Infant Head Ridges Not Necessarily Craniosynostosis

I want to put this out there for any other mamas who might be going through what I recently went through. In short, here is the info I searched all over the internet to find: A bony head or noticeable ridges does not necessarily indicate craniosynostosis!

The full story: On September 25th I gave birth to a big 9lb 3oz baby boy after a very short labor at home. Five days later I took him to his first pediatrician appointment. He was weighed, measured etc. and the doctor agreed with the midwife that he was perfectly healthy.

Soleo Lanz Obermeyer, 1 day old.
Soleo Lanz Obermeyer, 1 day old.

A few days later, at just over a week old, I started to think that maybe his head didn’t look quite right. The bones seemed really prominent, much more so than I remember from my older daughter. I could easily see and feel a ridge along the middle of the top of his head running from front to back, and even along the back of his head running side to side. Of course I know that there is a lot of variation in baby heads and it is common for heads to be misshapen, particularly in the first day or two after birth, but at two weeks old these features seemed even more obviously apparent. I wondered if they were normal and started googling.

If you search “bony head, newborn” or “newborn head ridge”, essentially the only thing that comes up is Craniosynostosis. It refers to a situation where the various bones in the infant head fuse prematurely. With the bones fused, the brain cannot grow properly. This leads to all kinds of problems including facial deformities, vision and hearing problems, as well as developmental delays. It’s rare, only 1 in 2000 babies are afflicted. How bad it is depends on which of the bones – which sutures – are fused, but in most cases the treatment is surgery.

My husband thought I was just being a paranoid mama spending way too much time staring at his head, but I had become very worried. I did find one forum of others talking about the ridges on their baby’s head that the doctors had declared normal. Multiple parents on that one forum shared stories and even photos, but everything else I read pointed to craniosynostosis.

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The only thing (besides that forum) that gave me hope that he was fine was that applying gentle pressure to the edge of the bones made them move independently. The ridge also changed based on which side he was laying on. It didn’t seem like one ridge down the center but more that one bone would be higher than the other and sort of stick up along the suture, causing the appearance of a ridge. Those observations made me think the suture couldn’t be fused. Nevertheless, I couldn’t find anything on the Internet to convince me that ridges were ok and normal at 1 month old.

I was worried, and since by then we were back home in Pavones (a 6 hour drive from our doctor in the capital of San Jose, Costa Rica) I sent pictures to our pediatrician to ask his opinion.

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The pediatrician responded that his head looked perfectly normal. But when I sent the same pictures to our midwife who happens to be married to a neurosurgeon, her husband thought it did look like he could have craniosynotosis of the sagital suture. He recommended we take our son to a pediatric neurosurgeon and gave us the contact information for a friend of his.

Based on what the pediatrician had said, I had relaxed into thinking my husband was right and I was over thinking it, but now a neurosurgeon thought I might be right about the craniosynotosis! I called the pediatric neurosurgeon immediately but we couldn’t get an appointment for 10 days. I spent that time spiraling deeper down the freaked-out Google wormhole reading the same information over and over on different sites, and basically becoming an expert on the condition, the diagnosis and treatment. I convinced myself that based on the presence of the ridges he was definitely going to need surgery.

I finally got my husband concerned enough to start doing his own research. We reached out to what seemed to be the best treatment center in the US, whose doctors had pioneered a less invasive surgery technique and claim to treat more cases than anyone else. They were very helpful and suggested we send in photos of specific views of the head for an initial opinion.

Before hearing back from them we also reached out to a specialist in Los Angeles who also asked for photos.

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Amazingly to me, both responded that the photos looked normal. Big *sigh* of relief, but what about those ridges? I was not going to feel true relief until someone who knew what they were doing got their hands on his head and felt what I was feeling.

One of the signs of Craniosynostosis along the sagital ridge is a narrower head. I compared photos of Soleo and his sister Luna. This is them at 3 weeks old. Soleo on the left. His head is definitely narrower, but is it extremely narrow??? Not really.
One of the signs of Craniosynostosis along the sagital ridge is a narrower head. I compared photos of Soleo and his sister Luna. Here they are, both at 3 weeks old. Soleo on the left. His head is definitely narrower, but is it extremely narrow??? Not really.

On the day of the appointment I was so excited to get some answers but was also very nervous about what the answers would be. Soleo and I left the house at 4am, to get on a small plane for the city. At the Hospital Catolica we got 2 xray views of his head as recommended by the doctor. I seriously wish I’d posed for a picture with the doctor, especially now that I’m writing this post. He was 60ish, with an earring, a red bow tie, gold cufflinks in his button-up shirt, and a super cute vintage leather doctor’s satchel. Very stylish, but more importantly he was very friendly and patient. He listened to my concerns, felt Soleo’s head, examined the xrays and told me his head looked perfectly normal. I was skeptical and bombarded him with questions – “What about those ridges? Are you sure? How can you be sure? So, what if he wasn’t born with it, do the ridges mean the sutures are trying to fuse now?”

The xrays showed gaps between the sutures to assure me that they are not currently fused. He explained the ridges by saying that since he was born with a very big head – 38cm at birth (39cm by 1 month old), that the sutures had been forced to overlap during birth and he simply needed to grow into his head. Over the next few months the brain will expand causing the bones to move and flatten out.

“Nothing to worry about, he’s a very pretty baby. I don’t think you need to schedule an appointment for another checkup, but if you need more reassurance, feel free to send me photos in a few months.”

Another bit of info that I never found during my google searching but that the doctor confirmed is that if they have it, they are almost always born with the condition. Only in incredibly rare situations, involving certain other conditions like swelling in the brain requiring a shunt, would the plates fuse after birth.

