Move and Play Paediatric Therapy

Move and Play Paediatric Therapy

“What is plagiocephaly?” you may ask.  While few parents might have heard this ancient Greek word before, many would know or have about the condition that this word refers to – flattened or oblique head shape.

Plagiocephaly, or flattened head shape is a relatively common condition that occurs in young babies.  The approximate incidence of flattened head shapes in babies aged 7-12 weeks is up to 40%.  Although most babies will get better over time, as they grow or with appropriate treatment, seeing a flat spot on your babies head can cause lots of concern for new parents.

This article aims to share with you some important things you should know about flattened head shapes in babies, so you can give your baby the best chance of avoiding or correcting this common condition:

Four quick facts about flattened head shape in babies:

  1. The most common flattened head shape presentation is Plagiocephaly, where there is flattening on the back of the head off to the left or right side of the head. However, there are also two much less common flattened head shape presentations – flattening on the centre of the back of the head (called Brachycephaly) or flattening on the two sides of the head (called Scaphocephaly)
  2. Lots of babies are born with slightly flattened or misshapen heads due to being squished in the birth canal in the weeks leading up to birth or in some way during the delivery process. However, these variations in a baby’s head shape should resolve within the first 6 weeks of life.
  3. If your baby has a flattened head shape after 6 weeks of age, it is likely could be due to persistently having their head positioned to one side. A baby’s skull is still soft (an important feature that allows their head to grow rapidly), so persistently lying on one side will mean that the pressure on that side of their head will ‘flatten’ the soft skull.
  4. The head shape changes seen in plagiocephaly (or brachycephaly/scaphocephaly) from the pressure on the skull can range from mild to severe. When the flattening is only mild, it only affects the back of the head.  However, when the flattening becomes moderate or severe, it can affect other changes in the skull shape such as a bulging or prominence of the forehead at the front, one ear coming forwards compared to the other, or asymmetry in facial features such as one cheek appearing bigger.
  5. Flattened head shapes due to positioning are purely a cosmetic condition. Head shape changes are not thought to have any impact on the baby’s developing brain.

And one bonus fact:

  1. A flattened head shape due to persistent positioning can sometimes be prevented, and can be well treated if treated early – which is why you almost never see school aged children with flattened head shapes!

Preventing a flattened head shape in your baby:

Ideally, we would like to prevent all babies from developing a flattened head shape. Parents can help to prevent their baby developing from a flat spot on their head by:

  • Ensuring baby has their head turned to a different side each sleep. This prevents them from spending too much time on one side of their head which can cause flattening.
  • Giving baby plenty of tummy time when they are awake. F or typically developing babies tummy time can start from the day they are born and can either be on Mum or Dad’s body (eg: chest or lap) or on the floor.
  • Encouraging baby to learn to control and move their head when they are lying on their back by making eye contact and encouraging them actively turn their head to each side. This helps them to develop neck strength and awareness of both sides, so that they are more likely to turn their head to both sides and develop good control of their heads.
  • Using various ways to hold and carry baby to ensure the baby has opportunity to turn their head both ways when upright.

If your baby does develop a flat spot, it is best to seek treatment early:

Getting treatment for your baby’s flattened head shape early gives you the best chance to make improvements in their head shape and get their head looking symmetrical again.

Treatment for a flattened head shape can involve stretches to tight muscle in the neck or body, exercises to encourage your child to learn to move their head to the other side and hold their head in the middle, and providing you with strategies to try to keep the pressure off the flattened side of their head as much as possible.  The natural growth of a baby’s brain and skull in an outwards direction also helps to correct any flattened areas over time as your baby grows.

Sometimes a child might benefit from the use of a helmet to treat their flattened head shape.  But these are usually reserved for babies who have more severe head shape changes.

What to do now?

If your baby does not have a flat spot – keep encouraging your baby to lie with their head to either side when sleeping, encourage them to turn their head to either side when awake, and give them lots of tummy time to help keep pressure off the back of their heads.

If you notice your baby does have a flat spot – never fear, seek out the help of your local children’s physiotherapist who can assess your baby’s head shape, assess your baby’s overall development, and help you get started on treatment for any head shape changes (you don’t need to see a doctor). Early identification and treatment is key to ensuring optimal outcomes for your baby?


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