Topic Overview

What is positional plagiocephaly?

The shape of a newborn's head may be affected by how the baby was positioned in the uterus, by the birth process, or by the baby's sleep position.

Positional plagiocephaly (say "play-jee-oh-SEF-uh-lee") means that a baby's head is flat in the back or on one side, usually from lying on the back or lying with the head to one side for long periods of time. Sometimes a baby's forehead, cheek, or ear may get pushed forward slightly on one side.

Babies can get a flattened head during the first few months of life. This is especially true since doctors began recommending putting babies down to sleep on their backs to reduce the risk of sudden infant death syndrome (SIDS).

Babies that are born early are more likely to get a flattened head. This is because their skulls are softer than in full-term babies.

How does a baby get a flattened head?

Lots of time spent in a crib, in car seats, or in carriers or similar seats may lead to a flattened head. But you can do things to help keep your baby's head from getting flat, such as giving plenty of "cuddle time" by holding your baby upright.

Torticollis, or "wryneck," can also lead to a flattened head. It's a problem with your baby's neck muscles that causes the head to turn to one side. If your baby has torticollis, your doctor may recommend neck exercises to help your baby turn his or her head.

How is a flattened head diagnosed?

Doctors can diagnose positional plagiocephaly by looking at the shape of a baby's head. The doctor will check to make sure that your baby doesn't have a different condition that affects the shape of the head.

How can you prevent or treat a flattened head?

These tips can help prevent a flattened head:

• Provide plenty of tummy time while your baby is awake. This means letting your baby lie down on the stomach while you are watching closely. This also helps your baby build strength and motor skills.
• Provide plenty of cuddle time by holding your baby in an upright position.
• Change the direction your baby lies in the crib each night. For example, have your baby's feet point one way in the crib one night and then switch the direction the next night. Alternate each night after that. This encourages your baby to turn his or her head a different way to look at people or things in the room.
• Change the location of the crib in your baby's room. This also encourages your baby to turn his or her head in a different direction. Babies usually turn their heads away from the wall, toward the inside of a room.
• If your baby has a flattened head, encourage your baby to turn the rounded side of the head toward the mattress. Use the tips above, such as changing the crib location or the direction your baby lies in the crib.
• Avoid having your baby spend too much time in car seats, carriers, or similar seats. But always put your baby in a car seat when he or she is riding in a car.

If your baby has a flattened head, there are things you can do to help your baby's head become rounder. Encourage your baby to turn the rounded side of the head toward the mattress. Use the tips above, such as changing the crib location or the direction your baby lies in the crib. Other treatments may include exercises recommended by your doctor or a physiotherapist. If your baby's head shape does not get better by around 6 months of age, be sure to let your doctor know.

If the flattened head is severe or other treatments haven't worked, your doctor may recommend treatment such as a custom helmet. The helmet can help correct the shape of your baby's head. Surgery usually isn't recommended except in rare cases.

How can you reduce the risk of SIDS?

To help reduce the risk of SIDS, place your baby on his or her back to sleep. Even if your baby has a flattened head, don't stop placing your baby on his or her back to sleep. Just offer plenty of tummy time and cuddle time, and change your baby's head position.

Talk with your doctor about how to position your baby so that you don't increase your baby's risk of SIDS.