Skip to main content

Flat Head Syndrome (Plagiocephaly/Brachycephaly): What It Is and How to Fix It

I'm a mom of twins. I had never heard of plagiocephaly until my son was diagnosed with the condition.

Illustration of plagiocephaly and brachycephaly

Illustration of plagiocephaly and brachycephaly

What Is Plagiocephaly?

The word plagiocephaly, pronounced pla-gee-oh-sef-a-lee, is derived from the Greek words plagio (meaning slanted) and kephale (meaning head). It is a condition in which the head is asymmetrical in appearance. It is also known as flat head syndrome. It can affect either side of the head or the back of the head, and the condition can range from mild to severe. Since the back-to-sleep program started, the incidence of flat head spots has increased.

Although I had heard of flat head syndrome before, I was a stranger to the word plagiocephaly until I was told my son had developed it. He was born with a misshapen head. He is a twin, and this condition is relatively common in twin pregnancies. As a newborn, he also had a preference for turning his head to the right while he slept, which didn't help because that's where his flat spot was.

What is Brachycephaly?

Brachycephaly, pronounced brak-ee-cef-a-lee, is a similar condition to plagiocephaly. In the case of brachycephaly, however, the entire back of the head is flattened, instead of only one side. It can cause the skull to become wider than normal. The name of the condition is derived from the Greek brachys, meaning short, and kephal, meaning head.

Causes of Flat Spots

Plagiocephaly can occur in a few different ways. It results from constant pressure on a specific spot on the head.

  • Premature babies require time in the NICU (Neonatal Intensive Care Unit). Premature babies have weaker muscles and may not move their heads as much. Their bones and skull are a little softer than full-term babies.
  • Babies who are multiples (twins, triplets, etc.), like my son, due to growth restrictions, are more likely to develop plagiocephaly due to the limited amount of space available for them in the womb. They're in really tight quarters.
  • Breech presentation, where the head is in the mother's rib area may cause a flat spot. There just isn't much room for the baby in that position.
  • Sleeping, or simply being repeatedly laid down on one spot for too long. Back sleeping is the recommended sleep position in order to avoid SIDS (sudden infant death syndrome), but supervised tummy time and frequent re-positioning are recommended.
  • Toticollis or CMT (congenial muscular torticolis), a condition of the muscles being too tight on one side of the neck causing the head to be held in one position, can cause plagiocephaly as the child always has pressure to one spot on his/her head.
Flat head

Flat head

How To Round Out the Head

Re-positioning and tummy time will help correct most cases of an uneven skull. Once the baby can roll over and crawl, some spots will fill out all on their own. In fact, most cases of flat spots self-correct themselves as the baby learns to hold their head up, roll over, and crawl. However, in more severe cases a special helmet may be required. It is a helmet with openings where the flat spots are. It doesn't hurt or squeeze the head, it protects the flat spots from having any pressure put on them so that they can fill in. Babies who require cranial helmets must wear them for 23 hours a day, for months, so re-positioning should be attempted first to avoid having to use one.

I've read about special pillows that take the pressure off the spot. They are made from memory foam, and they cushion the flattened area, taking pressure off of it. Think of how often the flat spot of your baby's head is on a firm surface, be it the crib, swing, car seat, carrier, etc. I could see how a pillow like this could work. It's something I really wish I'd known about when my son was an infant.

Ways to Prevent Flat Head Syndrome

You can prevent and even correct flat spots from occurring in most cases. In order to do this, you simply re-position the baby's head frequently. Lay the baby on the rounded side of her/his head; this helps take the pressure off the soft, dented spot. Do not leave the baby in a car seat or car carrier for longer than necessary. Hold your baby more often, without any pressure on the spot. Practice plenty of tummy time with your baby. Tummy time can begin right away with a newborn. Tummy time is done while the baby is awake and fully supervised. Some babies detest it, so start off for just a couple of minutes at a time, a few times a day, and gradually increase the amount of time your baby is on his/her tummy. This is the route we took with our son. Your doctor should be able to provide you with the recommended amount of tummy time for the age of your baby. Laying baby across your lap while burping them counts as tummy time, as does laying your baby across your chest. Just make sure tummy time is only done under supervision and only while your baby is awake.

Tummy time isn't just good for helping round out or keeping the baby's head round. It also helps develop important muscles in the neck, torso, and head that are needed for the baby to be able to hold their head up, reach, and learn to roll over, and crawl.

If your baby has a preference for keeping his/her head to one side, you will need to speak with the pediatrician to ensure it isn't torticollis. If your baby simply has a preference for turning their head to one side, you can use sounds, lights, toys, etc. to encourage him/her to turn their head in the opposite direction. Perhaps moving their bed, swing, etc., into an area where they must turn their head in order to see what's going on, will relieve pressure from the flat spot.

Things to Keep in Mind

Plagiocephaly and brachycephaly will usually correct themselves, at least somewhat. They are cosmetic concerns; they do not affect the brain's development. Remember, no one is perfect, and no one's head is perfectly round. Once your child reaches school age, as mine has, even if they have a slight flat area on their head, and even if they keep a short haircut, it probably won't be noticeable to anyone but you.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2017 liataylor