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Posted on 11-20-2017


What is plagiocephaly?

(pronounced play-jee-oh-sef-uh-lee)

Also known as “flat head syndrome,” this condition affects nearly half of infants today.  Plagiocephaly is characterized by a flat spot on the back or side of the head. Many factors can cause flat spots. A baby’s skull is very soft and pressure from everyday surfaces, such as beds or car seats, can cause misshaping. Rest assured it’s not your fault.

The important thing is you recognize the problem early, and do something about it.  We can help!

How does plagiocephaly affect my baby?

Plagiocephaly won’t affect your baby’s neurological development, however if left untreated, the head will remain misshapen into adulthood.

When deciding whether or not to move forward with treatment, consider your baby’s later years.  Some issues that may arise are:

  • Noticeable facial asymmetry
  • Poorly fitting eyeglasses
  • Poorly fitting safety equipment, including sports helmets
  • Visible flat areas with short or cropped hairstyles
  • Jaw misalignment resulting in a crossbite or underbite

What does plagiocephaly look like?

Parents spend so much time with their baby that recognizing an abnormal head shape can sometimes be difficult.  A flat spot can form in as little as one week. While plagiocephaly is the most commonly referenced abnormal head shape, it is actually one of three types.

Plagiocephaly, brachycephaly and scaphocephaly can be accompanied by other characteristics, such as asymmetrical facial features, misaligned ears, and a sloped or bulging forehead.  These abnormal shapes can develop to varying degrees of severity, and occur in combination with one another. 

Plagiocephaly Head Shape (pronounced play-jee-oh-sef-uh-lee)

  • Head is flat on one side
  • Head shape resembles a parallelogram from above

Brachycephaly Head Shape (pronounced brak-ee-sef-uh-lee)

  • Head is wider than normal
  • Back of head is flat rather than curved

Scaphocephaly Head Shape (pronounced skaf-oh-sef-uh-lee)

  • Head is longer and narrower than normal
  • Head is taller than normal

What causes plagiocephaly?

It’s our experience that parents of children diagnosed with plagiocephaly are often worried they’ve done something to cause it. Rest assured, plagiocephaly is quite common and many factors can contribute.

Babies’ heads are soft and malleable and even gentle external forces, whether met in the womb or in baby’s daily routine, can cause misshaping. The good news is babies with plagiocephaly typically respond very well to noninvasive treatments such as at home repositioning techniques, chiropractic adjustments, and cranial therapy work. These techniques help improve head shape by improving normal movement and reducing constricting patterns, allowing baby’s natural growth into a normal head shape.

Babies can develop misshapen heads for a number of reasons:

Womb Position

Babies who become stuck in one position or do not have enough room to move in the womb are at risk of developing plagiocephaly. A breech orientation can also lead to an abnormal head shape.

Multiple Births

Plagiocephaly is common in cases of multiple births, where limited space can lead to distortion of the head.

Premature Birth

Premature babies have especially soft skulls, making them even more susceptible to misshaping. These babies often spend extended periods of time in the neonatal intensive care unit with the head in a fixed position while on a respirator. Premature babies are also more likely to be physically delayed, which can prevent normal movement of the head.

Neck Subluxation/ Torticollis

Subluxations in the upper neck region due to the trauma of birth can create nerve disturbance, muscle spasm, and joint restrictions causing baby's head to stay turned to one side, resulting in plagiocephaly.

Carriers & Convenience Devices

While in car seats, bouncy seats and swings, baby’s soft head is often placed against a rigid, unyielding surface. Though normal use is not a concern, extended use—and allowing an infant to sleep in such devices, in particular—increases the risk of plagiocephaly.


The relationship between back-sleeping and plagiocephaly in infants is well-documented. While the American Academy of Pediatrics still recommends back-sleeping to prevent Sudden Infant Death Syndrome, they also recommend frequent rotation of baby’s head, as well as supervised tummy time.

How can I prevent or correct flat spots?

The medical recommended treatment for unresolved plagiocephaly is cranial helmet therapy. Our goal is to help parents avoid the need for baby helmets by diagnosing and treating misshapen heads before a helmet is necessary.

Simple at-home practices, including supervised tummy time and repositioning techniques, are known to effectively prevent and improve abnormal head shapes.  However, many times a subluxation in the upper neck region is the cause, and is easily detected and corrected by a pediatric chiropractor.  Gentle adjustments along with cranial therapy can help to improve normal movement, helping to reduce or eliminate abnormal cranial positioning.

When discovered and treated by a chiropractor early, parents can prevent the need for the emergency use of a helmet to force normal skull shape.  Most insurance companies will require parents to practice repositioning techniques for at least two months before proceeding with a cranial orthotics.  Parents should consider the addition of chiropractic and cranial work during this time to improve the chances for conservative methods to improve or eliminate a baby's misshapen head. 

Thanks so much for reading! We hope this has been helpful, and this article finds its way to the people who most need it. Please consult with a pediatric chiropractor in your area ASAP if you think your baby may have a misshapen head and address the issue early.  If you have any questions, or would like us to help you find a chiropractor in your area, please contact us.

The Doctors at Hassel Family Chiropractic

Hassel Family Chiropractic


[email protected]

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