Will using a horseshoe-shaped pillow give my baby’s head a round shape?

Pillows are not recommended for babies under the age of one. Any kind of pillow, soft object and loose bedding can obstruct the infant airway and pose a suffocation risk. These have also been linked to SIDS (Sudden Infant Death Syndrome) also known as cot death.

Even for children over one, pillows are not necessary. Parents often think a pillow will provide their child with extra comfort, not realising that their child was doing fine without it.

Many believe that using a horseshoe-shaped pillow will help give your baby's head a round shape. However, there is no evidence to support this.

Be aware that these pillows may cause a baby's head might get locked in the same position for a longer period. This, in turn, may cause a flat spot at the back of your baby’s head.

Also, if your baby's head is firmly placed in the middle of a horseshoe-shaped pillow, it will be difficult for him to turn his head to the side in case he spits up milk or vomits. This can make your baby choke on his own vomit.

Traditional horseshoe-shaped pillows are filled with mustard seeds or rai. Modern versions are usually filled with sponge chips and thermocol balls. If the pillow tears, the seeds, sponge or thermocol can spill out and pose a choking hazard.

In addition to the above, using any kind of pillow can cause your baby to overheat, which increases the risk of SIDS.

It's natural to be concerned about how your baby looks, but try to keep in mind that many newborns have misshapen heads. Your baby might have a cone-shaped head if you have had a normal vaginal delivery. This is because newborns spend a considerable amount of time squeezing through the birth canal.

If you had a forceps-assisted birth, your baby’s head might be misshapen due to the forceps used to pull out your baby.

However, the shape of your baby's head tends to correct itself as he grows and it also becomes less noticeable as your baby grows hair.

In the meantime, here are a few things you can try, to avoid putting pressure on the flattened area of the head:

Tummy time
During waking hours, supervised tummy time is essential for the development of motor skills. Tummy time also helps prevent plagiocephaly by strengthening babies' neck muscles.

Stronger neck muscles enable babies to move their head around when they are lying down and be less likely to develop a preference for having their heads on a particular side.

To make sure your baby enjoys being on his tummy, take the opportunity to put him on his tummy when he's not asleep starting in the first few days of life. See our video on how to do tummy time with your baby!

Reduce the time your baby spends in one position
Avoid leaving your baby for extended periods of time in a cot, car seat, pram, infant seat, baby swing, baby carrier, or any other place where his head is likely to rest on the same spot.

In addition to tummy time alternate between putting your baby in a baby carrier and a flat surface so that there isn't constant pressure on a specific part of his head.

When your baby is awake, encourage him to lie on the rounder part of his head rather than the flatter part. A rolled-up towel placed around his head may help position his head, however, do so for just a short time and only if your baby is under constant supervision.

Don't use pillows, loose bedding, cushions or positioners in the crib to get your baby to keep his head to one side. These increase the risk of SIDS and suffocation.

Alternate sides whenever you feed your baby
You'll most likely do this automatically when you breastfeed but take extra care if you are bottle-feeding. Adjusting your baby's position during feeding helps avoid pressure on the flat spot.

For the same reason, it's a good idea to alternate sides when carrying your baby.

Move the position of the cot mobile or toys
Vary the direction he has to turn to look at his cot mobile or toys. He'll change the side of his head that's pressed against the mattress.

That said, if you're still keen on using a horseshoe-shaped pillow, always consider these precautions:

• Only use the pillow for short periods of time during the day, when your baby is awake and under your supervision. Always keep a constant eye on him. If your baby falls asleep on the pillow, carefully remove the pillow and lay your baby in his crib or cot.
• Always place your baby on his back on a firm mattress whenever he needs to sleep or take a nap.
• Remove all pillows, soft objects, cushions, bolsters or loose bedding from his crib or cot or the family bed when he sleeps.
• If your baby is sharing a bed with you, ensure you take all precautions for safe co-sleeping.
• Do not use any kind of pillow if you are putting your baby to sleep in a cradle (palna) or jhoola.
• Never feed your baby while he is lying on a horseshoe-shaped pillow. Always choose a safe breastfeeding position or use a specialised feeding pillow if you want to use one.
• Ensure other family members or anyone caring for your baby is aware of these precautions.
  

If you are worried, or if your baby’s head seems very flattened, see your doctor, who can offer you reassurance and advice.

Bear in mind, despite popular belief, there is no proof to suggest that applying pressure on your baby's head will make it round.

Make sure you always massage your baby's head gently.
 
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