Plagiocephaly (flat head) in babies: Why Early Attention Matters
Noticing a flat area on your baby’s head can be worrying. You may wonder whether it will improve and what it could mean for your baby’s growth. Positional plagiocephaly is common. It develops because a baby’s skull is soft and can change shape when pressure is placed on the same area for long periods. It may be linked with a preferred sleeping position, tight neck muscles, premature birth or difficulty turning the head.
Plagiocephaly is usually diagnosed by looking at your baby’s head. A trained children’s health practitioner will check the shape of the skull, the position of the ears and forehead, and how easily your baby turns their neck. Scans are rarely needed. However, further medical assessment is important when the head shape is unusual, a hard ridge can be felt, or the skull may not be growing normally.
Plagiocephaly was once thought to be only a cosmetic issue. Research has found that babies and children with plagiocephaly are more likely to have delays in movement, language or thinking skills. This does not mean that the flat head shape causes these problems. It may be an early sign that a baby is moving less freely or needs developmental support.
Treatment may include supervised tummy time, changing carrying and feeding positions, encouraging your baby to look both ways, and reducing pressure on the flat area while the baby is awake. Babies should always be placed on their backs to sleep.
Manual therapy is gentle, hands-on care. Chiropractic is one type of manual therapy. Physiotherapists and osteopaths may also use manual techniques. Research trials suggest that gentle paediatric manual therapy, together with parent advice and movement exercises, can improve neck movement and head shape.
Early assessment can provide reassurance and help your baby move, explore and develop with freedom.
Research references
1. Speltz ML, et al. Case-control study of neurodevelopment in deformational plagiocephaly. Pediatrics. 2010;125(3):e537-e542.
2. Collett BR, et al. Development at age 36 months in children with deformational plagiocephaly. Pediatrics. 2013;131(1):e109-e115. doi:10.1542/peds.2012-1779.
3. Collett BR, et al. Cognitive outcomes and positional plagiocephaly. Pediatrics. 2019;143(2):e20182373. doi:10.1542/peds.2018-2373.
4. Pastor-Pons I, et al. Effectiveness of pediatric integrative manual therapy in cervical movement limitation in infants with positional plagiocephaly: a randomized controlled trial. Italian Journal of Pediatrics. 2021;47:41. doi:10.1186/s13052-021-00995-9.
5. Pastor-Pons I, et al. Efficacy of pediatric integrative manual therapy in positional plagiocephaly: a randomized controlled trial. Italian Journal of Pediatrics. 2021;47:132. doi:10.1186/s13052-021-01079-4.
General information only. Babies should continue to sleep on their backs on a firm, flat surface. Seek medical assessment if you are concerned about your baby’s head shape, neck movement or development.
