Cleft and Craniofacial Center
Hasbro Children's Hospital

Deformational Plagiocephaly (Flat Head Syndrome)

Plagiocephaly, also called flat head syndrome, is a common condition in which an infant’s soft skull develops flattening on the back of the head. If the flattening is uniform across the back of the head, the condition is called brachycephaly.

baby wearing a protective helmet

If you have concerns about the shape of your newborn's head, contact a specialist as soon as possible.

Consult a plastic surgeon or neurosurgeon to make sure your child does not have craniosynostosis, a condition that results from the skull bones fusing too early. Craniosynostosis requires surgery that is only possible when the baby is three to four months old. Unlike craniosynostosis, head flattening in most cases doesn’t require corrective surgery. 

If you have questions or would like to set up an appointment, please call  401-444-2299.

What Causes Plagiocephaly  in Newborns?

The skull bones of infants are soft, so they are susceptible to the flattening that can occur because of continual pressure on one area. Babies can develop flattening because of sleeping on their back. This position was advocated by the American Academy of Pediatrics in its “Back to Sleep” campaign, which began in 1992 to reduce the risk of sudden infant death syndrome (SIDS). While the incidence of SIDS has declined dramatically since parents adopted the back-sleeping recommendation, flat head syndrome has become much more common.

Flattening also can develop when infants sit in swings, bouncy seats, and car seats that keep them in a semi-reclined position for lengthy periods. 

Which Infants Are at Greater Risk?

Some infants are at greater risk for developing flattening of the skull. For example: 

  • Multiple-birth pregnancies may cause a fetus to remain in one position in the womb for a prolonged period, causing flattening of the skull before the baby is born. This can also occur if the mother has a small uterus or pelvis. 
  • Premature infants are at greater risk as they may need medical care in the neonatal intensive care unit that requires them to remain on their backs for longer periods of time. 

As many as 70 to 95 percent of children who have skull flattening will also have congenital muscular torticollis. Torticollis is a condition in which the neck muscles are tight and short. It prevents the baby from being able to turn his or her head normally.

Treatment for Plagiocephaly and Brachycephaly in Infants

Fortunately, plagiocephaly and brachycephaly are very treatable. Treatment includes increasing your infant’s “tummy time,” changing his or her position frequently throughout the day, and possibly wearing a custom-made helmet (cranial orthosis) to reshape the skull. Special physical therapy exercises may be recommended.