About plagiocephaly and brachycephaly (flat head syndrome)
There are 2 main types of flat head syndrome:
- plagiocephaly – the head is flattened on one side causing it to look like two sides of the head are not the same; the ears may have an incorrect position and the head looks like a flat shape that has four sides when seen from above, and sometimes the forehead and face may bulge a little on the flat side
- brachycephaly – the back of the head becomes flattened, causing the head to widen, and occasionally the forehead bulges out
These problems are quite common, affecting around 1 in every 5 babies at some point.
In most cases they aren't a major cause for concern, as they don't have any effect on the brain. The head shape will often improve by itself over time.
Your baby won't feel any pain or have other symptoms, or any problems with their general development.
Causes of plagiocephaly and brachycephaly
The skull consists of plates of bone that strengthen and join together as a child gets older.
A young baby's skull is still relatively soft. It can change shape if there's constant pressure on a particular part of their head.
Reasons why this may happen include:
- sleeping on their back – the back or side of a baby's head can become flattened as a result of always sleeping on their back, but it's important they do this to reduce the risk of sudden infant death syndrome (SIDS)
- problems in the womb – pressure can be placed on a baby's head before it's born if things are a bit squashed in the womb or there's a lack of amniotic fluid to cushion the baby
- being born prematurely – premature babies are more likely to develop a flattened head because their skull is softer when they're born and they may like to rest their head on one side at first because they're not yet able to move their head themselves
- neck muscle tightness – this can prevent a baby turning their head a particular way, meaning one side of their head is placed under more pressure
Occasionally, a flattened head can be caused by the plates of the skull joining together too early. This is known as craniosynostosis.
When to get medical advice
Speak to your health visitor or GP if you're concerned about the shape of your baby's head or think they may have problems turning their head. They can examine your baby's head and suggest things you can do to help.
A slightly flattened head isn't usually anything to worry about. But it's a good idea to get advice early on so you can take steps to stop it getting any worse.
What you can do
The shape of your baby's head should improve naturally over time as their skull develops and they start moving their head, rolling around, and crawling.
Simple measures to take pressure off the flattened part of their head can also help:
- give your baby time on their tummy during the day – encourage them to try new positions during play time, but make sure they always sleep on their back as this is safest for them
- switch your baby between a sloping chair, a sling and a flat surface – this ensures there isn't constant pressure on one part of their head
- change the position of toys and mobiles in their cot – this will encourage your baby to turn their head on to the non-flattened side
- alternate the side you hold your baby when feeding and carrying
- reduce the time your baby spends lying on a firm flat surface, such as car seats and prams – try using a sling or front carrier when practical
If your baby has difficulty turning their head, physiotherapy may help loosen and strengthen their neck muscles.
- Read more about treating craniosynostosis
Helmets, headbands and mattresses
There is no clear evidence to suggest that helmets or headbands work in treating this condition. They often cause problems such as skin irritation and rashes. They are expensive, typically costing around £2,000.
Some people try special curved mattresses that are designed to spread the weight of a baby's head over a larger area so less pressure is placed on a particular point of their skull. These are cheaper than helmets and headbands, but there's currently only limited evidence to suggest they may help.
Mild flattening of the head will usually improve if you use the simple measures in the ‘What you can do’ section above. It may be a couple of months before you start to notice an improvement.
Your baby's head may not return to a completely perfect shape. But by the time they're 1 or 2 years old any flattening will be barely noticeable.
More severe cases will also get better over time, although some flattening will usually remain.
As your child becomes more mobile and their hair grows, the appearance of their head should improve.