Newborn Head Measurement

One of the important checks performed by the pediatrician accompanying the obstetrician is measuring the newborn's head circumference. Some mothers may be surprised by this step, thinking the doctor is overdoing the tests, while others notice that their newborn’s head shape is uneven, with a flat spot on one side, and the ear on that side may appear pushed forward, which increases maternal concern.

It is essential for mothers to understand the importance of measuring the newborn’s head and monitoring any unusual signs for several reasons. Dr. Mohamed Rabee, a specialist in pediatrics and neonatology, highlights the reasons for regular head circumference measurements, the correct way to measure, and aspects of concern regarding the results:

Reasons to Monitor Your Newborn’s Head Circumference:

• Measuring the newborn's head is not just a number for the vaccination card. It provides important information about brain growth and development. A normal, gradual increase in head circumference indicates healthy brain growth without congenital problems.

• It helps detect conditions such as hydrocephalus (fluid accumulation in the brain) and can signal growth or genetic issues if the head is unusually small.

• Head measurements combined with weight and length at regular intervals give a complete picture of the child’s growth and help protect against diseases.

Steps for Mothers to Measure Head Circumference:

• Use a medical measuring tape around the largest part of the baby’s head, above the eyebrows and around the back of the skull.

• Record the measurement at each pediatric visit and share it with the doctor for comparison. Continue this until the child is two years old.

• Ensure the doctor plots the head circumference along with weight and length on a growth chart to monitor trends. Any significant deviation will prompt evaluation.

• Measure monthly for the first year, then every three months until age two. Afterward, measure as needed, especially if there are noticeable changes in head shape. The skull shape usually completes after age two.

Concerns Regarding Head Measurements:

• Rapid, excessive growth in head circumference.

• Lack of change or minimal growth between measurements.

• Significant differences compared to normal measurements for the child’s age, weight, and leg bone length.

Why Newborns’ Head Shapes Differ:

• Newborn skulls are soft and flexible to facilitate natural delivery.

• Skull shape can be influenced by late pregnancy positioning and the delivery process.

• Some asymmetry at birth is normal and usually corrects itself.

Causes of Head Shape Abnormalities:

• Premature birth.

• Male infants are slightly more prone to abnormal head shapes.

• Difficult labor, use of suction, or episiotomy.

• Lack of fetal repositioning in late pregnancy or congenital neck issues (e.g., congenital muscular torticollis).

Simple Tips to Adjust Newborn Head Shape:

• Alternate the baby’s head position while asleep or awake; this regular adjustment before four months can help achieve a normal shape.

• Change the arm used to carry the baby, and avoid prolonged sleeping on hard surfaces.

• Short supervised tummy time while awake can help reshape the head.

• Use special pillows or medical hats designed for flat head syndrome.

• In some cases, the doctor may recommend a specialized helmet and exercises under supervision for several months to correct the head shape.