Deformational Plagiocephaly

As parents, the health and development of your newborn is your highest priority. It is natural to carefully monitor every milestone, from the first smile to the first roll.

However, some common physical changes can cause significant concern, one of the most frequent being the noticeable flattening of a baby’s head, often referred to as baby flat head syndrome.

This condition, known clinically as Deformational Plagiocephaly, is surprisingly common, yet often misunderstood. At Xtremity, we specialise in providing compassionate, expert care and advanced orthotic solutions for infants.

We are here to demystify the condition, explain the available treatments, and assure you that with timely intervention, your child’s head shape and future can be perfectly healthy.

What is plagiocephaly? Understanding the meaning

An asymmetric or uneven head shape in infants characterises Deformational Plagiocephaly (DP).

Unlike a much rarer and more serious condition called craniosynostosis (where the skull bones fuse prematurely), DP is non-synostotic, meaning a problem with bone growth does not cause it, but rather external pressures on the soft, pliable skull of a developing baby.

A flat head baby will typically exhibit:

A flat spot on one side of the back or the head.
The ear on the flattened side appears pushed forward.
A bulge or prominence of the forehead on the same side as the flattening.

There is a direct correlation between the success of the “Back to Sleep” campaign (which correctly advises back sleeping to avoid SIDS) and the current rise in baby flat head syndrome.

While life-saving, this consistent back positioning places pressure on the same skull spot over time, leading to the characteristic flattening.

The causes: Why does plagiocephaly occur?

The infant skull is incredibly soft, allowing the brain plenty of room to grow rapidly during the first few months of life. This softness, however, makes the skull highly susceptible to external pressures. Key factors contributing to plagiocephaly include:

Supine sleeping: Sleeping on the back is the single most significant contributing factor. When a baby consistently favours turning their head to the same side while sleeping, that area flattens.

Torticollis (Wry neck): This is a condition where neck muscles are tight or imbalanced, causing the baby to hold their head tilted to one side and turned to the other. If a baby has torticollis, they can only rest their head in one position, rapidly accelerating the development of a flat spot.

Limited time off the back: Increased use of car seats, swings, and bouncers keeps the baby on their back, extending the time the soft skull is under pressure.

In-utero constraints: In some cases (such as multiple births or a crowded uterus), the baby’s head position before birth can already cause a degree of flattening.

Early intervention: Prevention and repositioning

The first three months of life are critical for prevention and simple plagiocephaly treatment. The skull is growing fastest during this period, and simple changes can be highly effective:

Tummy time: This is the most essential preventative measure. During the day, brief, supervised periods of Tummy Time help strengthen your baby’s neck and shoulder muscles while also crucially relieving pressure from the back of the head.

Counter-positioning (Repositioning therapy): Consciously change the baby’s head when sleeping or lying down. For instance, if the baby favours looking right, place stimulating toys or objects on the left side of the crib or room to encourage them to turn their head away from the flattened side.

Vary carriers: Limit the time spent in restrictive equipment like car seats and swings. Opt for carrying, holding, or spending time in a front carrier to keep the baby upright and relieve pressure.

If simple repositioning is started early (ideally before 4 months of age), it often corrects the flat head baby syndrome without further intervention.

When to seek professional plagiocephaly treatment?

If the flattening persists or worsens by four to six months of age despite consistent repositioning and Tummy Time efforts, it is time to consult an expert. Our specialists at Xtremity can accurately diagnose the degree of plagiocephaly and determine if advanced treatment is necessary.

The effectiveness of the treatment is constrained by time, given that the skull’s rapid growth dramatically decreases after the child reaches one year old.

The role of the plagiocephaly helmet

For infants aged between approximately 4 and 12 months with moderate to severe deformational plagiocephaly, the most effective and globally recognised plagiocephaly treatment is orthotic management, specifically using a cranial remoulding orthosis—or plagiocephaly helmet.

How does the plagiocephaly helmet work?

A plagiocephaly helmet is a custom-fitted device that guides the infant’s natural head growth. It does not actively squeeze or push the skull; instead, it works passively:

Contact: The helmet is precisely shaped to maintain gentle contact with the prominent, non-flattened areas of the baby’s head.

Empty space: It provides a small space over the flattened area.

Guidance: As the baby’s brain grows, the head expands into the space where the flattening occurred, while the helmet prevents further expansion in the already rounded areas. This process gently and safely redirects growth toward a symmetrical shape.

The treatment is worn for most of the day (typically 23 hours) and requires regular follow-up appointments (usually every 2-4 weeks) with our clinicians at Xtremity for adjustments. This ensures that the helmet continues to fit perfectly and guides growth correctly.

The Xtremity difference: Precision and peace of mind

At Xtremity, we utilise state-of-the-art 3D scanning technology to create a custom-fitted plagiocephaly helmet tailored to your baby’s unique shape.

This non-invasive scanning process takes only minutes and ensures maximum comfort and optimal results. Choosing the right partner for your child’s plagiocephaly treatment is vital.

Our commitment is to combine technical precision with compassionate care, guiding you through the process every step of the way.

We understand the journey can be worrying, but the results of a cranial orthosis are consistently positive. They provide parents with peace of mind and, most importantly, give the child the best start with a beautiful, symmetrical head shape.

If you suspect your child has baby flat head syndrome, don’t delay. Early assessment is crucial to maximising the effectiveness of non-invasive therapies. Take the first step toward a symmetrical and confident future for your child. Schedule your consultation with Xtremity today.

About Us

Xtremity Prosthetics and Orthotics is a specialized health clinic where treatment is provided by a specialized team which comprises allied health professionals as well as medical professionals giving a multidisciplinary approach towards prosthetic and orthotic rehabilitation care.