Plagiocephaly, also called flat head syndrome, is when a baby’s head develops a flat spot or uneven shape. This often happens because babies’ skulls are soft and moldable in the first months of life. Spending a lot of time lying in one position—such as on their back—can sometimes cause flattening on the back or one side of the head.
Its important for parents to know that plagiocephaly is very common and usually does not affect a child’s brain growth or development. In most cases. the shape of the head improves over time with simple positioning changes or if needed, treatment recommended by your doctor.
Signs of Plagiocephaly
Plagiocephaly often develops gradually, and parents are usually the first to notice changes in their baby’s head shape. Here are the most common signs:
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How is Plagiocephaly Diagnosed?
Pediatricians usually diagnose plagiocephaly by:
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Most babies with plagiocephaly or brachycephaly improve as they grow and start moving/sitting up more. Treatment is focused on relieving pressure and encouraging growth to the flattened area.
At-Home Treatments
Medical Treatments
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When a baby’s plagiocephaly is moderate to severe and/or not improving with at-home treatments like repositioning and tummy time, doctors may recommend helmet therapy (also called a cranial remolding orthosis). A helmet helps guide the baby’s skull into a rounder, more even shape as the head grows.
How Helmet Therapy Works
The helmet is custom-made to fit your baby’s head, that has space in the flattened areas to allow your babies’ head to grow in those spots.
When Helmets Are Used
Ideal age: Starting treatment time is ideally between 4 and 6 months, when the skull is most moldable and head growth is fastest, but helmets may still be helpful up to 18 months.
What to Expect as a Parent
Wearing schedule: Babies usually wear the helmet 23 hours a day, for an average of 3 to 6 months, depending on severity and age at the start of treatment.
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Follow repositioning strategies
Increase tummy time
Give your baby supervised tummy time several times a day. Start with short sessions and build up as they get stronger.
Limit time in contained places
Reduce long stretches in car seats (when possible), swings, or bouncers where the head rests against a flat surface (when possible).
Hold your baby in upright positions
Carrying your baby upright in your arms, a sling, or a carrier takes pressure off the head.
Watch for torticollis
Notice if your baby always tilts or turns their head one way. If so, ask your doctor about neck stretches or a physical therapy referral.
Keep follow-up appointments
Regular checkups help track head growth and make sure treatment is working.
Discuss helmet therapy early if needed
If your baby’s flattening is not improving or you have concerns, ask your pediatrician about helmet options—best results come when started between 4–6 months.
Stay patient and positive
Most babies’ head shapes improve over time, and the condition does not affect brain development.
Despite everything she’s been through, she’s still smiling- and her family is so proud of how far she’s come.
Georgia was diagnosed with left craniosynostosis at 9 weeks old. After her surgery, a cranial helmet was needed quickly, with some help from the OPSB clinic, Georgia rocked her helmet journey.
