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What is Plagiocephaly?

Plagiocephaly, often referred to as “flat head syndrome,” is a condition with which not many people are familiar despite its increasing occurrence. Some experts estimate that nearly one in two infants are affected while one in every ten infants require treatment with a cranial helmet. Essentially, one side of an infant’s skull is flattened, causing an abnormal head shape. If this occurs during childbirth, it will often correct itself without any type of intervention. Nevertheless, if this condition continues after six weeks, it is time for to see a qualified professional for an evaluation.

What Causes Positional Plagiocephaly?

Babies’ heads are very soft and malleable enough that outside pressures can distort their shape. For instance, when a baby’s head stays in the same position for an unusually long time, the skull tends to flatten. In addition, there are a number of other factors that lead to positional or deformational plagiocephaly.

    • Twins or Multiple Births
      Often, a tight space within the uterus can cause distortion of a baby’s head. For this reason, the risk rises with twins or multiple births.
    • Womb Position
      If a baby becomes stuck in one position or cannot move at all within the womb, he may develop plagiocephaly. A breech birth can also result in an abnormal head shape.
    • Premature Birth
      Because premature babies have softer skulls, they are even more susceptible to misshaping than full term babies. Since these babies are also more likely to be physically delayed, they may experience less normal head movement. Consequently, many remain in hospital after birth on a respirator with their head in a fixed position.
    • Muscular torticollis 
      A congenital condition in which one or more of a baby’s neck muscles is unusually tight on one side, which causes the baby’s head to turn to one side. Being held in a single position can result in a craniofacial disorder.
    • Back-Sleeping
      While many pediatricians still endorse back-sleeping as a way to prevent Sudden Infant Death Syndrome, remaining in this position can cause plagiocephaly. As a result, doctors also recommend frequent rotation of the baby’s head in addition to limiting the amount of waking hours spent on his or her back.
    • Carriers
      Putting a baby in a car seat or swings can result in its head being positioned against a hard surface. Normally, a baby doesn’t spend enough time in these devices to be of concern. However, spending an inordinate amount of time in this position or sleeping this way can increase the chance of developing plagiocephaly.

    How to Prevent or Reduce the Risk of Plagiocephaly

    The good news is that there a few relatively simple things you can do to prevent positional plagiocephaly from occurring.

    • Try repositioning your child in their crib on regular basis, so they aren’t always lying on the same area of the head. A good way to change it up is by changing which direction a child’s feet are pointing in the crib. You could even hang a mobile or crib toy in the direction you want the child to face.
    • Make sure that your infant gets enough supervised playtime on his or her stomach. This can help to build up the arm, shoulder and neck muscles.
    • Always try to avoid any extra pressure on the flat side of the head, especially when feeding or carrying an infant. It helps to switch their head position from one side to the other during feeding time.
    • Cut down on the time spent in carriers or car seats, especially while the baby is awake.

    These simple at-home practices are usually effective for both preventing and improving abnormal head shapes. Indeed, once a child is able to both sit and stand on their own, any deformity usually improves since the outside pressure on the head is removed.


    Although plagiocephaly or flat head syndrome can be fairly common among infants, these simple at-home techniques that can prevent or improve a baby’s head shape.There are times, however, when plagiocephaly is too severe for positional therapies. In these cases, a pediatrician will usually recommend a cranial remolding orthosis,  such as the STARband plagiocephaly helmet. A cranial helmet keeps pressure away from the flat spot, enabling the baby to sleep in any position he or she wants. For best results, treatment should start by eight months of age.

    It’s important to have your baby examined as soon as possible if you notice an abnormal head shape or are concerned about a flat area. As long as you catch this problem early, these treatments can be very effective and will not interrupt your child’s normal brain growth and development.



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