Plagiocephaly is an uneven or asymmetrical head shape, or a flattened spot on the back or side of a baby’s head. This change in head shape can happen because newborn skull bones are soft and moveable.
Causes of plagiocephaly
Newborn skull bones are soft, thin and flexible. This means that the heads of newborn babies can change shape easily.
Newborn babies often have strangely shaped heads. This can be caused by the head’s position in the uterus during pregnancy, or it can happen because of the squashy passage down the birth canal. It usually fixes itself within about six weeks.
Some babies might look like they have a flat head or a flattened spot on the back or side of their heads. This condition is known as deformational plagiocephaly. It might happen because babies lie with their heads in the same position for a long time.
Deformational plagiocephaly can be mild, moderate or severe. It can affect the shape of the head, the position of the ears, and the symmetry of the forehead.
In some babies, more severe deformational plagiocephaly can be caused by tight neck muscles (congenital muscular torticollis), a strong preference for turning their heads to one side, or low muscle tone. Some babies with severe deformational plagiocephaly might also have a delay in the development of gross motor skills like rolling and crawling later in infancy.
Signs and symptoms of plagiocephaly
Your baby might have an uneven head shape, a flat head or flattened sections at the back or side of her head. Your baby’s ears might look uneven, and her forehead might be more prominent compared to the rest of her head.
When to see your doctor
See your General Practitioner (GP) or paediatrician if:
The GP or paediatrician can refer you to the right specialist for targeted help, if needed. This might be a paediatric physiotherapist, or a plastic surgeon.
Treatment of plagiocephaly
Often, mild deformational plagiocephaly doesn’t need treatment. There’s good evidence that it will improve as your baby grows. It should fix itself by the time your child begins primary school.
This is because your baby’s head shape will naturally improve as her head grows and her gross motor skills develop. When your baby starts to spend less time on her back and more time on her tummy or sitting, there’ll be less pressure on the back of her head.
If your baby needs treatment, your doctor will refer you to a paediatric physiotherapist, paediatrician or a plastic surgeon, who’ll develop a treatment plan.
Treatment might include:
Physiotherapy and counter-positioning are likely to improve your baby’s plagiocephaly, especially when these treatments start as soon you notice your baby’s head shape.
For severe plagiocephaly, your specialist might recommend that your child wears a specially fitted helmet, which takes the pressure off the flat spot and allows your child’s head shape to improve as her head grows.
It won’t help to take your child to a chiropractor for back or neck adjustments. Research doesn’t support this as a treatment for babies with plagiocephaly.
There are several things you can do to help prevent your baby from developing deformational plagiocephaly:
If your baby has tight neck muscles (congenital muscular torticollis), it’s a good idea to ask your GP about seeing a paediatric physiotherapist for gentle neck stretching exercises.
Sleeping baby on her back is the safest sleeping position. Putting your child to sleep on her stomach or side increases the risk of sudden unexpected death in infancy (SUDI) including Sudden Infant Death Syndrome (SIDS) and fatal sleeping accidents.