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Deformational Plagiocephaly at North Austin Campus

Conditions

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Deformational plagiocephaly is also known as “flat head syndrome” or “positional plagiocephaly”. It is a very common condition that causes a one side or both sides of a baby's back of the head to become flattened from how they lie in their crib. Deformational plagiocephaly is not treated by surgery. In severe cases of flatness that isn’t going away by itself, we can provide a cranial molding helmet to improve your baby’s head shape.  

Infants with any head shape difference need an experienced team like the one at Texas Children’s North Austin Campus to make sure the flatness is not because a very rare condition called lambdoid craniosynostosis that will need surgery. Our team can tell the difference between these two conditions by a physical examination of your baby in clinic.

  • A baby’s skull must be flexible to allow the head to pass through the birth canal. 
  • This flexibility also means the infant head shape can be changed or molded after birth by a constant pressure. 
  • In the 1990’s the “Back to Sleep” initiative was started to avoid newborns falling asleep on their belly which would put them at higher risk of sudden infant death syndrome (SIDS).
  • When a baby sleeps on the same side of the back of their head for long periods of time it can cause one side to become flatter over time. 
  • Some babies always sleep on one side of their head because one of their neck muscles is too tight and their head can’t turn to one side. This is called muscular torticollis. 
  • Some babies can be born with a different head shape if there has been a tight space in the uterus, such as in a twin pregnancy. 
  • Infants who are born prematurely are at a higher risk of deformational plagiocephaly since their younger skull is even more flexible, and they spend a lot of time in the hospital or intensive care unit lying on the back of their heads. 
  • Deformational plagiocephaly does not cause any problems with how your baby’s brain grows or works.
  • Deformational plagiocephaly does not cause any pain or discomfort.
  • As your baby starts to gain more neck strength and the ability to change position while sleeping, the flatness will stop getting worse and often will get better by itself.
  • In addition to flatness on the back of the head, a baby with deformational plagiocephaly may have one ear position further forward than the other and may have one side of the forehead more prominent. 
  • Deformational plagiocephaly is not treated by surgery. 
  • In the first few months of their life we recommend changing your baby’s sleep position by turning the head to the opposite side. Sometimes this is as easy as changing which side of the crib you place their head. 
  • Maximizing tummy time when your baby is awake and minimizing time in infant devices with a head rest (such as swings and car seats) can also help. 
  • If your baby has signs of muscle tightness of on side of the neck (muscular torticollis) we will refer you to our physical therapy team of experts to help stretch the muscle and improve symmetry.
  • If the head shape flatness is moderate to severe or the plagiocephaly does not improve enough by the age of 4 months, we may recommend a cranial molding helmet. 

Infant with deformational plagiocephaly wearing a cranial molding helmet