Most babies are born with some sort of abnormal shape to their heads due to the pressure of the birth canal during delivery. Most babies’ heads will return to normal shape within a few weeks of birth. Some, however, do not return to normal, and this is what doctors call Plagiocephaly or Flat Head Syndrome. There is typically either an asymmetrical look to the infant’s head, or a flat spot somewhere on the head. Most parents should be concerned at around six weeks if the child’s head stays abnormally shaped or develops a flat spot. Some children with Flat Head Syndrome can also have abnormally shaped ears, a prominent forehead, and uneven facial features.

What Causes Flat Head Syndrome?

There are a few different reasons that a child can develop Flat Head Syndrome other than pressure during delivery. During the 1990s, parents were continuously warned about the dangers of SIDS and were advised to put their babies to sleep on their backs to reduce the risk. When the child continuously sleeps in one spot, the pressure from the mattress can cause Flat Head Syndrome.

Another reason that an infant can develop this condition is if the womb is constricted somehow. This happens often when there are twin pregnancies, if the baby is breach and becomes wedged within the womb, or if the mother’s pelvis or uterus is very small. If, after six weeks or so, you notice that your baby is developing a flat area on her head, or if the original problem has not corrected itself, it is advisable to check with your child’s pediatrician. In most cases, the pediatrician will refer the parents to a craniofacial specialist or pediatric neurosurgeon.

Getting a Diagnosis

If your child’s condition is more than just the normal asymmetry, either a pediatric neurosurgeon or a craniofacial specialist will be able to tell you if action will need to be taken to treat your child. In most cases, the specialist will perform an x-ray of your child’s skull to rule out a condition called Craniosynostosis. This is a condition that displays similar symptoms but requires different treatments.

Once the specialist has determined that your child suffers from Plagiocephaly, he will then recommend a course of action.


The most common recommendation a specialist will make is reposition therapy. This is simply where you place your child in a different sleeping position and avoid putting pressure on the flat spot. Typically, this works best in children under six months old. After this age, it is difficult to control the way your child sleeps. Your specialist may also recommend a specially tailored sleeping helmet, specifically molded for your child’s skull and will straighten out the shape of the head. Usually, reconstructive surgery is the very last resort and only if the case is extremely severe.

Preventing and Correcting Flat Head Syndrome

If your child needs reposition therapy, which is what most parents hope for, you will simply need to make sure your child doesn’t continually sleep in the same position. Your specialist can tell you different ways to position your child so there will be a lower risk of SIDS while you are correcting the Flat Head Syndrome. If the child must wear a special helmet or band (called a cranial orthotic), they will probably have to wear it for 23 to 24 hours out of the day. Usually, this type of treatment continues for around six months at a time.

In order to try to prevent Flat Head Syndrome, there are a few things you can do. Do not place your child in the very same position every time they sleep. Make sure they are placing pressure on different areas rather than the same one over and over again. You may try to place your baby on her side to sleep as well as on her back. Limiting her time in a carrier or swing is advisable, as well. Switch from side to side when you are bottle or breast feeding and you should reduce the risk of this condition greatly.

While in most cases your efforts and those of the pediatric specialist will pay off, sometimes there will be a degree of flatness left. If the specialists determine that the amount of flatness is too small to cause problems, it will most likely be hidden when your child’s hair grows.

This can be a scary condition, but overall, the success rate of correction is high. However, the earlier your child is treated, the better the chances will be of correction.