Plagiocephaly is Common, but Some Babies Don’t Grow It Out

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With early intervention and the right care, the vast majority of babies see their head shape return to normal as they develop and begin moving more. However, if the flattening is severe and left untreated, it can persist into later years, even into adulthood. Fortunately, there are many ways to prevent or correct plagiocephaly, especially when action is taken early.

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What Causes Plagiocephaly?

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Plagiocephaly or flat head syndrome, is a condition where a baby’s skull becomes flattened on one side or in certain areas. Recognizing plagiocephaly early is important, as timely intervention can help correct the shape of the skull and prevent future complications. Here’s how to identify it:

 

Observe the Shape of the Head

• Flat Spot: The most common sign of plagiocephaly is a noticeable flat spot on one side or back of the baby’s head.

• Uneven Forehead: In some cases, the forehead may appear uneven, with one side protruding more than the other.

• Asymmetry of the Ears: Plagiocephaly can also cause the ears to be misaligned. One ear may appear to be pushed forward or lower than the other.​​

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Check the Head from Above

• Observe from Above: To assess plagiocephaly accurately, lay your baby on a firm, flat surface (not soft or cushioned). Then, lower yourself by bending your knees so that you are at eye level with the top of your baby’s head.

• Look for Flattening: From this position, look directly down at the top of your baby's head. This will allow you to see if there is any flattening or asymmetry in the shape of the skull. A flat spot may be more visible when viewed from above, and you can also observe if one side of the head appears more pronounced than the other. Also asymmetry of thee ars and forehead can be best observed in this position.

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Check for Facial Asymmetry

• In some cases, the flattened area on the skull may cause subtle asymmetry in the baby’s face. For example, the eye or cheek on the affected side may appear slightly different in shape or position.​

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Consult Skully Care

• If you notice any signs of plagiocephaly, it’s important to consult Skully Care or a pediatric physiotherapist. With Skully Care you can examine the baby’s head shape yourself and, if necessary, get recommend further assessments or treatments.

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Did You Know? The Position in the Womb Can Contribute to a Preferred Head Position

It’s likely that the position your baby was in while in the womb plays a key role in the development of a preferred head position, also known as torticollis or positional preference. Studies show that around 65% of babies spend most of their time in the womb lying with their backs against the left side of the mother’s belly. This natural position causes the baby’s head to turn slightly to the right.

Interestingly, about 65% of babies with plagiocephaly (flat head syndrome) show a preference for turning their head to the right and experience flattening on the right side of their skull. This is probably not just a coincidence, but rather a result of the baby's position while growing in the womb!

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The Role of Preferred Head Position and Habits After Birth

After birth, many babies develop a preferred head position due to the asymmetrical position they had in the womb. This can quickly become a habit, where the baby tends to lie with their head turned to one side—often to the right. Over time, this becomes their "relaxed" or "normal" resting position, and they start to feel most comfortable in this posture.

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You may notice this habit even during sleep: many babies can only fall asleep when they’re positioned in their preferred head turn. Once the baby is asleep, you can gently turn their head to the other side. This preference helps the baby adjust to the overwhelming new world they’re experiencing, offering comfort and a sense of predictability. Babies quickly learn the patterns around them—such as the sound of the tap running while a bottle is being prepared, or the routine of getting undressed for a diaper change—and also the posture they need to relax and fall asleep.

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To help reduce this preference, it’s helpful to encourage your baby to lie on the opposite side when they are awake. The side-lying position can be a great way to do this. The more you practice positioning your baby on the other side of their face during awake times, the more they will get used to it. This can help eliminate the preferred head position and encourage the head to grow more symmetrically over time.

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How Does Plagiocephaly Go Away?

As babies grow, they start rolling to the side and to prone position. So, at that time the baby variates far more in their position. As a parent you can prevent flat head syndroom by taking early action to address your baby’s head shape. Here’s our advice on how to get started.

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When to Take Action on Plagiocephaly

If the flattening of your baby’s head seems to be getting worse, it's important to take action. The earlier you start, the better. By positioning and carrying your baby in certain ways, you can help encourage symmetrical growth of the head. This is why many countries offer advice on preventing plagiocephaly right after birth.

As mentioned, nature helps the head shape to correct itself over time, but if the flattening is too severe, the child might have asymmetry or a flat spot that lasts for life. Fortunately, with the latest technology from Skully Care, you can measure the degree of head flattening yourself. Using an app, you can take a photo of your baby’s head and receive the results within minutes. This information helps guide you on the next steps to take as parents.

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There are many effective ways to help your baby’s head regain a more normal shape, and below you’ll find tips from a pediatric physiotherapy expert on how to support your baby’s development.

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Start with Positioning

The best time to begin preventing flat head syndrome is right from the start—ideally as soon as you notice your baby has a preferred head position. Babies often develop a preference for looking to one side, and this can lead to a flat spot forming on the side of the skull that they favor.

If you have already tried the three steps and the preference or flatness persists by the time your baby reaches 6 weeks, it may be time to seek professional help. Consult a pediatric physiotherapist specializing in infant care, who can assess your baby’s head shape and provide targeted exercises or tips to help correct it.

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Sometimes, a baby’s head preference may not be noticeable right away. If you notice a flat spot forming or a significant tilt in your baby’s head, don’t wait to seek help. Early intervention is key to achieving the best outcome. It needs to grow to improve the shape of your baby’s head, and the most significant growth occurs during the first year.

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Extra tips: 

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• Tummy Time:
  Make sure you are giving your baby enough tummy time while they are awake. This helps strengthen the neck muscles and prevents them from lying on their back too often, which can cause flattening. Start with short sessions and gradually increase the time as your baby gets stronger. 

• Lie on the Side (When Awake):
  When your baby is awake and supervised, you can also encourage side lying on the non-preferred side. This helps relieve pressure from the flattened area and allows for more balanced head development. It is not a problem if your baby lies on this one side even from nap to nap. On the contrary, this helps the head to grow more symmetrically and ovally. 

 

Monitor progress with the Skully Care App 

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You don’t have to do this alone! Our Skully Care app is a fantastic tool to help you monitor your baby’s head shape and track your progress. Here’s how it works: 

1. Take a photo:
   If you notice a flat spot or asymmetry in your baby’s head, take a photo using the Skully Care app. This will give you an initial measurement of the degree of flattening. 

2. Take action:
   Start with the repositioning techniques and other tips you've read here. Give it a few weeks—around 2-4 weeks—and then take another photo to see if your efforts are making a difference. 

3. Evaluate the results:
   The app will show you if there has been improvement, and if not, you can adjust your efforts accordingly. This feedback helps you stay on track and take the right steps at the right time. 

4. Therapist support:
   If you need additional guidance, our team of Skully Care therapists are there to help you. They can call you and provide tailormade advice based on the most recent research. They are experts in the latest methods and can give you the support you need to ensure that you’re doing the best for your baby.

 

Conclusion

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With early and consistent attention, many babies can avoid needing helmet therapy altogether. By adjusting their sleeping and resting positions, offering tummy time, and monitoring progress with tools like the Skully Care app, you can help your baby’s head shape improve naturally. And if you need extra support, the therapists are there to help guide you through the process. By taking action early, you’re giving your baby the best chance for a balanced, healthy head shape—and potentially preventing the need for a helmet later on. 

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