Movies inevitably show a mother who gives birth and has a perfect, cute baby placed in her arms. But this is often not the case in real life (and that movie baby might actually be two or more months old!). Birth, while natural and wonderful, can be stressful for a baby's body and can leave a mark, especially on their fragile heads.
It's completely normal to feel concerned if your baby is born with a cone-shaped head. But Pathfinder Health is here to help!
This article will discuss what causes a baby to be born with a cone-shaped head and explain why or when it’s nothing to stress about.
In this article:
Should you worry?
We'll address the most pressing question first:
No! It is completely normal for a baby to be born with a cone-shaped head.
A baby's conehead appearance after birth usually resolves on its own. Often, the head will regain its round shape after the first few days, although it may take some babies a few weeks to lose the cone shape entirely.
Understanding your baby's skull
So if a cone-shaped head is nothing to worry about, what causes it? To understand why this phenomenon occurs, it's helpful to understand how a baby's skull is special.
Structure of a baby's skull
Your baby's skull is very different from that of an adult, or even a toddler.
A newborn's skull is more flexible, to make it easier for their large head to squeeze through the tight birth canal during a vaginal birth. This flexibility also accommodates the rapid brain growth that occurs during infancy.
In an infant, the bony plates that make up the skull have not yet fused together.
Instead, in between a baby's skull bones are gaps called cranial sutures. The areas where the cranial sutures come together are called fontanelles, or "soft spots." These spots allow the skull plates to shift—and even overlap sometimes—during birth.
The 2 large soft spots are:
the anterior fontanelles
the posterior fontanelles
You can feel the anterior fontanelle when you touch the top of your baby's head. Because these fontanelles are not solid bone, you should always be extra gentle with a baby's head!
How birth impacts a newborn's head shape
The average baby's skull is wider than the mother's cervix.
So when a baby is born in a head first position, the birth canal exerts a great deal of pressure on their skull and can mold the head into an oblong shape, or even a cone. This is referred to as newborn head molding.
Babies who are born in a breech position, where the baby's head faces up and their bottom or feet come out first, generally do not experience this head molding because their heads spend less time in the birth canal. They may be born with almost perfectly round heads.
Likewise, c-section babies generally have round heads because they do not experience the tight squeeze through the birth canal at all, unless they drop into the mother’s pelvis early or are born by emergency c-section after the mother has already labored.
Prevalence of cone-shaped heads
It is completely normal for a baby to be born with an uneven head shape—even a conehead!—as a result of the birth process.
In fact, approximately 1/3 of babies born vaginally will temporarily have a cone-shaped head.
A cone-shaped head is particularly likely to occur if a baby drops into the mother's pelvis early or if the mother has a narrow birth canal or a long labor, which keeps the baby in the birth canal for a longer time.
What to do for a conehead baby
Most cone heads resolve without intervention
The good news: You probably won't need to do anything at all! Most instances of a cone-shaped head will resolve on their own within days or weeks after birth.
Vary your baby's head position
You should make an effort to vary your baby's head position to prevent a flat spot from developing and give it the best opportunity to regain its round shape. Some strategies to try include:
1. Change your baby's sleep position. Your baby should always sleep on their back, but you can alternate the direction that they lie in the crib.
For example, if your baby always turns their face towards the window, place them with their head at the "foot" of their crib so they have to turn the other way to face the window. Alternate ends of the crib each night.
You can also hang a mobile over the crib to encourage your baby to move their head.
2. Alternate sides for feeding. If you bottle feed, try alternating the arm you use to hold your baby for each feeding so that their head is not always facing the same direction while they eat.
If you breastfeed, you are probably already alternating sides during a feeding.
3. Hold your baby frequently. Hold your baby upright in your arms or a carrier as much as possible to reduce the pressure on the back of their head.
4. Maximize tummy time. Place your baby on their tummy to play as often as possible when they are awake. Be sure to use a firm surface for tummy time and supervise your baby closely.
Helmet therapy
A molding helmet (also called a cranial helmet or cranial orthosis) is occasionally used to correct severe flat spots on babies' heads by relieving pressure on the flat side.
Molding helmets are almost never needed to correct a head that is cone-shaped as a result of the birth process.
Relax!
