Positional Flat Head Syndrome (also known as plagiocephaly)

By Tara Liddle

What is Plagiocephaly and how can you prevent it?
Plagiocephaly is a flattening of the skull causing asymmetry in the head shape and face. 

There are several causes of positional flat head syndrome:
One major cause is too much time spent in the same position, especially when sleeping or when spending too awake time on their backs with the head turned to the same side for prolonged periods of time. 

 Other causes of plagiocephaly may include:

·      Congenital causes: Occurring during fetal development

·      Craniosynostosis: Is a rare condition that causes the sutures of a baby’s skull to close early, preventing brain growth. The skull is also misshapen. Surgical intervention is often required.

·      Multiple births: Limited space in the womb may cause crowding, making movement during fetal development difficult.

·      Premature birth: A premature baby may require extended time in the NICU, attending to medical needs, and may require prolonged periods of time on their back. Positioning in the NICU is very important for the growing baby.

·      Difficult birth deliveries: Using birthing instruments may cause neck tightness using the infant to maintain their head in one position, as changes in head positions may cause discomfort tor pain. The use of instruments on the skull may also cause a change in the shape of the bones.

·      Torticollis: Noted with the neck muscle on one side is shortened causing the head to tilt one way and rotate the opposite way. A full description of torticollis is provided in another post. 

👶Flat head syndrome is noted when a flattened area occurs on the back or side of the head. This occurs because the bones of an infant’s skull are not fused together yet. 

The moveable skull bones allow the baby to move through the birth canal and accommodates the growing brain.
👶Most pediatricians screen for flat head syndrome during early well baby visits
The earlier it is identified the quicker the results to restore the head shape.
👶For babies with a lot of hair, it is easier to detect a flat head during bath time when the hair is wet.

Typical signs include:
❗️A bald spot
❗️A flat area on the back or side of the head
❗️The ears may be maligned ( one ear in front of the other)
❗️A missing soft spot on top of the head
❗️Rough ridges felt on the skull
❗️Uneven chin or eyes

⭐️There is more to flat head syndrome than appearances.
👶A severe misshapen head can affect proper brain development.
The flat head may be related to torticollis which has its own set of complications and secondary impairments.
⭐️Please speak with your health care provider or a pediatric PT if you suspect positional flat head syndrome.

One way to prevent positional flat head syndrome is to:
⭐️Change your baby's sleeping position: take turns which way your baby faces in the bassinet or crib.
⭐️Switch it up: meaning to change play positions throughout the day (see our Instagram post on November 21, 2022)