This study examined potential predictors of postnatal head molding in very low birth weight (VLBW) infants. Occipital-frontal circumference (OFC) and anterior-posterior (AP) and biparietal (BP) diameter measurements were obtained on 144 premature infants with birth weights of less than 1,500 gm. Measurements were obtained at four days of age (baseline) and weekly until discharge. Increasing gestational age, higher birth weight, and delivery by cesarean section predicted larger OFC at three weeks of life. Only baseline AP:BP measurements significantly predicted AP:BP measurements at week 3 and 5. Within-group t-tests indicated that the severity of head molding (as indicated by AP:BP ratio) increased throughout the first six weeks of life. Results indicate that postnatal head molding can be reliably predicted and that neonates with higher AP:BP ratios at birth are at greater risk for continued narrow, elongated head shape.