• 1 week ago

Flat Head Syndrome (Plagiocephaly) in Babies: When Is Intervention Needed?

What Is Plagiocephaly?

Plagiocephaly refers to an asymmetric flattening of one side of a baby’s head. It often involves:

  • Flattening on the right or left side of the back of the head
  • One ear appearing to shift forward compared to the other
  • Head shape appearing uneven or slanted when viewed from above

The most common type is positional (or deformational) plagiocephaly, caused by consistently lying in the same position.

What Causes Plagiocephaly?

  • Lying flat on the same side for extended periods
  • Intrauterine positioning (e.g., twins, limited space in womb)
  • Torticollis (tight neck muscles causing head tilt)
  • Premature birth (softer skull bones, longer hospital stays)
  • Lack of tummy time or insufficient holding

When Is It Considered Normal or Mild?

Feature

Interpretation

Mild flattening at the back

Often resolves with repositioning

Normal head growth

No developmental concerns

Facial and ear alignment preserved

Cosmetic only

Normal neck movement

Torticollis unlikely

Most cases of positional plagiocephaly improve by 6–12 months, especially with early action.

When to Seek Medical Attention

Consult a pediatrician or pediatric physical therapist if:

  • Flattening is noticeable beyond 3 months
  • One ear appears misaligned or facial asymmetry develops
  • Head shape worsens after 6 months
  • Baby prefers turning head to one side (possible torticollis)
  • You notice developmental delays or family history of skeletal concerns

Early assessment helps prevent long-term cosmetic concerns and avoids unnecessary treatment later.

Treatment Options for Plagiocephaly

1. Repositioning (Ideal for 0–6 months)

  • Practice daily tummy time while baby is awake
  • Alternate head position during sleep
  • Place toys, light, or interaction on non-preferred side
  • Breastfeed on both sides evenly

2. Physical Therapy

  • Recommended if torticollis is present
  • Includes stretching exercises to improve neck mobility and symmetry

3. Helmet Therapy (Cranial Orthosis)

  • For moderate to severe cases not improving with repositioning
  • Usually started between 5–12 months of age
  • Helps guide head growth into a more symmetrical shape

Helmet therapy is painless and non-invasive. It doesn’t affect brain development.

Can Plagiocephaly Be Prevented?

Yes—most cases are preventable with early positional care:

  • Start tummy time from the newborn period
  • Avoid prolonged time in car seats, swings, or bouncers
  • Alternate baby’s head direction during sleep
  • Watch for neck stiffness or head preference and address early