Molding, Conehead, & Your Baby's Birthday Party Hat

Meeting your baby is something new parents imagine often in the final weeks of pregnancy. Will your baby be cute? Ugly? If you have an ugly baby, would you even know and actually think it's cute because it's your baby? There are many important questions to be asked before your little ones arrival, and in the midst of a long labor you can certainly lose sight of whether your baby will have that funny ear thing like you and all the cousins on your mother's side of the family. There's something else you've heard people talk about, though. Maybe you were born with it, especially if you were a first born or first vaginal delivery: a conehead.

First, what exactly is a "conehead" ...and how does it happen?

molding on a baby girl born OP "sunny side up"

Coning of a baby's head is what we in the birth world call "molding". It's most noticeable after a labor with a long pushing stage (like with first vaginal births), or when baby's head has been sitting low in the upper part of the vagina for a while, whether pushing or not. The longer amount of time a baby spends with it's head in the birth canal, the more severe the molding will be. Sometimes, it's just swelling, but most of the time it's the actual overlapping of plates of your newborn's skull. WHOA.

The drawing below (A.) shows how a newborn's skull is divided by suture lines. We have these as adults, but in babies they aren't yet locked together. Babies also have two somewhat

large openings in the skull that allow for growth and overlap;

we call these "fontanelles" or, more commonly, "soft spots".

If you didn't know, babies continue movements during labor they may have started in the last weeks of pregnancy to help prepare for birth. They play a pretty significant role in helping themselves be born. They swivel around so their backs are in the hammock of their mother's bellies, facing her backside, tucking chin to chest, so the very back of their head will sit on top of the cervix and enter the birth canal first.

A. fetal skull with visible suture lines

...or usually, anyway.

For babies that can't seem to swivel their backs the way we'd want, and come out facing their mothers front (sunny side up or OP), their heads may curve in a slightly different way than the babies with their backs on the preferred side. These babies are generally harder to push out, and remember, molding may be more severe if it takes a while.

See on the left, a newborn head shape that belongs to a baby facing the usual way. On the right, a baby that was born OP, like the image of the baby girl at the top of this post.

Thankfully, molding is noticeably better even just one hour after birth and by the next day you won't be able to see the shape at all. Babies don't wear birthday cone hats for long, so you can go back to deciding whether their perfect nose is from your mom or theirs, and celebrate passing on the family ears.