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Twins, especially those who are born prematurely, are more likely to have a flat spot on their head.
This is called flat head syndrome, and it can happen for three reasons:
- Premature babies' skulls are softer when they're born;
- They may spend lots of time on their backs if they have a long medical stay in the neonatal intensive care unit (NICU); and
- They can be born with flat spots if there's continued pressure on their skull from their twin or their mother's pelvis while they're cramped in utero.
Our twins both had flat spots, thanks to all three points above.
They were born 6.5 weeks premature, so they had skulls that were softer than a full-term baby would have.
After they were born, they each had to spend time in the NICU for medical reasons (one spent two weeks there, the other spent four weeks there), and while they were there, they spent a lot of time lying in their incubator and cribs.
Before they were born, they shared cramped quarters and were stacked on top of each other much of the time. Baby A was specifically squashed, thanks to his position, and he was lodged etra-low in my pelvis for several weeks leading up to their delivery.
Because I was already taking tons of pictures of our brand-new babies, I was able to easiliy compare how the flat spots were faring as time went by.
According to Kids Health, flat head syndrome, also called positional plagiocephaly can be caused by spending too much time in one position, either while they're asleep or while they're lying on their back or side during the day.
As noted above, Kids Health also points out that many babies from multiple-birth pregnancies are born with heads that have flat spots resulting from cramped quarters in the womb or extra pressure from being pushed up against their mother's pelvis during pregnancy.
The most common cause of a flattened head, according to Kids Health, is a baby's sleep position, but, spoiler alert, when you have twins or higher-order multiples and there are two or more sets of feeds to do throughout the day, babies spend more time on their backs in strollers, swings, or bouncers, or on activity mats, leading to flat spots or cranial asymmetry.
...spoiler alert, when you have twins or higher-order multiples and there are two or more sets of feeds to do throughout the day, babies spend more time on their backs...leading to flat spots or cranial asymmetry.
Even if you feel like you're constantly holding your babies whenever they're not sleeping or being changed, it can still not be enough to prevent flat spots, and that's just the reality of being a parent who only has so many hands and can only do so much at once.
Tight neck muscles (torticollis) can make it hard for a baby to turn their head, which can also cause flat spots (and, in turn, makes torticollis worse).
While severe cases of flat spots might require cranial reshaping helmets, mild to moderate cases can usually be resolved without the need for helmets.
Here are three tummy time toys that can help improve flat spots on your babies' heads.
Three toys to encourage tummy time and improve flat spots
If you're still expecting your babies, you may want to add these toys to your baby registry. We had all three of these toys, and our twins loved each of them.
As parents, we loved them, too, because they were either big enough for our multiples or they were designed in a way that made them work for two babies to play with at the same time.
This meant no squabbles during tummy time, just giggles.
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1. High-Contrast Baby-Safe Mirror Sensory Toy by Tremhoo
Is That Me?
This is a baby-safe mirror toy that encourages your babies to engage their core muscles and investigate what's going on in the reflective surface. The high-contrast patterns are easy for your babies to see and the toy's design incorporates a crinkle book they can flip through, which stimulates and supports cognitive development and hand-eye coordination.
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2. Inflatable Water Activity Play Mat by Infinno
Big Enough for Tummy Time for Two
This is an inflatable water activity play mat that's actually big enough (26 by 20 inches) for both of your babies to play with at the same time. Designed for infants who are three months and older, this leak-proof tummy time mat promotes sensory development and encourages your babies to strengthen their neck, shoulder, and core muscles while they play. It's filled with bright, colorful sea animals that float in the water. As your babies try to grab them, they also work on developing their hand-eye coordination and fine motor skills. This durable mat is made of BPA-free, non-toxic, heavy PVC materials.
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3. The 4-in-1 Kickin' Tunes Music Activity Gym Play Mat by Baby Einstein
Babies' First Dueling Pianos
Rated for kids from newborn up to 36 months, this activity mat will introduce your little ones to music and set the stage for discovery. It can be used for laying down and comes with a prop pillow for the early days with your newborns. It's also great for sitting up and playing or encouraging tummy time to strengthen muscles. The included Magic Touch piano accessory encourages exercise and exploration through kicking, and seven detachable toys will spark their curiosity.
When to consult a doctor
If you notice persistent flat spots on your babies' heads or that they favor one side of their head regularly, bring up any concerns to their pediatrician and ask for their advice.
Mild to moderate cases may improve with increased tummy time, a change in sleeping position, or physical therapy if your baby has tight neck muscles, and without the need for cranial remolding helmets.
If your babies' doctor indicates that helmets are needed to reshape their skulls, this intervention works best when it's started between four and six months of age.
Cranial helmets are often worn for three to six months for 23 hours each day (the other hour is for cleaning and a short break). They provide gentle pressure to help improve severe flat spots that won't resolve on their own.
Round things out
While twins are at a higher risk of having flat spots (either being born with them or developing them during the early months after delivery), there are things you can do to try to help improve them if they're not too severe.
Changing the side their head faces every now and then during the time they're sleeping can help put less pressure on flat spots.
Piquing your infants' interest with exciting toys can help increase the amount of time they spend on their tummies, which, of course, decreases the amount of time they spend lying on their backs or sides.
If it's tight neck muscles from torticollis that's making it difficult for your duo to turn their heads from side to side, ask their doctor about physical therapy and the benefits it might bring.
And if you notice your little ones have flat spots and you aren't sure if they're mild or more severe, take pictures and contact your babies' pediatrician to get their guidance on the best course of action.
Did your twins have flat spots? Were they born with them or did they develop over time? Did they need cranial helmets or did they resolve with alternative techniques? Let us know in the Comments section below or connect with us on Instagram to share your thoughts!
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