Positional plagiocephaly is a disorder in which the back or one side of an infant's head is flattened. It's most often the result of babies spending a lot of time lying on their backs or often being in a position where the head is resting against a flat surface (such as in cribs, strollers, swings, bouncy chairs, and carseats).

It can also be caused by torticollis in which the neck muscles are too tight causing the head to tilt one way while the chin points in the other direction. Being premature can also cause plagiocephaly because a premature baby’s skull is often softer than a full-term baby and they can spend many hours on their backs in the NICU if they require long-term care. It can even develop before birth if pressure is placed on the baby’s skull by either the mother’s pelvis, or a twin, or possibly if the mother has low amniotic fluid.

There has been a significant increase in the number of cases of positional plagiocephaly since the Back to Sleep Campaign began in the early 90’s to help reduce the incidence of SIDS by placing babies to sleep on their backs. However, Back to Sleep is still recommended by the American Association of Pediatrics.

If you notice your baby is developing a flat spot, be sure to bring it to the attention of your Pediatrician. Their first course of action will probably be to teach you how to use some repositioning techniques. For example you can roll up a blanket and place it under his or her side so that he or she can not roll on that side. You can place toys on the side of the crib in the direction you want your baby to look to take pressure off the flattened side. And finally, to help develop the neck muscles for good head control you can start to do some supervised tummy time.

If the plagiocephaly is severe and does not correct with time, your Pediatrician may recommended cranial orthotic therapy. This will be in the form of a custom-fitted helmet or headband. Research suggests that this kind of therapy is most successful when started before the age of six months. The length of treatment time for a helmet or band is dependent on several things. The age at which the baby starts the therapy, the particular design of the band or helmet used, the rate at which the individual baby grows, and the degree of positional plagiocephaly all play factors into determining the length of treatment necessary. However, recognizing that every baby is different, it can be said that most complete treatment within 6 months.

Below are some informative links about Plagiocephaly and the different kids of orthotic therapies that are available.

BabyCenter.com Plagiocephaly Info

CAPPSkids-Plagio info

Cranial Tech-DOC band

Orthomerica-STARband

Gillette Children's Minnesota-Cranio Cap

Positional Plagiocephaly

In addition, there are many threads regarding Plagiocephaly on TS. The best way to find them is to type Plagiocephaly, or flat head, into the search bar.