Positional Plagiocephaly (Flattened Head)
What is flat head syndrome?
Flat head syndrome means that a baby's head is flat in the back or on one side. Most often, it's from lying on the back or lying with the head to one side for long periods of time. Sometimes a baby's forehead, cheek, or ear may get pushed forward a bit on one side. The condition is also called positional plagiocephaly.
Flat head syndrome doesn't hurt your baby. And in most children it goes away on its own when the child can sit and stand. If some flattening remains, it's usually minor. Most of the time it's covered by hair as your child grows.
What causes it?
The shape of a newborn's head may be affected by how the baby was positioned in the uterus. It can also be affected by the birth process or by the baby's sleep position.
Flat head syndrome has become more common since doctors began advising that babies sleep on their back to lower the risk of sudden infant death syndrome (SIDS).
Lots of time spent in cribs, car seats, carriers, or other seats may lead to a flattened head. Torticollis, or "wryneck," can also lead to a flattened head. It's a problem with your baby's neck muscles. It causes the head to turn to one side. If your baby has torticollis, your doctor may recommend neck exercises. They may help your baby turn his or her head.
How is it diagnosed?
Doctors can diagnose flat head syndrome by looking at the shape of a baby's head. The doctor will check to make sure that your baby doesn't have some other condition that affects the shape of the head.
How is flat head syndrome treated?
Your doctor may recommend physical therapy to treat flat head syndrome. This is especially true if it's caused by problems with your baby's neck muscles.
There are also things you can do to help your baby's head become rounder. Try to get your baby to turn the round side of the head toward the mattress. Try moving the crib to a new place. Or try changing the direction your baby lies in the crib.
Talk with your doctor about how to position your baby so that you don't raise your baby's risk of SIDS. Don't use sleep positioners. Until your baby's first birthday, always place your baby on their back to sleep, even if your baby has a flattened head. Just offer plenty of tummy time and cuddle time. And change your baby's head position when your baby lies down.
If your baby's head shape does not get better by around 6 months, let your doctor know.
If the flattened head is severe or other treatments haven't worked, your doctor may have you try a custom helmet. The helmet can help correct the shape of your baby's head. Surgery usually isn't done, except in rare cases.
How can you prevent it?
These tips can help prevent a flattened head.
- Provide plenty of tummy time while your baby is awake. This means letting your baby lie down on the stomach while you are watching closely. This also helps your baby build strength and motor skills.
- Provide plenty of cuddle time by holding your baby in an upright position.
- Change the direction your baby lies in the crib each night. For example, have your baby's feet point one way in the crib one night and then switch the direction the next night. Alternate each night after that. This encourages your baby to turn his or her head a different way to look at people or things in the room.
- Change the location of the crib in your baby's room. This also encourages your baby to turn his or her head in a different direction. Babies usually turn their heads away from the wall, toward the inside of a room.
- Avoid having your baby spend too much time in car seats, carriers, or similar seats. But always put your baby in a car seat when he or she is riding in a car.
Current as of: August 3, 2022
Author: Healthwise Staff
John Pope MD - Pediatrics
Kathleen Romito MD - Family Medicine