re talking about, but I know like there’s flat head syndrome pillows where it says it takes the pressure off of the head, which is crazy. Of course there’s gonna be pressure on the head. Yeah. And those restrict movement a lot Uhhuh. Um, and so I wouldn’t be, um, like, um, I wouldn’t believe the sales part that if that there’s products that you can do really, you need your baby to turn their head on their own, to the other side and they need to be on the floor or on a flat surface to do that. Right. So you don’t have to spend a lot of extra money on products and gadgets. Again, we’re trying to find a product to help all of these things. Right. Right. When in reality you just need a couple sessions of therapy and to get your baby on the floor.

Eva: (16:10)

Jennifer: (16:10)
When I say on the floor on the back is fine. So a lot of people are thinking, oh, my baby has a flat head. There’s no way I’ll ever put them on the floor. Um, you need to put ’em on the floor so they can move and they can grow and they can kick and they can start rolling. And you know, there’s all these beautiful things that happen developmentally on the floor. Yes. So a lot of my moms I hear say, well, I just held him all the time to keep him off the back of his head. Yeah. Um, and that breaks my heart because that’s a lot of stress on a new parent to feel like you have to hold your baby all day long.

Eva: (16:42)

Jennifer: (16:42)
Um, please, please do not feel like you have to do that. If you are, at that point, you need to get professional help as far as with therapist an OT. Right.

Eva: (16:52)

Jennifer: (16:53)
Just because that being on the floor is not gonna worsen the head. It’s really when the baby is sleeping and so you need to be able to reposition your baby when they’re sleeping. Right. And the only way would be that is to loosen the neck.

Eva: (17:05)

Jennifer: (17:05)
So I would not, I would not say that you need any special products.

Eva: (17:09)
Mm-hmm okay. Right. And you’re saying that it’s, it’s, it sounds like it’s almost a little bit counterproductive to be holding the baby the entire time, because then it means that if you’re not, you know, putting him on his tummy or, you know, letting him learn how to roll around and move that he’s then not gonna be able to develop those neck muscles that he needs to be able to sleep in both positions.

Jennifer: (17:32)
Right. Well that, and also just general development. Right. Mm-hmm so if they’re not working their muscles, they’re gonna be this weak little thing that doesn’t, can’t pull up, um, but play with their feet and they’re not rolling on time. And then you have some delays with development because they’re never on the floor. And then it’s this snowball effect where now you’re really gonna need therapy.

Eva: (17:52)

Jennifer: (17:53)
It’s better just get it early, get ’em on the floor and babies know what to do. Yeah. They really, babies are these the most amazing things. And they’re so good when you just give them the freedom to explore.

Eva: (18:05)
It’s true. It’s true. And I’ll, and I’ll just share that anecdotally. Um, you know, I obviously took this very seriously because it’s not, I, and I, I just obviously wanna emphasize that, you know, if the child does need a helmet, I don’t think that that’s the worst thing in the world to happen. You know, however, however it’s inconvenient, you know, and nobody wants to have to go down that road if they don’t have to. And so, you know, I took my job very seriously at that point to really do everything that I possibly could to avoid needing that helmet at five months. And again, knowing that at two months, that is the best time to be able to intervene and avoid that problem. And it, it actually really didn’t take that long to change the course of things, because I ended up doing a lot of the things that you did, you know, lots of tummy time, lots of, you know, moving around, letting him move around, encouraging movement on his back, keeping him out of the, the, the stroller quite a bit, um, encouraging him, you know, positioning him like in the bassinet to move his neck, his head to the other side.

Eva: (19:16)
And then I, I remember I booked the follow up appointments with my pediatrician when he was three months. So this was four, four and a half weeks later, you know, not a long period of time in the grand scheme of things, because it’s almost like I wanted, I wanted the midterm report card. You know, I wanted to be able to say, I wanted to show my pediatrician, okay, this is where we’re at so far. How am I doing? And it was a five minute long appointment and he looked at my son’s head and he’s going, this is really great progress. He goes, keep doing this and you shouldn’t have to use a helmet. Um, so I wanna just share that anecdote because I think a lot of people, gosh, you know, you know what, maybe in the show notes, maybe I’ll figure out a way if I can find, and like post a picture of my son’s head when he was at two months, it was very, very apparent. This was not mild plagiocephaly or, you know, just a little bit of flat head syndrome. This was, it was very, very obvious that his head was misshaped and in a four to a four and a half week period, I was able to completely change the shape of his head, which is crazy. It’s that’s when you think about that,

Jennifer: (20:28)
That’s because those skulls are so malleable.

