Plagiocephaly (Flat Head Syndrome)
When a baby is born, the birth process often causes their head to have an irregular shape. Rest assured that a normal shape usually returns within a few weeks.
In the first few months of life, however, some babies develop a lasting flat spot on one side of the head or the back of the head. A baby’s head could become misshapen when they spend a lot of time on their back, or because of problems with their neck muscles (torticollis). This is called positional plagiocephaly, or “flat head syndrome.”
What causes flat spots on a baby’s head?
The skull flattens when a baby’s head stays in one position for long periods of time. Factors that may increase this risk include muscular torticollis, early birth (prematurity) and back sleeping. Babies who sleep on their back or in a car seat without changing positions for long periods of time can develop flat heads. It is important to note that the American Academy of Pediatrics recommends that babies sleep on their back to reduce the risk for SIDS. Young babies who can’t roll over or move on their own should not be placed on their belly to sleep.
How can flat spots on a baby’s head be prevented?
There are steps parents and caregivers can take to try to avoid flat spots on an infant’s head:
- Parents should still place babies on their back for sleep.
- When babies are awake, put them on their tummy for a while. This eases pressure on the back of the head and helps babies build shoulder and neck strength.
- Relieve pressure on the back of the head when you lay an infant down for sleep by propping the child slightly to one side. Alternate sides nightly.
- Alternate which direction you place your child in the crib each night. Your child will then alternate which direction he or she looks out of the crib.
- Minimize the use of car seats when not traveling in the car, as well as other types of seats such as bouncers and swings, in which babies are positioned on their backs.
- Pick up the child often. The more time the baby is held in your arms, the less time he or she is lying down with pressure to the head.
The AAP mentions these suggestions to make tummy time fun for babies:
- With your baby on their tummy, place a favorite toy just a bit out of reach to encourage them to stretch for it.
- Surround your baby with a circle of toys to encourage strengthening muscles by reaching in different directions.
- Once your baby is old enough, place them belly-down on your chest, so they will pick up their head to look at your face.
- Encourage other young children to play with your baby during tummy time, as long as you carefully supervise them together.
How is Flat Head Syndrome treated?
Positional plagiocephaly can often be treated by repositioning your baby’s head when they’re laying down. For some babies, physical therapy may be prescribed to help their neck muscles.
Your baby may need to wear a cranial molding helmet if the problem is moderate to severe and if repositioning the baby’s head has not helped. Helmets are usually made of an outer hard shell with a foam lining. Gentle pressure helps to reform the head. As the head grows, adjustments are made. The average treatment with a helmet is usually three to six months. This will depend on the age of the baby and the severity of the condition. Helmet therapy is most effective before 6 months of age, so the earlier treatment can start, the more effective it can be.
At CHOC, we will assess your baby’s head using a 2-second laser analysis called the STARscanner™, which is eye-safe and radiation-free. You’ll see a pediatric neurosurgeon and a cranial specialist in a single appointment, and we will form a treatment plan with you.
Could a misshapen head be a sign of something more serious?
Most of the time, the head deformity is simply positional plagiocephaly, a benign condition that does not require surgical intervention. However, some deformities are caused by craniosynostosis. Similar to plagiocephaly, craniosynostosis can cause flat spots and bulging areas on the head and forehead. It is important to get your child properly diagnosed to avoid getting these two conditions confused.
Contact Us
We treat all conditions of the head, including plagiocephaly, craniosynostosis and torticollis. We provide laser analysis of the head shape and a full range of surgical and non-surgical treatments such as cranial remodeling and custom helmeting. Contact us today to schedule an evaluation of your baby’s head.