Flat Head

What is Flat Head syndrome?

Also know in medical terms Plagiocephaly, pronuced (play-gi-o-cef-a-ly) is a condition caused by prolong sleeping time spent on one side of the baby's head normally during the first 6 to 9 weeks due to their soft skull bones, newborn babies heads can change shape occurring a flat spot knowing as (flat head syndrome) on the back or side of their head, brow, ear or cheek may be pushed forward.

Flat head plagiochepahaly


Flat Head Incidences babies affected:

  • 11% of singleton's have some flatting
  • 56% Of twin born neonates affected
  • 30% Deformities persisting at 2 years of age
  • Right side more common

Flat Head Causes

  • Prolonged pressure the skull in a particular position
  • SIDS protocols “Back to sleep”
SIDS reduced significantly since inception of Back to Sleep’ campaign (up to 40%) Dramatic increase (10-48%) in incidence of Plagiocephaly since “Back to Sleep” campaign.
  • Torticollis – a tightening of the neck muscles
  • Macrocephaly - abnormalities in which the head circumference is greater then normal form
  • Child resistant to ‘tummy time’ and lead to muscle weakness
    take pressure off his head.
    , reliefs head pressure
    take pressure off his head
  • Lack of education of prevention methods
  • Utero constraints e.g. multiple births and insufficient pelvis

    flat Head Plagiocephaly

    Common Risk Factors

    • Male
    • First born
    • Multiple pregnancy
    • Prematurity
    • Oligohydramnios
    • Supine sleeping
    • Less then 5 mins of tummy time/day
    • Delayed motor milestones
    • Preferred head orientation for sleep at 6 weeks
    • Positioning to same side for all bottle feeds

    Traditionally Multiple Treatment Methods are available

    1. Keep an eye the baby's head circumference
    2. Changing the forces on the head by alternating the child’s sleeping head position.
    3. Supervised Tummy Time
    4. If torticollis is present (abnormal neck position) turned to one side, Physiotherapy treatment
    5. Cranio-reshaping helmet therapy

    Prevention is the key!

      1. Early detection of Torticollis & referral to Physiotherapy
      2. Encourage prone & side-lying during supervised awake play periods several times per day
      3. Nightly/weekly alternating head positioning during supine sleeping
      4. Avoid prolonged repetitive positioning (e.g. Car seat carriers, buggies, baby swings & bouncers.
      5. Regularly change position of cot in room or toys/mobiles around cot.
      6. Counter positioning / alternating the orientation of infant in the cot
      7. Alternating feeding positions.

      Moulding Helmet Therapy

        • Option for 4 months old and up
        • 23 hours per day for months
        • Known side effects
        • Pressure sores
        • Ethanol erythema
        • Skin erosions/skin infections
        • Deficient fitting
        • Neck Flection. Superior airways obstruction
        • Difficulty to cuddle the baby
        • Distributed efficiency
        • Average US cost of treatment $4,500

        (Saeed et al., 2008; Task Force on Sudden Infant Death Syndrome, 2005; Neufeld & Birkett, 1999; Persing et al., 2003; van Vlimmerman et al., 2008., Canadian Paediatric Society, 2001).