Frequently Asked Questions

What is Positional Plagiocephaly/Baby Flat Head Syndrome?

Plagio is caused by external pressures on the head, causing the cranial vault to change shape over a period of time.

This can be caused post natal by baby predominantly lying in one position or in the womb when there is a restriction of space caused by multiple foetuses, position or low amniotic fluid.

Does natural birth cause Plagiocephaly/Baby Flat Head Syndrome?

No, there is a natural deformation of the cranial vault during vaginal birth but this is a temporary shape change and the intracranial pressures will soon round the head out. From birth it is important to practice supervised tummy time and to alternate head direction at each activity or sleep, this will ensure that there are no unequal pressure points on the skull.

Will Plagiocephaly/Baby Flat Head Syndrome affect my baby’s intellect?

Research is presently being undertaken in the USA that shows that depending on the severity of the deformation that there is an amount influence to the intellect. This will depend on the location of the flat spot as to how the baby is affected. Generally the baby with soon catch up to unaffected babies and the difference will be barely noticeable. There are many adult intellectuals that have Plagiocephaly.

Will the flat spot fix its self?

Baby’s bone structure is soft and supple from birth. In the first few months the intracranial pressure and soft bones may allow the head to round its self out, but it is vital to keep baby off the flattened area.

Alternate head direction at each activity and practice as much supervised tummy time as possible.

From about five months on, baby’s bone structure becomes denser and positional therapy is not always effective. From five months onwards only helmet treatment is completely effective.

Your baby’s head growth is at its maximum between five and seven months. After twelve months head growth rapidly decreases and even helmet treatment becomes more difficult.

A five month old baby with 18mm deformation may wear a helmet for three months.

Same baby at twelve months may have to wear a helmet for up to six months.

Research shows that 70% of babies left untreated show signs of Plagio 12 years later.

How do I know if my baby has Plagio/Flat Head Syndrome?

From six weeks old the cranial deformity caused by birth should have rounded out, if there are still signs of deformity or the deformity is getting worse then it is best to see a specialist to check if your baby has Plagio.

It is possible to do a basic check yourself at home.


Looking from the top of you babies head see if any of the shapes relate to your baby’s head.

Next place your finger tips gently into babies ears and check to see if the ears are eqally spaced.

Lay baby on their back, looking along the tummy see if the cheeks and forhead are equally spaced with the eyes.

What is Craniosynostosis? (Early suture closure)

The skull of an infant is made up of free-floating skull plates, these are separated by sutures.

This allows the infant's head to pass through the birth canal and also enables the skull to grow with the brain in early infancy.

Premature fusing of these plates will cause the head to grow unevenly.

A misshapen head is usually the first clue that may have caused you to take your child to your doctor who needs to investigate if your child has Synostosis.

The fontanelle, or soft spot, may or may not be open. The suspected diagnosis is confirmed by a CT scan is often done to make sure there are no underlying abnormalities in the brain.

Craniosynostosis is serious and in most cases will need one or more surgeries to correct this

What is Muscular Torticollis (Wry Neck)

Torticollis means "twisted neck," and if a child has this condition, the head can be tilted to one side while the chin is turned to the other side, or the baby cannot turn the head equally from left to right. About 1 in 250 infants are born with torticollis. (Ten to 20 percent of babies with torticollis also have hip dysplasia, in which the hip joint is malformed.)

It is interesting that many adult’s ears are not level. This is one of the signs of mild Torticollis as an infant.

Congenital torticollis?

Congenital torticollis is most often due to tightness in the muscle that connects the breastbone and the collarbone to the skull. ( Sternocleidomastoid muscle)

This tightness might have developed because of the way your baby was positioned in the uterus (with the head tilted to one side) or because the muscles were damaged during delivery.

In severe cases the un-equal muscle tension can pull the skull out of shape.


Acquired torticollis

Acquired torticollis develops after birth.

Generally this occurs when baby is allowed to favour one sleeping position allowing the sternocleidomastoid muscles to develop unequally.

This is normally associated with Plagiocephaly.

How will I know if my baby has torticollis?

You'll probably notice that your baby holds her head to one side and has limited neck movement. Another telltale sign is a small bump on the side of her neck.

Congenital muscular torticollis is usually diagnosed within the first two months of a baby's life. Even if parents don't spot it, a paediatrician will.

Babies with torticollis may also develop positional plagiocephaly (asymmetrical head shape) because they'll often sleep with their head turned to the side.

In addition to a physical exam, the doctor may need to order X-rays of the neck to determine which form of torticollis your child has.

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