A Paediatric Physio’s Guide to Plagiocephaly (Baby Flat Head Syndrome)

Noticing a flat spot developing on the back of your baby’s head can be worrying for any parent. This condition, known as plagiocephaly, is common, and the good news is that in many cases, simple, proactive steps can make a world of difference.

As expert paediatric physiotherapists in the South West, we want to provide clear, evidence-based information to empower you. Here is what you need to know about plagiocephaly and how you can support your baby’s healthy development right from the start.

What is Plagiocephaly, and What is it Associated With?

The term plagiocephaly refers to a flattening at the back of a baby’s head. It can be present with or without a condition called torticollis, when the baby favours looking to one side. Plagiocephaly is not life-threatening and is not thought to affect the brain. In the absence of torticollis, it is difficult to know what causes plagiocephaly – it is associated with but not caused by a baby sleeping on their back. It may be associated with a preference for one position, bottle-only feeding in only one position, vitamin D deficiency, large head, reduced tummy time or motor delay.

Evidence-Based Tips to Help Prevent Plagiocephaly

It is important for baby to sleep on their back for their own safety. Based on our current knowledge, the best way to prevent plagiocephaly is:

1. Encourage the baby to move freely right from birth. You can do this by talking and singing to the baby from different angles while they lie on a mat, or by putting brightly coloured things around the baby to encourage them to look in different directions.

2. Limit the time the baby is restricted in car seats or baby bouncers.

3. Aim for 30 minutes of tummy time per day, so the baby can also develop head control in this position. Tummy time can include a baby lying on their tummy when you are lying on your back, for example.

4. Use “FaceTime to talk to bathe by and give them a chance to move their head in different directions while you provide support for that heavy head.

5. For bottle-fed babies, vary the side you hold them on to feed.

6. When putting the baby to bed, vary which end of the cot or bassinet you put them in.

When to Seek Expert Advice

These preventative tips are powerful tools for every parent. However, if you feel your baby’s head or movements are asymmetrical, if they have a strong preference for looking to one side, or if your baby really doesn’t like tummy time, it’s always best to seek advice.

Our compassionate team of paediatric physiotherapists can provide a thorough assessment and a personalised plan to support you and your baby. We offer clinic-based and mobile services across the South West, including Busselton, Bunbury, Dunsborough, Margaret River, and Katanning.

Contact us today to book a consultation and get the peace of mind you deserve.

FAQs – Supporting Your Baby with Plagiocephaly

1. What is plagiocephaly, and should I be worried about it?

Plagiocephaly is a flattening at the back of your baby’s head. While it can be concerning to notice, it is not life-threatening and is not believed to affect brain development. It’s common and often improves with simple, proactive changes at home.

2. What causes plagiocephaly in babies?

There’s no single cause. It’s often linked with factors like reduced tummy time, sleeping in one position, feeding a baby in the same position, or a large head size. In some cases, it may be associated with torticollis, a condition where a baby prefers looking to one side.

3. Can I still put my baby to sleep on their back?

Yes, absolutely. For safety reasons, always put your baby to sleep on their back. The tips provided in the article help prevent flat spots without compromising safe sleep guidelines.

4. What can I do every day to help prevent plagiocephaly?

You can help by encouraging the baby to move their head in different directions throughout the day. Tummy time, talking from different angles, and alternating bottle-feeding sides all help. Aim for 30 minutes of tummy time daily, broken into smaller sessions.

5. When should I get professional help for my baby’s flat head?

If your baby shows a strong preference for looking one way, if their head shape seems very asymmetrical, or if they dislike tummy time, it’s a good idea to see a paediatric physiotherapist for a personalised assessment and plan.

6. Do I need to avoid using baby seats and bouncers?

You don’t need to avoid them entirely, but it’s best to limit time in restrictive gear like baby bouncers and car seats when not travelling, so the baby has more freedom to move and explore different head positions.

References

Williams, Elizabeth, and Mary Galea. "Another look at 'tummy time' for primary plagiocephaly prevention and motor development." Infant Behaviour and Development 71 (2023): 101839.

Hillyar CRT, Bishop N, Nibber A, Bell-Davies FJ, Ong J. Assessing the Evidence for Nonobstetric Risk Factors for Deformational Plagiocephaly: Systematic Review and Meta-Analysis Interact J Med Res 2024;13:e55695 doi: 10.2196/55695