Flat Head Syndrome In Babies (Plagiocephaly & Brachycephaly)
Many parents notice that their baby’s head appears flatter on one side, or across the back, and wonder whether it is something they should be concerned about.
Flat head syndrome is common in babies, particularly during the first few months of life. In most cases it is not dangerous and does not affect brain development, but it can be a sign that your baby is spending more time in one position than expected.
Understanding why head shape changes occur, and identifying any contributing factors early, can help parents make informed decisions about their baby’s care.
What Is Flat Head Syndrome?
Flat head syndrome refers to changes in the shape of a baby’s head that develop after birth.
A baby’s skull is designed to be soft and flexible during infancy. This allows for rapid brain growth and makes birth possible. Because the skull bones are still developing, prolonged pressure on one area of the head can gradually alter its shape.
The medical term for this is positional head shape change.
In most cases:
- It is not painful.
- It does not damage the brain.
- It is relatively common.
- Early recognition can improve management options.
Parents often first notice changes when looking at photos of their baby from above or behind.
Types Of Flat Head Syndrome
Plagiocephaly
Plagiocephaly describes flattening on one side of the back of the head.
Common signs include:
- One side appearing flatter than the other
- Preference for looking one direction
- Mild facial asymmetry
- One ear appearing slightly further forward
Parents often notice that their baby consistently turns their head to the same side when sleeping or resting.
Brachycephaly
Brachycephaly refers to flattening across the entire back of the head.
Common signs include:
- Wider head shape
- Flattened appearance across the back
- Reduced rounding at the rear of the skull
This pattern is often associated with prolonged time spent lying on the back.
Why Does Flat Head Syndrome Happen?
There is usually more than one contributing factor.
Position Preference
Some babies naturally prefer looking one direction, or sleeping mainly face up.
When the head rests in the same position repeatedly, pressure is concentrated on one area of the skull.
Torticollis
Discomfort in the deep tissues of the spine, or asymmetrical tightness in the neck muscles may reduce a baby’s ability to comfortably turn their head both ways.
This can result in a strong side preference and increased pressure on one area of the head.
Time Spent On Their Back
Back sleeping remains the safest sleeping position for babies and should continue to be followed.
However, babies who spend extended periods on their backs during awake time may have fewer opportunities to vary head positions.
Deep and long sleeping babies, with neck turning limitations, may be at greater risk due to increased time spent with pressure on one part of the head.
Pregnancy And Birth Factors
Some babies are born with head shape preferences or neck stiffness related to:
- Position in the womb
- Multiple births
- Larger babies
- Assisted deliveries
- Longer labours
These factors do not necessarily cause flat head syndrome but may contribute.
Why Early Assessment Matters
Most parents are not concerned about head shape alone.
What they really want to know is:
- Why has this happened?
- Is it getting worse?
- Is there anything we should be doing?
- Could there be an underlying issue contributing to it?
The earlier contributing factors are identified, the more options families may have available.
This is particularly important when head shape changes are associated with:
- Torticollis
- Movement preferences
- Difficulty turning the head
- Delayed tummy time tolerance
- Feeding challenges
“Flat head shape in babies, onced established, can be very difficult to reduce. Early detection and good management is key. Many parents don’t come to see us until after the 2 month mark. At Sure Start Chiropractic, we have found that it is much easier to the fix the neck turning limitation behind the flat head, than it is to restore head shape.” – Richard M
Concerned About Your Baby's Head Shape?
If you’ve noticed flattening of your baby’s head, or your baby seems to prefer looking one direction, an assessment can help provide clarity and reassurance. Serving families throughout Adelaide from our Mitcham clinic.
Understanding The Whole Picture
Looking Beyond Head Shape
Head shape is only one part of the picture.
When assessing a baby with plagiocephaly or brachycephaly, we aim to understand why the changes may have developed.
Assessment may include:
Pregnancy History
Understanding factors such as:
- Baby’s position during pregnancy
- Multiple births
- Space restrictions in the womb
- Large baby
- Engaged early
Birth History
Including:
- Delivery type
- Length of labour
- Use of forceps or vacuum assistance
- Any early concerns after birth
Body Posture
Careful observation and measurement of any:
- Head-tilt or turn preference to one side
- Other body asymmetries
Neck Movement
Assessing whether your baby can comfortably:
- Turn left
- Turn right
- Look up
- Move freely through normal ranges
Palpation
Practitioner fingertips to gently feel for:
- tightness in neck or shoulder muscles
- guarding or sensitivity in spinal joints
Development
Understanding:
- Tummy time tolerance
- Rolling
- Head control
- Movement preferences
Head Shape
Looking at:
- Areas of flattening
- Symmetry
- Ear positioning
- Overall skull shape
Feeding
Because feeding can sometimes reveal important clues about:
- Side preferences
- Neck movement restrictions
- Comfort during feeding
Common Questions Parents Ask
Will My Baby Grow Out Of It?
Every case is different. The amount of head shape recovery that can be achieved depends on a combination of age, severity, underlying causes, growth potential, and management strategies.
After assessment, your Chiropactor will be better able to give you an idea of the progress you can expect to achieve.
Is It Affecting My Baby's Brain?
There is currently no strong evidence that typical positional plagiocephaly directly causes significant impairment of brain function in otherwise healthy children.
Should I Stop Putting My Baby On Their Back To Sleep?
Back sleeping remains the safest sleeping position for babies and is recommended to reduce the risk of sudden infant death.
Could Torticollis Be Contributing?
A preference for turning the head one direction is a common factor associated with developing plagiocephaly. A preference for sleeping primarily ‘face up’ can make brachycephaly more likley.
When Should Parents Seek Advice?
Consider seeking professional advice if:
- You notice flattening developing
- Your baby strongly prefers one side
- Turning the head appears difficult
- Tummy time is unusually challenging
- Head shape changes appear to be worsening
- You simply want reassurance and guidance
Many parents find that understanding what is contributing to the problem provides clarity and confidence moving forward.
How We May Help
Our role is to assess your baby’s movement, development and head shape to better understand the factors that may be contributing.
Where appropriate, we may provide:
- Assessment of neck movement
- Assessment for torticollis
- Guidance regarding positioning and movement
- Advice regarding tummy time strategies
- Advice on practitioner treatment options
- Recommendations regarding further assessment if needed
- Answers to questions about Helmet Therapy
If we feel another healthcare professional would be better placed to assist, we will discuss this with you.
Got questions about Chiropractic care for your baby?
Will Chiropractic Care Be Safe For My Baby?
Can Chiropractic Help My Baby’s Particular Problem?
What Actually Happens During A Baby Assessment?