Flat Head Syndrome Explained Simply for Parents
Updated: Oct 1
Noticing a flat spot on your baby’s head can be worrying, but it’s actually very common. Let’s break down what flat head syndrome is, why it happens, what you can do at home and when it may be helpful to seek advice.
What Is Flat Head Syndrome?
Flat head syndrome, sometimes called plagiocephaly, happens when a baby’s skull develops a flat spot, usually on the back or side of the head.
Babies’ skulls are soft and flexible, which helps them grow quickly in the first year, but it also means that pressure on the same spot for long periods can contribute to flattening.
The reassuring news? It’s very common, so don't fear - you're certainly not alone!
You may also hear different terms used to describe your baby's head shape.
Plagiocephaly generally describes flattening affecting one side of the head, while brachycephaly describes flattening across the back of the head.
What Causes a Flat Head in Babies?
Flat spots usually develop because of:
Positioning
Babies spend a lot of time on their backs, which is recommended for safe sleep. But spending long periods with pressure on the same part of the head can contribute to flattening.
Babies should still always be placed on their back to sleep. Activities to reduce pressure on the back of the head should take place while your baby is awake and supervised.
Premature Birth
Babies who are born prematurely can be more susceptible to changes in head shape because their skulls are particularly soft, and they may spend longer periods lying in one position.
Tight Neck Muscles
Some babies have a condition called torticollis, where movement of the neck is restricted and they may favour turning their head in one direction.
If your baby always looks to the same side, struggles to turn their head the other way or has developed a flat spot on one side of their head, it can be useful to have their neck movement assessed.
Read more about torticollis in babies and how physiotherapy can help.
Is a Flat Spot on My Baby's Head Normal?
Some flattening is common, especially in the first few months.
You might notice:
A slightly flattened spot at the back or side of the head
One ear appearing slightly further forward than the other
Your baby turning their head more to one side
A difference in the shape of the head when looking down from above
For many babies, head shape can improve as they grow and become more mobile. Rolling, sitting and eventually crawling all mean regularly repositioning themselves and spending less time with pressure on the same area of the head.
When Should I Get My Baby's Head Checked?
It’s worth checking in with a healthcare professional if:
The flattening seems severe or is becoming more noticeable
One side of the head looks very different from the other
Your baby has trouble turning their head or seems stiff on one side
Your baby strongly prefers looking in one direction
You notice changes in facial symmetry, such as differences around the eyes or cheeks
You are concerned about your baby's head shape or movement
This is particularly important where a change in head shape is accompanied by restricted neck movement or a strong preference for one side, as addressing the movement difficulty can form an important part of managing positional flattening.
A paediatric physiotherapist can assess your baby's head and neck movement, posture, symmetry and gross motor development and advise you on appropriate activities for your individual baby.
Simple Ways to Help at Home
The great news is that there are simple ways you can support your baby’s movement and reduce prolonged pressure on the same part of their head through everyday activities.
Tummy Time
Tummy time gives your baby's neck, back and shoulder muscles a workout while taking pressure off the back of their head.
Little and often can work well, particularly if your baby isn't a huge fan of tummy time yet.
Change Positions
Give your baby plenty of opportunities to experience different positions while they're awake and supervised, rather than spending long periods in the same position.
When putting your baby down to sleep, continue to follow safe-sleep guidance and always place them on their back.
Encourage Looking Around
Put toys, interesting objects or yourself on the side your baby doesn’t naturally turn towards to encourage them to look in both directions.
If they seem unable or very reluctant to turn towards one side, rather than simply preferring the other, consider having their neck movement checked.
Carry and Cuddle
Holding your baby upright or over your shoulder gives them a nice break from lying on the back of their head - and provides plenty of opportunities for interaction too.
Swap Feeding Sides
If breastfeeding, changing feeding positions naturally encourages your baby to turn their head in different directions.
If bottle feeding, switch the arm you hold your baby in so they have opportunities to turn their head both ways.
Can Tummy Time Help With Flat Head Syndrome?
Yes - tummy time is useful for much more than simply taking pressure off the back of your baby's head.
It also gives your baby opportunities to develop the head control, shoulder strength and trunk strength needed for later gross motor skills.
If your baby dislikes tummy time, always turns their head to the same side or seems uncomfortable in the position, there may be simple adjustments that make it easier for them.
Trust the Process
Most flat head syndrome improves naturally as babies grow and start moving more. Helmets or surgery are rarely needed (but can be easily arranged through the necessary referral channels when required). With a little guidance and plenty of movement, your baby’s head shape usually evens out beautifully. And as always, the earlier the intervention, the better the outcomes!
Concerned About Your Baby's Head Shape or Movement?
If you'd like personalised support, our Baby MOT includes a full assessment of your baby's posture, range of movement, gross motor function, neurological presentation and head shape, with follow-up sessions available to support their development.
At Ribble Valley Children's Physiotherapy, we can look at your baby's development as a whole rather than simply looking at the flat spot in isolation.
Or, if you've noticed a flat spot, your baby prefers looking in one direction, or you simply aren't sure whether what you're seeing needs further assessment:
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