Plagiocephaly

Plagiocephaly is often either unnoticed or not present at birth. It may develop during the first few months of a baby’s life. Symptoms of the condition include:

• Flattening of the back or side of the head
• Bulging of the forehead and cheek on one side
• An ear pushed forward on the flattened side
• Tilted jaw

Plagiocephaly is often diagnosed during a child’s wellness checkup. If you notice your child has symptoms of plagiocephaly, talk to your child’s healthcare provider.

Many factors can cause plagiocephaly. Early in life, a baby’s skull is very soft and still developing. Pressure from everyday surfaces, such as crib mattresses and car seats, can cause flat spots. If a baby stays in one position for long periods of time, it can cause plagiocephaly to develop. Other causes of plagiocephaly include:

• Position in the womb. Babies who become stuck in one position or don’t have enough room to move in the womb are at risk of developing plagiocephaly.
• Premature birth. Premature babies have especially soft skulls, as the bones of the skull become harder near the end of pregnancy, making them susceptible to plagiocephaly.
• Congenital muscular torticollis. This is a condition that occurs when a child’s head is tilted to one side and turned toward the opposite side. It is caused by having tight muscles on one side of the neck and weak muscles on the other side of the neck. This may cause the baby to keep their head in a single position, which can lead to plagiocephaly.
• Back sleeping. Babies who sleep on their backs for long periods of time can develop flat spots on their heads. However, research shows that putting a baby on his or her back to sleep can reduce the risk of Sudden Infant Death Syndrome (SIDs). Babies should always sleep on their backs until they are at least a year old.

A pediatrician will usually diagnose the condition during a physical exam by checking and measuring the baby’s head.

Treatment will depend on how severe the condition is and the child’s age. In mild cases, a baby may not need treatment. The condition will usually get better once a child begins to sit up.

For more severe cases, doctors may recommend:

• Changing sleep position. Turn a baby’s head to the opposite side to sleep while keeping the baby on his or her back to reduce the risk of SIDs.
• Increasing “tummy time.” Have the child spend more time on his or her tummy while awake. Be sure to talk to your child’s healthcare provider about the duration of tummy time. Always stay with your child during tummy time.
• Wearing a helmet. If other measures don’t work, a child may need to wear a helmet. Helmets are made of an outer hard shell with a soft foam lining. Gentle pressure from the helmet will help reshape the head.

Plagiocephaly has become more common recent years. One reason is because parents are encouraged to put infants to sleep on their backs to reduce the risk of SIDS. By following this recommendation, the number of SIDs-related deaths have decreased by more than half.

Continue to put your baby on their back to sleep. To help prevent plagiocephaly:

• Increase tummy time while your baby is awake and can be supervised
• Hold your baby often to give them time to be upright
• Avoid placing your baby in car seats or carriers for long periods of time

American Academy of Pediatrics

Plagiocephaly [pley-jee-uh-SEF-uh-lee] is a condition in which a baby’s head is not shaped correctly. The condition, sometimes called flat-head syndrome, is common in infants and babies. Plagiocephaly occurs when a flat spot develops on the back or side of the infant’s head. This will not affect your baby’s neurological development. However, if untreated, the head may remain misshapen into adulthood.