Plagiocephaly: What is Flat Head Syndrome?

by Meghan

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Plagiocephaly, more commonly known as Flat Head Syndrome, is estimated to affect as many as 46% of babies each year.  However, it is 100% preventable!  Many parents are unfamiliar with what it is, how to prevent it, detect it and most important of all, how to correct it should your baby be affected.  I recently interviewed Reeti, a Pediatric Occupational Therapist from Baby Begin to learn more about this increasingly common issue, and how we, as parents, can help our babies, without significant, ongoing and costly medical intervention.

Plagiocephaly - What is Flat Head Syndrome?

Q&A with Reeti from Baby Begin

What is plagiocephaly?

Plagiocephaly is a condition that develops when a baby’s rapidly growing skull attempts to expand and meets some type of resistance. The resistance can be either prenatally in the mother’s womb or after delivery because the baby’s head is pressed against a surface. This results in an asymmetrical head shape in which one side of the back of a baby’s head is flatter than the other.

What are the causes of plagiocephaly?

Plagiocephaly can occur from a number of different causes.

  • Plagiocephaly can occur in a mother’s womb because of the way the baby is positioned against her uterine wall. This occurs more often with multiple babies.
  • Plagiocephaly can be caused by spending extensive time in the same position in a container, such as a car seat, swing or rock-n-play.
  • Babies with torticollis, which is the tightening of neck muscles, often have plagiocephaly because their heads are constantly in the same position, tilted to one side.
  • Plagiocephaly occurs more often in premature babies whose skulls are even more pliable than full-term babies. Premature babies may spend a great deal of time lying down in one position as they receive treatment for other medical complications.

What are the long-term implications of Flat Head Syndrome?

Flat Head Syndrome can impact more than just physical appearance.

  • Along with the head asymmetry, babies with plagiocephaly, aka Flat Head Syndrome, often have facial asymmetries.
  • Ear asymmetries can cause increased ear infections.
  • Asymmetrical head shape can make wearing glasses and sport/bike helmets challenging.

What can I do with my baby to prevent plagiocephaly?

There are a number of easy changes parents can implement with their babies to prevent plagiocephaly.

  • Let the baby have tummy time throughout the day.
  • Limit baby’s amount of time in containers (swings, car seat or rock-n-play).
  • Have baby sleep on flat surfaces.
  • Try baby wearing or holding baby during the day so that he is off the back of his head.

My baby hates tummy time.  How can I help her enjoy it more?

Not every baby loves being on their tummy, but there are a few things you can do to make them more comfortable and enjoy it more.

  • When doing tummy time on the floor, lie down facing your baby and sing and talk to her.
  • Place a mirror and/or toys in front of your baby.
  • Lay the baby on your chest or lap to do tummy time.
  • Lay your baby on a Boppy pillow to do tummy time.

How do I check my baby’s head for flat spots?

Look over the top of your baby’s head with a bird’s-eye view and check to see if there is any flatness on the back of his head.

What should I do if I think my baby already has a flat spot on her head? Is plagiocephaly reversible?

If you are concerned your baby has a flat spot, have your pediatrician give you a referral to occupational/physical therapy. Through repositioning and occupational/physical therapy, plagiocephaly is fixable. The earlier treatment starts, the better chance of a good outcome.

Does this mean my baby will have to wear a helmet?

In most cases, mild to moderate plagiocephaly can be treated with repositioning and physical/occupational therapy prior to 6 months of age. The earlier treatment starts, the better the results.  Most babies we see require only two to four treatments.  We provided occupational/physical therapy visits in the baby’s home where he or she is most comfortable.

Babies with more severe plagiocephaly and babies over six-months-old will most likely require a helmet. There are several brands of helmets that cost different amounts. For helmets, your baby will have to attend regular office visits.

Are treatments for plagiocephaly covered by most health insurances?

Plagiocephaly is a diagnosis that is covered by most health insurances.

How does Baby Begin help families dealing with plagiocephaly? What if I live outside the Dallas and Houston area?

Baby Begin provides expert occupational/physical therapy services to babies in the comfort of their own home. We teach parents about positioning and show them exercises to help round out their baby’s head. We provide lots of parent instruction and home programs.

We also treat torticollis, tightness in the neck muscles, which is often present with plagiocephaly. Most babies only require two to four treatments.

If you live outside of Dallas or Houston, Baby Begin can provide Skype consultations.  Contact Baby Begin for details.

A huge thank you to Reeti and Baby Begin for answering all my questions, and helping inform my readers about plagiocephaly! To learn more about plagiocephaly, torticollis, and Baby Begin, their team and services, please visit their website at is Flat Head


Has your baby or a baby you know suffered from plagiocephaly?  What course of treatment did you pursue?  If you enjoyed this post, be sure to follow our Babies board on Pinterest for more great insights into your baby’s first year.

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About Reeti

Reeti is a Pediatric Occupational Therapist who loves working with babies. She has been treating babies with plagiocephaly and torticollis for 14 years in the clinic, hospital and home settings. She enjoys educating families, physicians and other therapists. When she is not helping babies round out their heads, she is busy playing soccer, swimming and reading with her own two children.

About Baby Begin

Baby Begin is a leading provider of infant physical therapy, with unmatched expertise in baby flat head prevention. Offering home therapy for plagiocephaly and torticollis, the therapists at Baby Begin are able to provide real assistance to families, in the setting where the baby feels most comfortable. Early intervention is the key to success, so if you have concerns about your baby’s head shape, contact Baby Begin today to learn how we can help.  Contact Baby Begin.

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