Eva: (20:30)
Yeah. Right.

Jennifer: (20:31)
That’s why they get flat so quickly. And that’s why you can correct them so quickly if the baby is young,

Eva: (20:37)
Right, right. A hundred percent.

Jennifer: (20:39)
And two things I wanted to speak to that you mentioned was, first of all, taking pictures of your baby head shape is very good advice because you don’t really remember what’s going on. Like we’re not sleeping. Life is changing. Like there’s so much

Eva: (20:53)
Going. I mean, I was sleeping, but okay, fine. Yeah. I won’t, I won’t too my own board here,

Jennifer: (20:57)
Parents, both

Eva: (20:58)
. Yeah.

Jennifer: (21:00)
Uh, you know, take a picture from the top and once a week, take another picture and that will help you see the progress that you’re having. And the other thing is, even if your baby is not two months old, if you’re listening to this podcast and your baby is three months or four months, we have still gotten very good change with head shape. So it’s worth a try to, um, to try to change it on your own. So don’t feel like, oh, I’m, I’m not my baby’s not two months. So I can’t do anything. You absolutely can do things with the head shape. Right. And the other thing I wanted to say was if your baby does need a helmet, they are very well tolerated. You should not feel guilty about it. It’s an easy fix to a misshape in skull, and this is your baby’s head shape for the rest of their life.

Jennifer: (21:45)
Right? So if it’s something you need to do, absolutely go tomorrow and get it. If your baby is over five or six months, and you’re still concerned about the head shape, mm-hmm please don’t feel bad or feel guilty. Um, I deal with a lot of guilty parents. They feel very guilty about a head shape. Yeah. And I just wanna make sure that, that we’re, we are clear that there are ways to fix it without a helmet. And there are ways OB obviously you can fix it with a helmet, so just get it done. So you stop worrying about it and your baby has a pretty little

Eva: (22:14)
Head. Oh, absolutely. I totally agree. I mean, I’ll, I’ll tell you, you know, my son, my son was born in the beginning of September. And so this was, you know, beginning of November now, um, we, and I’ll tell you, you know, my, I went into this, you know, saying, okay, you know, what, if he needs a helmet, like worst case scenario, it’s not so bad. And in in fact, um, we’re Jewish and we celebrate this holiday called Purim. Um, which, you know, was we do lots of dressing up on that day. So it’s, it’s sort of like a, a Jewish Halloween, you know, is the best way to compare it to, I was literally, and that, and that holiday happens in March. So, you know, if my son had needed a helmet, he’d be in a helmet by March. And I was already thinking, okay, if JJ needs a helmet, maybe we’ll be like a football team because he’s gonna be in. So we’ll literally figure out like a costume theme around JJ J’s helmet. And like, he’ll be the quarterback. And my girls will be the cheerleaders and my husband and I can be the refs. Like that was where my mind was going. if we ended up meeting a helmet, uh, cause at the end of the day, yes, it’s not convenient, but it’s also not the end of the world either.

Jennifer: (23:20)
Oh, it isn’t. It is. And it’s over before you know it.

Eva: (23:24)

Jennifer: (23:25)
All of this, just like, like my daughter’s 18 and I’m already saying it’s over before, you know, it like it time goes by so quickly. Okay. So

Eva: (23:33)

Jennifer: (23:34)
If your therapy, if it’s, if it’s not quite enough, get a helmet, it’ll all be over

Eva: (23:38)
Soon. Yeah. Yeah. I agree. Amazing. So Jennifer, where can people find more of you? Um, if they, you know, wanna reach out, get your support, get some help where, where, how what’s the best way to reach you.

Jennifer: (23:51)
Yeah. So, so we have a lot going on on Instagram, so you can find us on Instagram, our website, if you wanna schedule an appointment with us, um, if you’re in Texas, we can do, you know, one of our therapists, if you’re outside Texas we have two really great parent educators that are helping new parents all over the world. So you can schedule that on our website. Um, so it’s everything is baby begin, baby And uh, we would love to help we’re our mission is to eradicate flat head syndrome but we got a lot of work to do

Eva: (24:21)
yeah. Yeah. Amazing. Amazing. Thank you so much, ed, for your, for your time. I appreciate it so much. And thank you everyone for listening. Hope you all have a great day.

Eva: (24:33)
Thank you so much for listening. If you enjoyed this episode, please subscribe, leave a review and share this episode with a friend who can benefit from it. I also love hearing from my listeners. So feel free to DM me on Instagram @mysleepingbaby, or send me an email at until next time have a wonderful restful nights.

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