So, in our case, Soleo is fine and we are relieved. He’s just got a bony head and my husband has jokingly started calling him “ruffles” as in “ruffles have ridges”.

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Soleo at 5.5 weeks old.

I wanted to follow up on the above story and say that Soleo is now 6 months old and his ridges are completely gone. He has grown into his head and several people who have met him have commented on his “great head” shape.

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15 thoughts on “Infant Head Ridges Not Necessarily Craniosynostosis”

  1. Thank you so much!!! I’ve been googling like crazy because my 2 month old has these same ridges. His head is otherwise normal (shape wise). The pediatrician wants to see us again at 3 months to check his head again, and I’ve been so paranoid. It’s good to hear a story where it turned out to be normal. I can sleep better now !

    1. Im so glad I could help as I went through that same struggle. He is now 5 months old and the ridges are way less noticeable! check out my instagram feed @salt_water_mama to see photos. I couldnt figure out how to attach one here.
      If your son has a normal shaped head, you don’t have anything to worry about!

  2. Has your son’s ridges resolved now? My daughter is 2 months old and her head looks exactly like the pics you posted! Her head is growing appropriately on the growth chart and fontanelle is normal so we have not done any referral or imaging and just wondering what to expect about when this would resolve. Your blog is the only thing I have found on the Internet that does not suggest craniosynostosis! Thanks for posting!!

    1. yes the ridges are mostly gone! he is almost 8 months now and the only ridge still slightly visible is the occipital ridge along the back of the head and I can just barely feel it.
      I’m so glad you found my post reassuring!
      you can view recent pics on my instagram @salt_water_mama

  3. Thank you Momma! I’ve been googling everything related to ridges driving myself crazy!
    9 weeks old with a tiny soft spot and visible ridges, 100% percentile for height, weight & head… here’s hoping he just needs to finish growing into his huge head 🙂

    1. Glad to help. My little guy was in the 95th% on head size and height too. He is 8 months old now and has definitely grown into his head, the ridges are gone. Cuddle that little guy, he’ll grow fast!

  4. Thank you so much holly beck! Our son is 1 month old and we have been worried sick. Same here 50 percentile in head, ridges, with perfect health. If you don’t me asking would you be willing to call my wife and give us some information about the neuro you used and what not? Thank you for this maybe dad can sleep better.

  5. Thank you for posting your story! It can be so easy to spiral out of peace when you notice something off and start looking on the internet. I’m sincerely sorry you and Soleo had those stressful times, but very thankful you shared.

  6. THANK YOU for posting this! My daughter is 1 month old and my concern began at 2 weeks old when I noticed her head has some ridges along the plates and her occipital bone stuck out a little bit… but her face has remained completely normal. I terrified myself reading what’s online and went to two pediatricians who both told me they thought her head was fine. The panic definitely set in after googling and I scheduled an appt with a specialist who doesn’t have openings for two weeks! Your article saved me from spending two weeks worrying myself sick. I completely related to you saying it feels like the plates are just overlapping bc one side feels higher than the other when I press lightly. I’m also glad to know that doctor told you the fusion almost always happens before birth, I haven’t read that anywhere!

    Thank you again from a very worried and sleepless mama. I’m glad to know there are other possibilities! I’m praying the specialist tells me what they told you.

  7. Thank you so much for spreading your experience! I’ve been worried sick about my boys! My almost 6 months old still has the ridge on top of the head. Was born with a big head (37.5cm) and we have seen craniospecialist 2x and both times he just brushed us off with a smile on his face! That makes me feel good of course! But still the mother worrier instinct is active and am wondering why is the ridge still there? I read everywhere that they are gone by 6months or so.
    My oldest boy (2 years) has a prominent ridge on metopic and some bumps over coronals on top of his head. Keeps me worried but craniospecialist dismissed even without touching his head.
    Both, our pediatrician and craniospecialist just seem so chill about babies and toddlers with bumpy heads!

  8. Thank you. So so so very much. I have been slightly freaking out but my story is identical to yours and my infant’s head looks exactly like your son’s head. The midwife and craniosacral therapist have both said his head looks normal but it just looks so different from my other son’s. Also, I have never seen this before on another baby. I am e trembly grateful to you for posting.

  9. Just an update on my previous comment since it seems like a lot of us are in the same boat with these symptoms: I went to the craniofacial specialist and he said he did not think she had craniosynostosis. In his opinion, the ridging is due to overlapping skull plates rather than fused sutures. My daughter also had a big head at birth and her ridges look identical to those posted in this blog. He said her skull is slightly elongated but it is not narrow, which would be characteristic of craniosynostosis and no frontal bossing. He said he couldn’t be 100% definitive unless we did a CT scan but he said he didn’t think there was enough concern to warrant a scan and expose her to the radiation. He said he’d just follow up with us when she is three months to be certain head growth continues to be on track.

    He also said to please stay away from Dr. Google on this issue! So true. I wish the internet provided more information about babies with skull ridging that didn’t immediately make parents fear the worst. Again, your post has been really helpful! Thank you!

    Quick question if you don’t mind: Do you remember at what month your son’s sagittal ridge starting to smooth out?

    1. Hi Jenny,
      I’m so glad you found the post helpful. Honestly, I dont remember at what point the ridges smoothed out. It was a gradual process. I’d say by 3-4 months they were gone.
      Im sure yours will be fine as well!
      : )

  10. Thank you so much mama! Sometimes Google is foe, not friend ( especially at 2 AM). I just noticed my four week old son’s coronal ridges sticking out. I will follow up with the pediatrician, and will hold off booking a flight to the Mayo clinic for surgery. Your detailed description of your experience, both medical and emotional, really helped to calm me down. I wish there was more of this on the Internet. Thank you again!

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