Positional Plagiocephaly
Generally, a baby has an oval shaped head. The right and the left sides appear to be the same.
A baby with ‘positional plagiocephaly’ has a flat spot on the back or side of the head. It is caused by pressure against the very soft bones of the baby’s head. This happens when a baby lies in one position most of the time. Usually this is in the first 3-6 months of life. Sometimes the baby can be born with it.
The bones and the areas in between the bones (called ‘sutures’) are soft so the baby can move through the birth canal. This softness continues for the first two years of life to allow for rapid brain growth.
Positional plagiocephaly does not affect a baby’s brain growth or cause brain damage.
Diagnosis
Sometimes positional plagiocephaly looks like a more serious condition called ‘craniosynostosis’. The ear, near the flat spot, is shifted forward on most babies. The diagnosis is made by our doctors in the clinic with an examination of the baby’s head. There is no need for X-Ray, CT, or MRI.
Causes
• Although, it is safest for babies to sleep on their backs, this can result in a flat
spot on the back of the head. Healthy babies should always be placed on
their backs to reduce the risk of Sudden Infant Death Syndrome (SIDS).
• Some babies will look in one direction due to limited range of motion in the
neck (torticollis). This is common and almost always goes away by itself.
Physical therapy may be needed in some cases.
Once your baby is able to sit and stand, the pressure on the head bones is reduced. The head shape begins to improve. The flattening does not show as much as your baby gets older. Thicker skin will develop and hair will grow.
Treatment
The most important treatment is to change the positioning of your baby’s head. Most cases self-correct.
• Try to keep your baby off the flat portion of the head.
• While you are watching and playing with your baby, have active 'tummy
time'. Tummy time helps your baby’s head, neck, and shoulder muscles get
stronger.
• Encourage crawling, rolling, reaching, pushing, pulling, holding, and grasping.
• Choose different ways for your baby to be held.
• Babies need a lot of time sitting in laps, cuddling, playing, and chances to
move.
• Avoid long periods of time with your baby in the same position (as in car
seats, strollers, infant seats, cribs, and playpens).
• Every few days alternate the position your baby is lying in the crib.
• Change the location of your baby’s crib so that he or she has to look in
different directions to see the door or the window. Babies tend to want to
turn toward noise, music, light, people etc. Your creativity is the limit.
• A rolled up towel behind your baby’s back will help to reduce pressure on the
flattest part of the head. Do not put the towel under the head, as this could
worsen the flattening. Another option is a set of two rolls that are velcroed
together to prevent the baby from rolling off them. These are available at
baby stores.
• If your baby has torticollis there are exercises that can help. A physical
therapist can teach you these exercises.
• Very gently turn your baby’s head in each direction with every diaper change.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 08/21/2012
Copyright © 08/21/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7402
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