Plagiocephaly is a condition in which the back of the head, one side of the head, or a combination of the back of the head and one of the sides is flattened. This causes the shape of the head to appear asymmetrical. It mainly occurs in infants, because their skull is soft to allow for brain growth in the early years of life. This results in pressure on one area of the skull over a prolonged period of time, causing an asymmetrical moulding. This does not cause any pressure on the brain and is not associated with any developmental or learning problems. It has no impact on the baby’s hearing, vision, or ability to chew. There are no other symptoms – it is completely cosmetic. As the skull plates are not fused together, only moulded into another shape, it does not require any surgical intervention. It is more commonly seen in premature babies as their skull is softer and they spend increased periods of time in one position while their medical needs are being cared for.

A baby with plagiocephaly.

What Are the Causes?

Plagiocephaly is mostly caused by the baby spending a considerable amount of time in any one lying position. It can also be due to spending too much time in the buggy or car seat. As the baby’s skull is soft, it will easily change shape if there is pressure on a particular area. In some cases, torticollis (tightness of the neck muscles) makes it difficult for them to change the position of the head. Please refer to our torticollis page for more details about this.

What You Can Do

The earlier in life plagiocephaly is diagnosed, the better the chances of making a difference in facial appearance are. Detailed below are some of the ways you can prevent it.

  • When your baby is on their back, encourage them to look away from the flattened side. This will relieve the pressure from the flattened areas of the skull, allowing them to remodel. This can be achieved by keeping toys in the direction you want them to turn their head.
  • Approach your baby from the side opposite the flattened side, as this will make them turn their head away from that side.
  • Supervised tummy time helps in working the neck muscles against gravity. A rolled towel under your baby’s chest will assist them with lying on their tummy as well as in taking some weight through their forearms. Engage them in play so they lift their head in the desired direction. This will strengthen their neck muscles as well as their arms. As the strength in the neck muscles improves, your baby will be able to move the head from one position to the other with ease.
  • When your baby is lying on their back, placing a towel under their pillow might help to relieve the pressure from the flatter side.
  • Whenever possible, try to change the sleeping position of your baby and make sure they are not lying in one position for a prolonged period of time.
  • Keep in mind the position of your baby during feeding, making sure that the flat spot is not under pressure.
  • Hold your baby more often, as this will reduce the time they spend in one position or where their head is resting against a surface. Ensure that buggy and car seats are only used for the desired purposes.

What’s the Role of the Physiotherapist?

The physiotherapist will check for any abnormal muscle tone; restriction in range of movement in the neck, arms, or legs; squint in the eyes; abnormality in the spine, hips, or feet; and other musculoskeletal or neurological signs. An assessment will be carried out to identify whether your child is developing age-appropriate gross motor skills.

Advice will be provided on how to position your baby during the day to encourage symmetrical head development. The physiotherapist will also demonstrate how to position your baby while carrying them. Exercises will be provided for working on the muscles of the head and neck, and stretches will be demonstrated if there is any tightness. Your baby will be assessed for the need of a helmet, which will have to be worn over a prolonged period of time for approximately 23 hours a day.

Contact us now, in Wellingborough, Northamptonshire, for further details about the way our paediatric physiotherapy assists with plagiocephaly.