Flat Head Syndrome (Deformational Plagiocephaly)
Flat head syndrome (deformational
plagiocephaly) is when a baby’s head develops a lasting flat spot. The flat spot may
either on one side of the head or on the back of the head. This happens when a baby
sleeps in the same position most of the time or because of problems with the neck
This condition is different
from craniosynostosis. In craniosynostosis, a baby’s skull bones fuse together before
they are supposed to. In deformational plagiocephaly, the skull bones don't fuse.
The skull flattens when a baby’s
head stays in one position for long periods of time. Sometimes a baby is born with
flattening because of a tight space in the uterus. This may happen if you are having
twins or other multiples. Other factors that may increase the risk for flat head
Muscular torticollis. This is a problem that is present at birth (congenital). One or more of the neck muscles
is extremely tight. So the baby’s head stays in the same position.
Early birth (prematurity). The skull bones of premature babies are softer. And many premature babies spend a
lot of time in the hospital on respirators with their heads in the same position.
Back sleeping. Babies who sleep on
their back or in a car seat without changing positions for long periods of time can
develop flat heads. But to reduce the risk for SIDS (sudden infant death syndrome),
babies should always sleep on their back until they are 1 year old.
A baby is more likely to have this condition if any of the following are true:
- They are the first-born child
- The baby is a boy
- The baby was born with the help of
forceps or vacuum extraction
- The baby has torticollis
This problem may not be noticeable or present at birth. It may develop during the
first few months of life. A flat spot may appear on either side or the back of the
head as the baby grows.
Your baby’s healthcare provider will check your baby’s head from all
positions. They will also feel your child's head, particularly along the suture
lines. Your baby’s healthcare provider will also take measurements of your baby’s
to figure out how serious the condition is.
Treatment will depend on your
baby’s symptoms, age, and general health. It will also depend on how severe the
condition is. Some babies don't need treatment. The condition may go away when the
begins to turn their head on their own or sit up.
For other babies, treatment may include:
- Changing your baby’s sleep position by
turning their head to the opposite side
- Having your baby spend time on their
tummy (stomach) while awake and supervised
Your baby may need to wear a
special band or helmet if the problem is moderate to severe and turning the baby’s
hasn't helped. Helmets are often made of an outer hard shell with a foam lining.
Gentle pressure helps to reform the head. As the head grows, adjustments are
made. Some studies have shown that helmets weren't helpful for moderate to severe
The average treatment with a helmet
is often 3 to 6 months. This will depend on the age of the baby and the severity of
condition. Your baby's healthcare provider will need to check your child carefully
often. Helmets must be prescribed by a licensed healthcare provider with craniofacial
As babies grow and develop, they will move and reposition themselves. This removes
the pressure that may have caused the condition. But if the flat spot is moderate
to severe, it may not get better on its own. If treatment is not started early enough,
the head may continue to be uneven.
This condition has increased since
the national Back to Sleep campaign began. This campaign was started to decrease deaths
from SIDS. It has been very successful. It is important that young babies who can't
over or move on their own not be placed on their belly to sleep. To help prevent a
- Let your baby have tummy time while you are watching.
- Reduce the time your baby spends in
car seats and baby carriers.
- Hold your baby, giving the baby time to be upright.
When to Call a Healthcare Provider
If you notice that your baby’s head is misshapen or you are worried
about a flat spot, have your baby checked by their healthcare provider.
- Flat head syndrome (deformational plagiocephaly) is when a baby’s head develops a
lasting flat spot, either on one side or on the back of the head.
- With this condition, the skull bones
don't fuse together.
- The first step in treating this condition is to change your baby's head position.
- Some cases need the baby to wear a
helmet or remodeling band.
- Mild cases often go away on their own
with simple ways to change a baby's head position.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a
new diagnosis, and any new medicines, treatments, or tests. Also write down any new
instructions your provider gives you for your child.
- Know why a new medicine or treatment
is prescribed and how it will help your child. Also know what the side effects
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s
provider after office hours. This is important if your child becomes ill and you have
questions or need advice.