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I’m Told Why Chinese People Have Flat Heads

I ask about an observation and I’m told about an interesting and widespread cultural practice.

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Chinese baby pillow

After you’ve traveled for a while you notice certain slight physical contrasts between different cultures and peoples. You note them, shrug, maybe go “hmm,” and generally don’t think about them too much after that.

In China, it’s difficult not to notice that the backs of people’s heads tend to be relatively flat, the parietal bone compacted so that there isn’t much of a bulge running up from the neck. This is best evidenced, of course, by men with buzz cuts or shaved heads, and after you’ve noticed it a hundred times or so it becomes clear there’s a pattern that could only be the work of culture.

I may have been more prone to noticing this because my mother has a similarly shaped head. My family used to tease her about it, going as far as to nickname her “Flat Head.” It was my grandmother who gave my mom her flat head. Fearing that she may suffocate as a baby, my grandmother made sure that she was always laying on her back, and her pliable baby skull molded to the likeness of the surface it was placed upon.

There’s actually a medical term for this: positional plagiocephaly. During the early 90s this condition arose with remarkable frequency due to the “back to sleep” campaign which instructed parents to keep their babies on their backs to ward off SIDS. The head shape that results has no known impact on brain development.

I just figured that this was the reason that many people in China have heads that tend to be a little flatter in the back, and I didn’t give it much thought beyond this. Until, that is, I found out that the reason for this is very different than I’d originally assumed.


“What are these pillows for?” I asked a Chinese friend who just had a baby.

I was poking around her new baby room and I found an apparatus that consisted of two elongated, hot dog bun-shaped pillows that were attached together by a six inch length of cloth.

“To put on each side of the baby’s head to keep it facing up,” my friend responded simply.

“Oh, is that so it doesn’t stop breathing?” I asked, thinking of my mother.

“No, it’s to make the back of its head flat,” she replied. “Like this.”

She then turned to the side and pushed the hair down on the back of her head, revealing to me that it was remarkably flat.

“Why do you want your baby’s head to be flat?” I queried.

“To make its head bigger.”

“Why do you want its head to be bigger?”

“I don’t know. Maybe because we think big heads are more beautiful.”

Fair enough.

My curiosity was again stoked. I further inquired about this with other people and it became evident that the use of these pillows to keep babies on their backs for the purpose of giving them flatter heads was very common in mainland China, seemingly to the point of being almost universal.

“Yes, my parents used those pillows for me,” Cody Chao, a medical student in Suzhou said with a laugh. His statement was echoed over and over as I went around asking my friends how their heads became so flat.

Chao told me that the pillows are generally not applied until the baby is three months old, stating that it could be dangerous to do it prior. He reaffirmed that it was done purely for aesthetics, and mentioned that it was similar to how clips are sometimes applied to the noses of adolescents to make them grow longer and more narrow.

I asked my Chinese researcher if she used these pillows for her daughter when she was a baby.

“Yes,” she replied. “I used the pillow when my daughter was about 4 months old. My grandma made a pillow for her. It was useful . . . because she kept sleeping sideways. Her head shape was not good looking at first.”

“What’s a good looking head shape?” I asked.

“People think a good head shape shouldn’t bulge too much on the backside.”

I asked her if she knew where this custom came from.

“I think it’s an old tradition,” she responded. “Because in ancient times people used hard materials to make pillows and if your head bulged too much on the backside when you are sleeping on the hard pillow your head hurt.”

People in ancient China used to sleep on wooden pillows, apparently to keep the head from becoming too warm, so . . . maybe???

As myriad societies across the planet become more and more similar to each other on a superficial level, there is still a deep stream of diverse reasoning and preferences that runs strong beneath the surface. While we all drink the same lattes in the same cafes, eat the same foods in the same restaurants, type the same texts on the same phones, post the same selfies on the same websites, it is still possible to find yourself intrigued by a custom that’s rooted in an outlook or aesthetic that starkly diverges from your own. Some societies like skulls that bulge while others prefer them flat.

This is an open blog post, meaning that information will continue being added to it as it becomes available. If you have anything to add please leave a comment below.

Filed under: China, Culture and Society

About the Author:

I am the founder and editor of Vagabond Journey. I’ve been traveling the world since 1999, through 90 countries. I am the author of the book, Ghost Cities of China and have written for The Guardian, Forbes, Bloomberg, The Diplomat, the South China Morning Post, and other publications. has written 3657 posts on Vagabond Journey. Contact the author.

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VBJ is currently in: Astoria, New York

9 comments… add one

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  • Julie T February 22, 2016, 9:35 am

    Thanks for asking this question and doing the research! I’ve wondered the same thing. The pillows are so interesting to me. Now I wonder if they think MY head is funny looking! 🤓

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  • Julie T February 22, 2016, 9:40 am

    Thank you for researching this. I have wondered the same thing. Now I’m curious what my head looks like to people in China.

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  • BobRoss October 25, 2017, 3:46 am

    Apparently, Chinese people are stupid.

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    • Judy September 28, 2019, 1:11 pm

      WOW it’s so clever of you to draw such conclusion

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      • Wade Shepard September 28, 2019, 1:23 pm

        I didn’t draw any conclusions. This is what Chinese people told me.

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  • flek March 10, 2020, 6:34 pm

    Many Inca in South America have flat back of the head.
    However their DNA is mostly Asian. Many Asians have wide portrait and slender profile but not all.
    If the flat head Asian is the purest form of the race the practice to flatten the head artificially in Asia may have been to pay homage to that portion of the race.


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  • sarah amer January 13, 2021, 11:31 pm

    This is done in Pakistan as well , people think its beautiful, and elongated heads are well thought to be not very pretty. Generally the mother just gently presses the baby’s forehead while breast feeding, to get a rounder wider back. Also if you notice most Indians, Pakistani’s and Bangladeshi’s have pressed back foreheads as well, my grandmother used to say “put your hand on the baby’s forehead you dont want her head to look like an English persons”

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  • Gary August 25, 2021, 8:29 pm

    Thanks for the article. I first noticed this with a Thai female friend of mine 25 years ago and have noticed it on other Asians ever since. Given that she is from Thailand, I would venture to guess that this is more widespread than just China.

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  • Lyric October 24, 2021, 2:53 pm

    Yes, I’ve definitely noticed this. I just thought to ask google today abt it, bc I was watching something with a latino man in it. And I’ve noticed that almost every latino I see has a flat head as well. I didn’t know if it was a genetic thing or not. I get why they do this with their male babies, but why their female babies? 9 times out of 10, you can’t even see the back of their heads bc of their hair. Also, what if they don’t want their heads flat? They said their self, it’s simply for aesthetics, vanity. I would be upset if my parent’s did this to me as a baby. But then again, It’s not part of my culture.

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