Positional plagiocephaly is the term used to describe asymmetric or flattened head shape, usually on one side or the back of your baby’s head.  It is caused by pressure on the bones of the skull before or after birth.  Many babies develop plagiocephaly by sleeping regularly in one position, or by spending extensive time sitting in the same position in a car seat or swing.

Plagiocephaly is not genetic, and can be caused by:

  • Torticollis, or muscle tightness on one side of the neck, so the baby prefers holding the head to one side or in one position.
  • Prematurity: skull bones are softer than full term babies, and they tend to move their heads less often.
  • In utero crowding: this can occur when there are twins or multiples, or if the mother has large fibroids or an abnormally shaped uterus.

Plagiocephaly is different from craniosynostosis, which involves more serious malformations of the skull bones and usually requires surgery.

Diagnosis of plagiocephaly

Positional plagiocephaly is diagnosed based on an examination of your child’s head and the history of your child’s birth and sleeping patterns.  The health care provider will be looking at the areas of flatness, the position of the ears and the movement of the neck.

Referring providers: Please include head circumference growth chart with medical records when referring a patient.

What is the treatment for plagiocephaly?

Most children with this disorder respond very well to non-surgical, minimally invasive interventions like:

  • Sleep position changes.
  • Increasing “tummy time” when awake.
  • Exercises to allow for full movement of neck.

If repositioning and these interventions don’t work, the Plagio team may recommend a special helmet for moderate and severe positional plagiocephaly. Helmets treat your baby’s uneven head shape and are usually worn for 2-3 months for best result.  A rehab specialist will meet with you and the Plagio team to do head measurements and help evaluate if your child would benefit from the use of a remolding helmet.

To prevent plagiocephaly, always place your baby to sleep on their back.  This is the safest way for your baby to sleep.  When awake, give your baby active “tummy time” and find ways for your child to play and move while on their tummy, several times each day.