Guide to Understanding Plagiocephaly

We have put together an all-inclusive resource on the various forms and causes of flat head syndrome in order to better inform concerned parents. We hope that this guide will not only help to educate you on your baby’s health, but also give you a starting point for answering the question: what can I do to help my baby’s head grow naturally and healthily.

The term Plagiocephaly is technically only used to describe a cranial asymmetry or malformation that results in one side of the back of the head being flat. Whereas Brachycephaly would describe a head that is completely flat across the back. Scaphocephaly would describe a long and narrow head with a widened forehead. These terms describe symptoms. More precisely, these terms differentiate one head shape from another. They do not describe the actual cause for the malformation. You can compare your child’s head to the diagram below to get an idea of how his or her asymmetry might be labeled.

plagiocephaly craniosynostosis diagram

This diagram is showing various head malformations caused by closure of the cranial sutures. Particular plates of the skull are closing prematurely, whereas others are not, causing the skull to grow unevenly. As you can see above, this process, known as craniosynotosis, can lead to plagiocephaly. It can also lead to brachycephaly, scaphocephaly, etc. In other words, craniosynostosis can lead to a particular head shape, which has its associated term. The synostotic term would simple denote that the head shape resulted from craniosynostosis, or the premature closure of the sutures.

So when we define an asymmetry that is not caused by premature closure of the sutures, but rather by the baby’s soft, forming skull being in contact with hard surfaces for extended periods of time, malforming the skull through pressure alone, we refer to this as flat head syndrome. But, it can also be confusingly referred to as positional plagiocephaly, even when the actual flat spot may result in a head shape that is not technically plagiocephaly. But, since the flat spot is most often on the back of the head, this has become the common term through usage.

Positional plagiocephaly can form before or after birth and is very treatable with passive methods such as positioning or a flat head pillow. Craniosynostosis, on the other hand - depending on its severity, may need medical attention. Your well child visits to the doctor should help you to diagnose the exact nature of your baby’s cranial health.

We would like to make note of the fact that we are all somewhat asymmetrical. This is often the uniqueness that makes us beautiful. If you take a moment to look at yourself in the mirror, you will quickly notice that both sides aren’t the same. But, if someone is not actively looking and comparing, it goes unnoticed. For example, how many people do you see walking around where you say to yourself ‘his head is so crooked’? Not often. But, if you look very closely, you might see that each head is not perfectly shaped. Remember, your baby’s head will grow, his hair will grow in, and he will be beautiful to his friends and family. This, of course, is not to say that there is no reason to concern yourself with your baby’s head shape. There are rare cases where medical attention is advised. And even in the majority of cases, where a flat spots are not a medical concern, it is still understandable that a concerned mother or father would like the do everything they can to improve their baby’s head shape.

Your baby’s head is very soft at birth. So soft, in fact, that pressure from outside over extended periods, can cause the skull to flatten. Or, even before birth, depending on the position within the womb, your child might already be working on creating a crooked head. His or her head might by lying on an arm, or the head might be low and forced against the uterus for longer than normal. Also, the birthing experience itself might contribute to a malformed head. If your baby is born looking somewhat like a Conehead from Saturday Night Live, don’t be alarmed, that is more common than you might think. This will subside.

To put it simply, your baby’s head is soft, and the world is full of hard surfaces. It is these surfaces, with extended exposure, that malform your baby’s skull. What a lot of parents aren’t aware of, however, is that even surfaces that are designed as padded, and which are supposed to protect your baby’s head, are not really doing their job. Crib mattresses, car seats, changing pads or strollers all promote comfort and protection, but they are often the cause of flat spots. Though soft, your baby’s head is even softer. So be aware, these are often the actual culprits of flat head syndrome.

There is nothing better for your baby than tummy time. This is the only time during the day when your baby is not actively lying on his or her head. There is no better therapy for plagiocephaly than having the head floating completely free without any contact to the outside world. A dip in the bath or pool might be another such therapy. Tummy time also has the added benefit of exercising your baby’s neck muscles. Your baby’s natural efforts to keep his or her head up during tummy time is a definite benefit to your baby’s growth and development. It will also help to alleviate and prevent torticollis, or uneven or underdeveloped neck musculature

We as parents, however, know that tummy time isn’t always possible. Often babies are not aware of how good tummy time actually is. If there is even the slightest hint of tummy time, many babies flip out – completely! We, as loving parents, can only take a few seconds of screaming and crying before we break down and turn them over. This is not bad parenting. This is called compassion. But, what can be done to help our babies head form more naturally?

The best way to help your baby’s head to form more naturally is to get them off their flat spot. This can be harder than anticipated since they often prefer lying directly on this spot. Sometimes this preference is how they got their flat spot in the first place. So you have to constantly make sure that they are lying in a position that gives their flat spot a rest. As mentioned above, tummy time gets the entire head up in the air, so this is best. But, in lieu of this, you can lie your baby on his or her opposite side. You can prop a blanket or cloth under him in order to help your baby to stay in this position. A good trick is to try to place something of interest in your baby’s line of sight in order to prevent him or her from trying to return to the favored side. Whatever it takes. Feel free to be creative. Just remember to do this only during supervision. It is important to keep your baby’s sleep environment free of loose objects for safety purposes.

In order to make your life easier, a baby flat head pillow can both help to position your baby and to protect his or her forming skull from hard surfaces. You can learn more about the benefits of such a product by visiting our ErgoPillow page. A flat head pillow is far softer than the surfaces that your baby encounters in his or her daily routine. Even products, such as car seats and strollers, which come equipped with cushioning and padding, are often not made soft enough to address this issue. Many flat spots have had their root cause in underpadded strollers and mattresses. By adding the extra soft padding of a flat head pillow, you help to eliminate this culprit. Some flat head pillows also help to align the baby’s neck, which is a great help with proper muscle formation and the alleviation of torticollis. We recommend our own product, the ErgoPIllow, but there are a number of other flat head pillows on the market that also do a good job in helping to shape your baby’s head. Do your research and find the style that best fits your needs.

We are there for your questions and answers. If we can help you to make a better, more informed decision on how to deal with your baby’s health, we have done our job. We will respond to you inquiries quickly and in full detail. Thanks for taking the time to read our Guide. We will be improving upon this continuously, so we also value your opinions on what is missing or what is unclear. We appreciate you.