What is Positional Plagiocephaly?

Positional Plagiocephaly, flattened head and flat head syndrome are all the same condition.   It is where the back or one side of the baby’s head is flattened. It is usually first noticed when the baby is around 2- 3 months old. The ear on the flattened side may be pushed forward and in more severe cases, another part of the skull may appear bulging. Parents are usually the first to notice the changes.

What causes it? 

Babies are born with soft skulls. In fact so soft, that if they regularly lie in the same position, their heads will become flattened. You can tell what position a baby with flat head syndrome sleeps in- eg a baby who has a flat right side of her skull will sleep with her head turned towards the right. The incidence of flat head syndrome increased dramatically when we started to place babies on their backs to sleep in order to prevent cot deaths. The modern transport systems for babies have also had an effect on it- the car seats now go directly onto the pram base and therefore the baby is in the same position for longer periods of time. Premature babies are at higher risk. Torticollis also puts a baby at higher risk. Torticollis is a condition where there is a swelling in the muscle in one side of the neck, causing the baby to tilt her head to one side. This is easily treated with physiotherapy.

Prevention/Treatment 

Even though it increases the risk of a flattened head, it is still very important to put your baby to sleep on her back as this helps to prevent cot deaths. You can help to prevent a flattened head by changing the head position of your baby’s head each night eg one night head turned towards the left, the next towards the right and the next facing upwards. If your having difficulty with this, try placing her mobile or other hanging toy, on a different side each night as this will encourage her to look and therefore turn her in that direction. During the daytime, give your baby lots of tummy time play as this to can help prevent a flattened head and also it helps the muscles involved in crawling to develop.

Generally as a baby becomes more active, the head shape will naturally return to a more rounded shape. 

If using the methods above and if you baby becomes more mobile, there is no improvement or if it continues to worsen, it is recommended that you see your GP for an assessment of the condition.