About plagiocephaly or flat head
Plagiocephaly is an uneven or asymmetrical head shape – a ‘flat head’. It can also be a flattened spot on the back or side of a baby’s head. Plagiocephaly can be mild, moderate or severe.
Babies are often born with misshapen heads. This can be caused by the head’s position in the uterus during pregnancy, or it can happen because of the squashy passage down the birth canal.
Also, newborn skull bones are soft, thin and flexible. This means that the heads of newborn babies can change shape easily. So plagiocephaly sometimes happens when babies lie with their heads in the same position for a long time.
In some babies, more severe plagiocephaly can be caused by tight neck muscles (congenital muscular torticollis), which means babies have a strong preference for turning their heads to one side.
Later in infancy, some babies with severe plagiocephaly might have a delay in the development of gross motor skills like rolling and crawling.
The proper medical name for this type of plagiocephaly is deformational plagiocephaly. There’s another type of plagiocephaly called synostotic plagiocephaly. It happens when a baby’s skulls bones don’t close properly. This article is only about deformational plagiocephaly.
Signs and symptoms of plagiocephaly
Your baby might have an uneven head shape, a flat head or flattened sections at the back or side of their head. Your baby’s ears might look uneven, and their forehead might be more prominent compared to the rest of their head.
Does your child need to see a doctor about plagiocephaly?
- strangely shaped head or a flat spot, which hasn’t gone back to a normal shape by about 2 months of age
- strong preference for turning their head to one side
- difficulty turning their head.
Treatment of plagiocephaly
Often, mild plagiocephaly doesn’t need treatment. It’s likely to fix itself as your baby grows.
This is because your baby’s head shape will naturally improve as their head grows and their gross motor skills develop. When your baby starts to spend less time on their back and more time on their tummy or sitting, there’ll be less pressure on the back of their head.
Treatment might include:
- repositioning your baby so they avoid lying on the flat head spot when awake
- doing gentle exercises and stretches with your baby to improve their neck movements
- encouraging motor skills like rolling, reaching and turning
- giving your baby tummy time and time on their side when they’re awake
- carrying your baby in certain ways – your health professionals will advise you.
For severe plagiocephaly, your specialist might recommend that your child wears a specially fitted helmet, which takes the pressure off the flat spot and allows your child’s head shape to improve as their head grows.
It won’t help to take your child to a chiropractor for back or neck adjustments.
There are several things you can do to help prevent your baby from developing plagiocephaly:
- Try to alternate your baby’s head position between right and left when they’re sleeping on their back.
- When using the change table or cot, alternate the end where you put your baby’s head.
- When your baby is awake, give them tummy time or time on their side during supervised play.
- Stimulate your baby – for example, talk, sing or shake a rattle – or put toys near your baby on the side they like least. This will encourage your baby to turn their head to that side.
Putting your baby on their back for sleep is the safest sleeping position. Putting your child to sleep on their stomach or side increases the risk of sudden unexpected death in infancy (SUDI).