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Positional plagiocephaly means that a baby's head is flat in the back on one side. Brachycephaly means that a baby's head is flat across the entire back of the head. Most often, it's from lying on the back or lying with the head to one side for long periods of time. Sometimes a baby's forehead, cheek, or ear may get pushed forward a bit on one side. You may hear this called flat head syndrome.
Positional plagiocephaly and brachycephaly don't hurt your baby. And in most children the flat area responds well to treatment, especially when we start early.
The shape of a newborn's head may be affected by how the baby was positioned in the uterus. It can also be affected by the birth process or by positions your baby spends a lot of time in.
Lots of time spent in cribs, car seats, carriers, or other seats may lead to a flat area on your baby's head. Torticollis, or "wryneck," can also lead to a flat spot on your baby’s head. It's a problem with your baby's neck muscles. It causes the head to turn to one side. If your baby has torticollis, your doctor may recommend neck exercises. These may help your baby turn their head.
Doctors, public health nurses, and physiotherapists can diagnose plagiocephaly and brachycephaly by looking at the shape of a baby's head. The doctor and physiotherapist will check to make sure that your baby doesn't have some other condition that affects the shape of the head.
Your doctor may recommend physiotherapy to treat plagiocephaly and brachycephaly. This is especially true if it's caused by problems with your baby's neck muscles.
Talk with your doctor or healthcare provider about how to position your baby so that you don't raise your baby's risk of sudden infant death syndrome (SIDS). Don't use sleep positioners or head-shaping pillows. Until your baby's first birthday, always place your baby on their back to sleep, even if your baby has a flat spot. Offer plenty of tummy time and cuddle time. And change your baby's head position when your baby lies down.
If your baby's head shape does not get better by around 6 months, let your doctor know.
If the head shape change is severe or other treatments haven't worked, your doctor may have you try a custom helmet. The helmet can help correct the shape of your baby's head. Surgery usually isn't done, except in rare cases.
To help prevent a flat spot:
Adaptation Date: 12/13/2023
Adapted By: Alberta Health Services
Adaptation Reviewed By: Alberta Health Services
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