Pointed Head in Babies: How Does It Improve and When Does It Matter?

Why do some babies have a pointed head?

A newborn’s skull is made of separate bony plates with flexible sutures and soft spots between them. During a vaginal birth, these plates shift and overlap so the head can pass through the birth canal. As a result, the head may look long, cone-shaped or pointed at the top. This is called birth moulding. It can be more noticeable after a long labour, a first birth or an assisted delivery, and is usually less common after a caesarean birth.

How does a pointed head improve?

Moulding needs no treatment; the bones settle back into place and the head becomes rounder, usually within days and sometimes over a few weeks. Meanwhile:

• Place your baby on the back on a firm, flat surface for every sleep.
• Alternate the direction the head faces between sleeps.
• Offer short periods of supervised tummy time while awake.
• Leave the head alone: do not press, squeeze or bind it.
• Let your pediatrician examine the head at newborn check-ups.

Does massaging or binding the head help?

No. There is no evidence that massaging, pressing or tightly wrapping a baby’s head improves its shape. The skull and soft spots are delicate, so these practices may irritate the skin, upset the baby and delay recognition of a real problem. Pillows and positioners are also not recommended for sleep.

What is the swelling on my newborn’s head?

• Caput succedaneum: Soft swelling of the scalp that can cross suture lines and usually fades within days.
• Cephalohematoma: Blood collected between a skull bone and its covering membrane; it stays within one bone and may take weeks or a few months to resolve.
• Vacuum-related swelling: A round swelling where a vacuum cup was used, usually settling quickly.

These are followed by your pediatrician. Seek advice if a swelling grows or hardens, your baby is unsettled or feeding poorly, or jaundice increases.

When does a pointed head matter?

• Scaphocephaly: Early fusion of the sagittal suture gives a long, narrow, boat-like head, sometimes with a ridge along the top. See sagittal suture synostosis.
• Other forms of craniosynostosis: Can cause a triangular forehead or one-sided flattening. See craniosynostosis.
• Dolichocephaly: A long, narrow head in premature babies who lay on their side in neonatal care; the sutures are open. See dolichocephaly.
• Flat back of the head: Brachycephaly can make the head look short, wide and tall at the top. See deformational brachycephaly.

How is scaphocephaly different from birth moulding?

Moulding is most obvious at birth and fades over days to weeks. In scaphocephaly the long, narrow shape persists and may become more noticeable with growth, and a ridge may be felt along the top of the head. Parents cannot tell them apart at home: a doctor examines the baby, may request imaging and refers to a neurosurgical team if craniosynostosis is suspected. A helmet does not replace surgery; it may be used after some surgical techniques as part of the team’s plan. Read more in when does a baby’s head shape settle.

When should you see a specialist?

• The pointed or long shape lasts more than a few weeks
• The head looks increasingly long, narrow or pointed
• A hard ridge is felt along the top of the head or the forehead
• The forehead looks triangular or one side looks flattened
• A birth swelling grows or hardens

You can book an appointment for assessment of positional head shape differences; babies with suspected craniosynostosis are referred to the appropriate doctor.

Frequently asked questions

Is it normal for a newborn’s head to be pointed?

Yes. Moulding after a vaginal birth is common and usually resolves within days to a few weeks.

Should I massage my baby’s pointed head?

No. There is no evidence it helps and it may cause harm. Shapes that do not resolve should be assessed by a doctor.

Can babies born by caesarean have a pointed head?

Moulding is usually less common after a caesarean. If you notice a long or pointed head, show your pediatrician.

When does the swelling on a newborn’s head go away?

Caput usually fades in days; a cephalohematoma may take weeks to a few months. Do not press on it.

Can a helmet fix a pointed head?

Birth moulding resolves without a helmet. A helmet may be recommended for positional shape problems after assessment, but it does not replace surgery in craniosynostosis.