What Is Plagiocephaly and Does My Baby Have It?

The first time you notice a flat spot on your baby’s head, your heart may skip a beat. Questions immediately pop into your head, like: Is it normal? Did you do something wrong? Will your baby’s head ever become round?

Before you launch into a panic-driven online search, let's look at what plagiocephaly is, what to watch for, and, most importantly, how you can help your little one. Share on X

What Is Plagiocephaly?

Plagiocephaly (pronounced play-jee-oh-SEF-uh-lee) is a medical term describing the condition in which a baby’s head develops an uneven or asymmetrical shape. The most common type, called positional plagiocephaly, occurs when pressure on one part of the soft, growing skull causes it to flatten. In other words, your baby’s head flattened because it received too much pressure for too long, such as against your pelvis in utero, or sleeping with the same head position too much.

You might notice a flat spot on the back or one side of your baby’s head (commonly behind the ear). The forehead may appear slightly more prominent on that side, or one ear may sit farther forward than the other. Many parents first notice the asymmetry in a photo of their child.

Why does this happen? Your baby’s skull is made of several bones that haven’t yet fused together. This flexibility allows the brain to grow rapidly during infancy. But it also means that spending a lot of time resting in one position can influence head shape.

How Can I Tell If My Baby Has It?

Look at your baby’s head from above when they’re calm and comfortable. Notice whether the back of the head looks evenly rounded or whether one side appears flatter.

You may also notice that your baby:

• Consistently turns their head to the same side
• Has one ear that appears farther forward than the other
• Seems to have difficulty turning their head in one direction

These signs can suggest positional plagiocephaly, especially when accompanied by torticollis—a condition involving tight or imbalanced neck muscles.

However, you can’t diagnose plagiocephaly by appearance alone. Your pediatrician can examine your baby’s head shape and neck movement to determine what’s happening. An uneven head shape can occasionally have a different cause, including craniosynostosis, a condition in which skull bones fuse too early.

What Can I Do to Help?

The good news is that many babies with positional plagiocephaly improve as they grow and become more mobile. Early, simple changes to the daily routine often help:

1. Make tummy time part of your day. Offer short, supervised sessions while your baby is awake. Gradually increase the time as your baby gets stronger and more comfortable.
2. Change the view. Encourage your baby to look in both directions by alternating the side you approach from, switching arms during feeding, and varying their position during awake time.
3. Limit unnecessary time in containers. When you’re not traveling, avoid leaving your baby in a car seat, swing, or bouncy seat for long stretches.
4. Ask about physical therapy. If your baby prefers one side or has restricted neck movement, a pediatric physical therapist can assess their movement and teach you appropriate positioning and exercises.

One important reminder: Always put your baby to sleep on their back. Don’t use pillows, wedges, or head-shaping cushions in the crib. Safe sleep is more important than trying to prevent a flat spot.

Will My Baby Need a Helmet?

Not necessarily. Many babies improve with repositioning and, when needed, physical therapy. For babies with more significant flattening, or when head shape doesn’t improve with conservative treatment, a specialist may recommend a cranial molding helmet.

The decision depends on your baby’s age, the severity of the flattening, and how their head shape changes over time. Your pediatrician can help you decide whether a specialist evaluation is appropriate.

When Should I Call the Pediatrician?

Bring up any concerns about your baby’s head shape at your next visit—or sooner if you notice a new or worsening change, a strong preference for turning one way, or difficulty moving the neck.

Early evaluation matters because it helps distinguish positional flattening from other conditions and ensures your baby gets appropriate care.

Here’s an encouraging truth: positional plagiocephaly does not mean you’ve failed your baby. It is common, and it can happen even when you follow safe-sleep recommendations. Research has not established that positional plagiocephaly itself harms brain development.

Motherhood is full of things we can’t control—but also plenty we can influence. You don’t have to make your baby’s head perfectly round overnight. With some modified daily routines, a little daily tummy time, and help from your baby’s healthcare team, you can support healthy growth one small moment at a time.

 

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(Photo: Canva)