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What Is Flat Head Syndrome/Plagiocephaly?

When babies are first born, their heads can often be misshapen for the first few days, especially after a difficult delivery. In most cases, a baby’s head shape will correct itself shortly after birth and there is no problem. But some infants’ heads continue to look flat. This is called flat-head syndrome or plagiocephaly.

How Do Babies Get Flat Heads (Plagiocephaly)?

Babies will naturally find positions that make them comfortable, like lying in bed on one side of their head. This is called positional plagiocephaly. Although this is not a new condition, the number of babies diagnosed has risen over recent years. This may be cause more parents are laying babies on their back to sleep in order to prevent sudden infant death syndrome (or SIDS).

Positional plagiocephaly can also be caused by torticollis. Torticollis means a twisted neck, which can happen with how the baby is positioned in the womb or after a difficult childbirth. Torticollis prevents a baby from using his or her neck muscles properly. 

Treatment for Torticollis

Torticollis is one of the main causes of positional plagiocephaly, but it can be corrected with physical therapy. But if your baby’s torticollis isn’t treated early on, then repositioning won’t work because your baby will find it difficult to turn his head in both directions.


Mild cases of plagiocephaly usually don’t need to be treated. However, for moderate or severe plagiocephaly, we recommend that either your baby wear a helmet, or that you reposition your baby (encourage your baby to lie in different positions). We will recommend a treatment depending on the age of your baby.

For mild cases, you should place your baby on her back when she’s sleeping. But, be sure to place your baby’s head on the right side one night, on the left side the next night, and on the middle the next night.

It’s also important to limit how much time your baby spends lying on her back during the day. You should also try to make sure your baby doesn’t spend too much time with her head against hard surfaces. You can encourage tummy time for your baby.

How Can You Help Prevent Flat Spots On the Back of Your Baby’s Head? Treating Flat Head Syndrome With Repositioning 

Repositioning is when parents encourage their baby to lie differently so a certain area on a baby’s head isn’t under constant pressure, which causes flatness.

Repositioning can make a real difference to a baby’s head shape. But if you don’t notice or treat flat head syndrome until your baby is about five-months old, he may need to wear a specially made helmet to coax or guide his head back into shape.

Helmets have an excellence chance of working until a baby is eight or nine months old. But by a child’s first birthday, their head is almost completely formed, so a helmet can’t help correct your child’s head shape by this time. This is why it’s so important for parents to do something about plagiocephaly when they first notice it.

If you would like to have your child evaluated for plagiocephaly or have another question about head shape, request an appointment today with one of our pediatric plastic and reconstructive specialists.

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