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4 Months Old

Updated: Feb 26, 2021

What should I be doing with my baby at four months old if I think they have a flat head? At four months old your baby is becoming a tummy time master and has made huge improvements in head and neck control. Now you might be wondering why they have a flat spot and why it has not started to correct on its own. There are many factors involved with head shape and we are here to help!

Here are the top 4 things you can do to be on the right path for monitoring cranial development!

1) REPOSITION BABY OFF THE FLAT SIDE You can improve your baby's head shape by getting your baby on the floor and finding alternatives to containers. We suggest limiting the time your baby spends restricted to one position. For example, decrease the amount of daytime they spend in a carseat, swing, or bassinet. Instead, block off space on the floor so they can safely explore their environment and build upper body strength and mobility. It's also a good idea to get some baby wearing time in if your baby isn't yet loving tummy time.

To decrease your baby's preference towards one side, we recommend re-positioning throughout the day and being intentional with playtime. Instead of placing toys overhead, place on the less preferred side and work on shifting their attention to improve range of motion. This can be done when your baby is on their back or during tummy time. In addition, you can switch the side they lay on for sleep, diaper changes, dressing, and bathing. This can be done by rotating their crib, changing table, or simply placing your baby on the opposite side.

Does repositioning work? By 4 months of age it is more difficult to consistently position your baby a specific way (they are just too mobile now.) Keeping them up and off the flat spot can definitely keep it from getting worse! If your baby has just a little flattening, you may be able to give them enough time off of the flat side to see improvement.

See this resource from Children's Healthcare of Atlanta for tummy time ideas and more info!

2) TALK TO YOUR PEDIATRICIAN Bringing up your concerns early to your pediatrician can help you both be on the same page regarding your baby's head. The pediatrician can also help screen your baby and tell you if there are other developmental concerns contributing to the head flattening (like torticollis). If your little one needs a helmet later you may be more likely to get the helmet covered by insurance if your pediatrician has notes documenting your concerns.

3) GET MEASURED! If you notice any flattening, abnormal growth, ear shift, or facial asymmetry come see us for a free consultation and scan to rule out the need for a helmet or to plan further assessment. An early measurement will allow you to quantify your baby's progress so you can know for sure if your baby's head is getting better or worse. Many of our patients that don't get a helmet start by having their heads measured with our star scanner. We collaborate with health professionals in various fields to get you all the information you need regarding your baby and at this appointment can also provide insight on your baby's development.

4) START YOUR HELMET We typically helmet between 4-6 months of age (although we can and do helmet later if needed.) Helmeting at 4 months of age may be for your baby if you:

  • Already have tried repositioning for weeks

  • Have a baby with a moderate/severe head shape

  • Would rather get your helmet done sooner than later

  • Will need a helmet even with a little head shape improvement

  • Have a baby with a complex medical history, developmental delay, or torticollis

Call with questions! And remember that studies have shown over and over again that the sooner treatment is started the better the outcomes. Concerned what people with think? See our post on busting the helmet stigma!

More Questions?

Do you have more questions that you want answered by our staff of experts? Head on over to our Q&A brunch. That's right, we like to think of our mom forum as a friendly trendy cafe where you can connect with others about the helmet journey.


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