Plagiocephaly (flat head syndrome) affects almost half of infants and is usually easily treatable in the early stages. However, parents are often left in the dark about the treatment options that are available to them. Here, we present some basic plagiocephaly information for parents, carers and healthcare professionals in the hope that it might dispel some of the mystery surrounding this common head shape deformity, and so that parents know how to correct it before it becomes severe.
Plagiocephaly Information for Parents, Carers and Healthcare Professionals
Information for Parents, Carers and
1. What is plagiocephaly?
3. Signs and symptoms
1. What is Plagiocephaly?
• A form of Flat Head Syndrome
• Believed to affect almost half of infants
• Characterised by an asymmetrical,
• One side of the head is usually flatter than the
What is Plagiocephaly?
Comparison of flattened and regular head shapes
2. Causes of Plagiocephaly
• A flattening occurs when the infant spends a
lot of time lying with the head resting in the
• Because the bones in the skull are still fairly
soft, the pressure on the head eventually
leaves an indentation.
3. Signs and Symptoms of
• An asymmetrical, parallelogram-shaped head.
• A tendency to face in one direction.
• The neck muscles may be tighter on this side.
This is called torticollis and may require
therapy to help correct it.
4. Preventing Plagiocephaly
• In the vast majority of cases, plagiocephaly
can be prevented or treated in the early
stages through ‘repositioning’.
• Repositioning involves removing pressure
from the back of the head while your baby is
awake, and varying the position of the head
when he or she is asleep.
• Please note: your baby should always be placed
on the back to sleep.
• This minimises the risk of Sudden Infant Death
• However, there are a few ways in which you can
subtly manipulate the head position while your
baby is asleep.
• Start repositioning as soon as you notice a
flattening (usually around eight weeks).
Encourage your baby to face in different directions
when asleep by:
• Gently turning the head with your hands
• Moving toys and other objects of interest from one
side of the cot to the other
• Turning the cot through 180 degrees
• Covering the thumb that your baby usually sucks
Reduce pressure on the back of the head when your
baby is awake by:
• Placing your baby on the front to play
• Using a carry sling or papoose
• Taking your baby out of the car seat / buggy when not
Aim to reduce pressure on the back of the head for at least
half the time your baby is awake.
Holding your baby
5. Treating Plagiocephaly
• In 95% of cases, active repositioning is adequate
for reducing the signs of plagiocephaly.
• A cranial helmet is the preferred treatment for
the most severe 5% of infants.
• If repositioning has failed to make the difference
you had hoped for by the time your baby is 4 – 5
months old, a helmet is the best way to ensure a
more normal head shape.
“[Helmet therapy] should be the treatment of
choice for moderate to severe cases [of
plagiocephaly]. Only mild cases (modified CVAI ≤
6.5%) can be adequately treated by conservative,
i.e. non-helmet, management.”
Sybill Naidoo and An-Lin Cheng (2014)
Long-Term Satisfaction and Parental Decision Making
About Treatment of Deformational Plagiocephaly
• A custom-moulded helmet is worn 23 hours
a day, usually for 3 – 6 months
• This gradually corrects the shape of the
head as the skull grows
• Cranial helmets are a safe and effective
treatment for moderate to severe cases of
• Unfortunately, they are not currently available on the NHS and
cost around £2,000 from a private clinic
• However, there are a number of charities that can help you raise
the funds if required (try Tree of Hope and Headstart4Babies)
• Provided you begin treatment before your baby reaches 12 –
14 months and follow treatment protocols, a cranial helmet
will make a significant improvement to your baby’s head
• After this time period, the deformity can only be corrected by
6. Advice for Parents & Carers
• If you notice a flat spot on your baby’s head,
begin repositioning straight away.
• If this has not made a difference by the age of
4 – 5 months, contact your local plagiocephaly
clinic and book an appointment to see if your
baby could benefit from helmet treatment.
Thank you for taking the time
to read this presentation.
Brought to you by Technology in Motion, UK orthotic
clinic and plagiocephaly specialist.
To find out about our TiMband treatment, please visit
www.technologyinmotion.com or call
us on 0330 100 1800
• Mawji, A., Robinson, A., Hatfield, J., McNeil, D., Sauvé, R. (2013). The
Incidence of Positional Plagiocephaly: A Cohort Study. Pediatrics, 132(2),
1-9. doi: 10.1542/peds.2012-3438
• Hutchinson, B. L., Stewart, A. W., Mitchell, E. A. (2010). Deformational
Plagiocephaly: a Follow-Up of Head Shape, Parental Concern and
Neurodevelopment at Ages 3 and 4 Years. Archives of Disease in
Childhood, 96(1), 85-90. doi:10.1136/adc.2010.190934
• Naidoo, S., Cheng, A. (2014). Long-Term Satisfaction and Parental Decision
Making About Treatment of Deformational Plagiocephaly. Journal of
Craniofacial Surgery, 25(1), 160-165. doi: 10.1097/SCS.0000000000000383