It's extremely common for a newborn's head to have a cone shape. You should feel reassured that it will go away soon on its own. Try not to let worry about your baby's head affect your enjoyment of your first few precious days and weeks with your little one!
When to consult your doctor
Although a cone-shaped head is almost always a natural and harmless result of a vaginal birth, you should always feel free to discuss concerns about your baby's head shape with your doctor. They can provide reassurance and guidance on head positioning.
You should contact your doctor if you notice any bulging or swollen areas on your baby's head, if their head becomes more misshapen (instead of becoming rounder), or if their head isn't growing.
These could be signs of an issue with their skull that might require treatment.
You should seek immediate medical attention if you notice that your child has a sunken fontanelle—this can be a sign of dehydration which is dangerous for infants.
Other causes of an abnormal head shape
1. Caput succedaneum
Caput succedaneum is another potential side effect of birth on a baby's head. It refers to swelling, puffiness, and possible bruising of a baby's scalp as a result of vaginal birth.
Caput succedaneum is most often caused by pressure from the uterus or vaginal wall during a head-first delivery, especially a long or hard delivery.
Just like a cone-shaped head, caput succedaneum goes away on its own, usually within a few days after birth.
2. Birth-assisting tools
Use of forceps or a vacuum during birth can also impact a baby’s head shape. Forceps can cause a slightly pinched appearance on the sides of the head. A vacuum can cause a lump on the top of a baby’s head.
Most instances of head molding caused by forceps or a vacuum will resolve themselves with time or changes to a baby’s position. However, you should always consult with your doctor if you have any concerns.
3. Flat head syndrome
Flat head syndrome (also known as positional plagiocephaly or brachycephaly) is an asymmetrical head shape or flattened spot on the back or side of a baby's head that usually develops after birth.
Flat spots most commonly occur when babies lie with their heads in the same position for a long time, putting constant pressure on the back or side of their skull.
Because babies' bones are more flexible, too much pressure on one area can create a flat spot. This can occur as a result of a condition called congenital muscular torticollis, in which a baby has tight neck muscles and limited neck mobility.
Flat head syndrome can go away on its own, although changes in how caregivers position a baby's head will help improve head shaping. Physical therapy might be necessary if the flat spot is the result of an underlying muscular issue. In rarer cases, a cranial helmet may be required to relieve pressure on the flat side of a baby's head.
4. Rarer head shape conditions
There are numerous other conditions that can cause an abnormality in head shape or size.
Some of these—such as craniosynostosis, macrocephaly (abnormally large head size), and microcephaly (abnormally small head size)—are rare but serious. They are not the result of the birth process or anything that occurs after birth.
Frequently Asked Questions
Q: Should I worry about my baby's cone-shaped head?
No. Approximately 1/3 of babies born vaginally will temporarily have a cone-shaped head. This will generally resolve itself within days or weeks after birth.
Q: Will an uneven head shape lead to developmental delays?
A cone head or flat spot is generally considered a cosmetic issue. It does not cause brain damage.
However, if a flat spot interferes with normal head and neck movement—for instance, if it is caused by torticollis—it can sometimes impact a baby's motor development and make it harder to turn their head both ways, learn to roll, or learn to sit up.
Additionally, an abnormal head shape may cause social difficulties when a child is older.
For these reasons, you should consult with your healthcare provider as soon as possible if your baby has an uneven head shape so that they can begin any treatment and have the best possible result.
Q: Will a cone-shaped head lead to flat head syndrome?
It shouldn't. A cone-shaped head usually resolves quickly after a baby's birth and should not affect the position in which they hold their head. However, you should always make an effort to vary your baby's head position to prevent flat head syndrome.
Q: Does my baby need a cranial helmet?
If you are concerned about the shape of your baby's head, you should consult with your healthcare provider. They will evaluate your baby's skull and recommend any treatment they might need.
The Takeaway
It's common for babies to be born with an irregular head shape and this doesn't mean that anything is wrong with them. A baby's cone-shaped head nearly always corrects itself soon after birth.
There are also many steps you can take to help your baby's head regain its rounder shape and keep it from developing any flat spots. If you need more reassurance, reach out to a medical professional who will be able to help you further understand how best to get that precious head back into form!
Sources:
Lipsett BJ, Reddy V, Steanson K. Anatomy, Head and Neck: Fontanelles. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542197/
