Positional Plagiocephaly (Flattened Head)

Condition Basics

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. These may help your baby turn their 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.

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 or head-shaping pillows. 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?

To help prevent a flattened head:

• Provide plenty of tummy time while your baby is awake. This means letting your baby lie on their stomach while you watch closely. This 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. This encourages your baby to turn their head a different way to look at things.
• Change the location of your baby's crib in the room. This also encourages your baby to turn their head to look in a different direction.
• 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 they're riding in a car.
• Do not use infant head-shaping pillows. The U.S. Food and Drug Administration (FDA) warns that these could be unsafe for your baby.