Understanding Flat Head Syndrome

Understanding Plagiocephaly: What Parents Need to Know About Flat Head Syndrome

As a new parent, you’re likely keeping a close eye on every little detail of your baby’s development. So when you notice a flat spot on your baby’s head, it’s natural to be concerned. One possible cause is plagiocephaly — commonly known as flat head syndrome.

But what exactly is plagiocephaly? What causes it, and when should you seek help? This blog breaks it all down.

What Is Plagiocephaly?

Plagiocephaly is a condition where a baby’s head develops a flat spot or becomes asymmetrical. It’s most often seen in infants due to the soft and malleable nature of their skulls, especially in the first few months of life.

What Causes Plagiocephaly?

Several factors can contribute to the development of flat head syndrome:

1. Positioning in the Womb

Sometimes babies find a comfortable position in the womb and stay there throughout the pregnancy. If their head remains pressed against the uterus wall, it can limit skull rounding and lead to flattening.

2. Limited Space During Pregnancy

Plagiocephaly is more common in multiple births, like twins or triplets, due to restricted space. When babies are tightly packed, their heads can become flattened from prolonged pressure.

3. Pressure During Delivery

Prolonged time in the birth canal can also affect head shape. The pressure during delivery can lead to flattening or asymmetry in the skull.

4. Extended Time on the Back After Birth

The "Back to Sleep" campaign, launched in 1994 to reduce SIDS (Sudden Infant Death Syndrome), encourages placing babies on their backs to sleep. While this has been a life-saving recommendation, it also increases the risk of plagiocephaly unless balanced with supervised tummy time during waking hours.

💡 Babies between 1–4 months sleep an average of 14–15 hours a day — that’s a lot of time with pressure on the back of the head.

5. Torticollis (Tight Neck Muscles)

Torticollis is a condition where one side of a baby’s neck muscles is tighter than the other, causing them to consistently turn their head to one side. This can lead to or worsen plagiocephaly if not addressed.

6. Reflux or Developmental Delays

Babies who struggle with tummy time due to reflux or delayed motor development may not spend enough time off the back of their head, making it harder for the skull to round out naturally.

How Common Is Plagiocephaly?

Since the "Back to Sleep" campaign began, the incidence of plagiocephaly has increased significantly. According to a 2013 study published in Pediatrics, about 46.6% of infants aged 7–12 weeks show signs of plagiocephaly.

📚 Source: Pediatrics. 2013 Aug;132(2):298-304. doi:10.1542/peds.2012-3438

Can My Baby’s Head Shape Improve on Its Own?

Yes, many babies experience some degree of natural correction, especially when caught early. However, improvement depends on several factors, including:

• The baby’s age

• The severity of the flat spot

• Whether torticollis is present

• The baby’s developmental progress

👉 Most natural correction occurs by 4 months of age. After this point, the skull becomes less malleable, and full correction is less likely without intervention.

When Should You Schedule an Evaluation?

Timing matters. Treatment for positional plagiocephaly works best while your baby’s head is still growing rapidly.

🗓️ If you notice flattening or unevenness in your baby’s head shape, the ideal time for an evaluation scan is between 3–4 months of age. This allows for the most options in care and the best potential outcomes.

When Is the Best Time to Start Helmet Therapy?

If helmet therapy is recommended, the ideal window to begin treatment is between 4–6 months of age. During this time, the skull is still growing quickly and responds well to gentle correction.

⏳ While treatment can still be effective up to 12 months of age, it often requires more time and may not achieve the same level of correction as earlier intervention.

Final Thoughts

Plagiocephaly is common and treatable — especially when caught early. If you’re concerned about your baby’s head shape, don’t wait. A quick evaluation can provide peace of mind and open up opportunities for early, effective treatment.

Want to learn more about evaluation options or helmet therapy? Reach out to a licensed clinician or pediatric specialist near you.

Tiny Wonders offers virtual head shape consultations; you can schedule online at:

https://tinywonders.janeapp.com/