Positional Plagiocephaly

How to prevent your baby from developing a flat head

What is Plagiocephaly?

Since the introduction of the “Back to Sleep” Program, the rate of Sudden Infant Death Syndrome (SIDS) has decreased. This is great news!

However, because so many babies are now spending long periods of time on their backs, there has been an increase in the number of babies developing flat heads.

A baby’s skull bones are very soft and flexible. Their heads can be easily molded when left in one position for long periods of time.

This flattening of a baby’s skull is called positional plagiocephaly.

When viewed from above, your baby may have a parallelogram shaped head with flattening on one side or a flat spot on the back.

Flat spot on the back and right side of the skull of parallelogram shape.

Flat spot on the back of the skull.

What causes some babies to develop a flat head?

Child showing plagiocephalyBabies who spend a lot of time lying on their backs or lying with their heads turned to one side are at risk for developing flat areas on their skulls.

Babies who always lay on their backs may have a flattened area on the back of their skull.

Babies who prefer to turn their heads to one side may have a flattened area on the back or side of their skull.

Some babies are born with these flat areas due to limited room in the womb.

Premature babies have softer skull bones that can be more easily molded. This places them at an increased risk for developing flat areas.

Some babies have tight neck muscles, a condition called torticollis. This limits a baby’s ability to change their head position, resulting in long periods of time with pressure on one side of their head.

Can having a flat head affect my baby’s growth?

In most cases having a flat area will not affect brain growth or development. The brain continues to grow regardless of the skull shape.

Plagiocephaly usually only affects a baby’s appearance. It may cause the head and face to develop unevenly, especially the eyes, ears, nose, forehead, and jaw.

If a baby does not have enough tummy time it can affect their development.

How can I help change my babies head shape?

Up until about 12 months of age a baby’s skull bones are very soft. During this time it is possible to improve head shape by using different positions such as tummy time, exercises and other strategies.

Some families choose to have a custom molded helmet which can help reshape the skull. Helmets are made by an orthotist.

Starting these strategies early means a greater chance of improvement.

How do I prevent a flat head?

  • Provide a lot of supervised tummy time when your baby is awake.
  • Change your baby’s position frequently. For example, from laying on their back, to their side, and/or their tummy. Once your baby has good head control you can start using a baby chair that does not support the head such as a Bumbo chair.
  • Try to avoid or limit having your baby spend a lot of time in infant seats or swings, where your baby’s head is supported on the flat spot.
  • Alternate the side on which you carry or hold your baby.
  • Change the position of mobiles and other toys in your baby’s crib, to encourage them to look in both directions.
  • Babies will look out into the room and will turn their head to look for you. Place the crib in their room so they can see you coming towards them. Or every time you put your baby to bed you can alternate the end of the crib your baby sleeps in.

Tummy Time

What can I do if my baby already has a flat head?

  • Try the prevention strategies already discussed in this brochure.
  • Also you can position your baby in a way that helps take the pressure off the flat areas of the skull. When your baby is awake, place a rolled blanket under your baby’s shoulder on the same side of the flat area. This will help keep your baby’s head
    turned away from the flat area.
  • Try to avoid putting pressure on the flat areas of your baby’s head when holding and carrying your baby.
  • helmetDiscuss with a specialist if helmet therapy would be a good option for your baby.

To make a referral to TVCC for physiotherapy:

If you think you need intervention, you can contact our intake team to make a referral for physiotherapy.

This information has been developed and provided
by TVCC with the
support of the Middlesex-London Health Unit

pdfDownload this brochure (pdf) 

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