Flat head and what to do about it…

Plagiocephaly is a very common craniofacial problem.
Positional or deformational plagiocephaly or flat head is a condition that may develop while in the uterus, at birth or during the first few months of life.

A small number of babies can develop positional plagiocephaly because of tight muscles on one side of the neck, a condition called torticollis. Plagiocephaly is more common in babies who have not had their head position varied while sleeping on their back and babies who have less than five minutes of tummy time per day in the first six weeks of life.

If the condition is not managed, it may alter the baby’s physical appearance causing uneven growth of the face and head.

Sample of plagiocephaly

Picture credit: The Royal Children’s Hospital Melbourne Australia

It is common for a newborn baby to have an unusually shaped head. Your baby’s head should go back to a normal shape within about six weeks after birth. Sometimes however it does not or even a further flattening on the back or on the side of the head develops. This happens because the bones of a newborn baby’s head are thin and flexible meaning the head is soft and may change shape easily.

What can you do?

– Babies should sleep on their backs in the feet to foot position. It’s important to vary the position of your baby’s head from left to right. You can also position your baby’s bed differently in the room, encouraging them to look in the opposite direction.

– Tummy to play… You should encourage tummy time as soon as the cord fall of. Teach them it’s an enjoyable experience by frequently putting babies on their tummies for short periods of time. The stronger the neck and back muscles are the time will increase. Tummy time doesn’t have to happen on the floor only. You can hold your baby on your chest, put them over your lap, hold them on your arm (tiger in the tree position). Don’t forget to massage your baby in the tummy position.

– In some cases, you need to see a doctor. In Switzerland you will see your baby’s paediatrician who will decide if treatment is needed. The doctor may recommend your baby should have sessions with a physiotherapist. They will show you exercises you can do at home and depending on how your baby is responding, you will continue to see the physiotherapist once or twice a week for several weeks. Sometimes when the uneven head shape is more severe, you may need to see a paediatric neurologist who will decide if a cranial remodelling helmet is needed.

I have looked after babies with positional plagiocephaly and have noticed it’s very common with twins. They had beautiful recoveries without the need of a helmet, just with hard work from parents and paediatric physiotherapists. I’ve also noticed that they were reaching their physical developmental milestones faster because of the strength their gained through the exercises.


Marta @ Maternity Consultancy


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