Flat head in babies vs normal shape: Baby head shape guide

As your baby grows, you may notice changes in their head shape. While some variations are typical, others may suggest flat head syndrome. Knowing what to look for can help you decide what to do next. This guide explains the signs and the support options available.

Understanding infant skull development

A baby’s skull is soft and mouldable, allowing for brain growth and passage through the birth canal. The skull comprises several plates that gradually fuse over time. This flexibility means that external pressures can influence head shape, especially during the first few months.

Normal head shape variations

It’s common for babies to have slight irregularities in head shape:
Moulding: Temporary shaping from birth canal pressure, typically resolving within a few days.
Positional preferences: Favouring one side while sleeping can cause minor flattening, often improving with movement and growth.

These variations usually correct themselves without intervention.

Flat head syndrome: what to look for

Flat head syndrome encompasses conditions like plagiocephaly (flattening on one side) and brachycephaly (flattening at the back). Signs include:

• noticeable flat spots: Areas of the head that appear flattened.
• asymmetrical features: Uneven positioning of eyes, cheeks or ears.
• bulging forehead: The forehead may protrude more than usual.
• preference for one head position: The baby consistently turns the head to one side.

If you notice these signs, speak to your GP or health visitor.

Causes of flat head syndrome

Several factors can contribute to flat head syndrome:

• sleep positioning: Consistently lying on the back without variation.
• limited tummy time: Insufficient supervised time on the stomach.
• Torticollis: Tight neck muscles limiting head movement, resulting in constant pressure on one side of the skull. The neck tightness can make repositioning difficult.
• premature birth: Premature infants have softer skulls and may spend more time lying down. Possibly requiring time in NICU and positioning due to underdeveloped muscle control and strength.
• large birth weight: Intrauterine crowding may result in some flattening of the skull before birth.
• multiple births: Intrauterine crowding and positioning may lead to some flattening of the skull prior to birth. Often born prematurely.

Preventative measures

To reduce the risk of flat head syndrome:

• encourage tummy time: Supervised time on the stomach strengthens neck muscles.
• vary head positions: Alternate the direction your baby faces during sleep.
• limit time in car seats: Reduce prolonged periods in devices that restrict movement.
• engage during awake time: Encourage your baby to turn their head by interacting from different directions.

When to seek professional help

If you notice persistent flattening or asymmetry, consult a healthcare professional. Early intervention can lead to more effective outcomes.

Treatment options

Depending on the severity, treatment may include:
1. Repositioning techniques
Encouraging the head position to alleviate pressure on the flattened area. Night time is when your baby may spend the most time lying on the flattened area.

2. Tummy time
This position helps encourage normal motor development and develops strength of trunk and neck muscles. This develops head and neck control helping to reduce the risk of positional plagiocephaly.

3. Physical therapy or cranial osteopathy
If torticollis is present, physical therapy or cranial osteopathy can help improve neck muscle tightness and balance the range of movement.

4. Cranial remoulding orthoses (helmet therapy)
For moderate to severe cases, or when repositioning and tummy time have not improved head shape as hoped, custom-fitted helmets can gently guide growth towards a more balanced shape. We offer bespoke cranial remoulding orthoses tailored to your baby’s needs, with regular reviews and adjustments as your baby grows. Learn more about our treatment options

Learn more about our treatment options.

Understanding the difference between a normal head shape and a potential flat head condition helps you make confident, informed choices for your baby’s development. Whether you’ve just noticed a flat spot or want to explore orthotic treatment options, we’re here to support you.

Our orthotists can assess your baby’s head shape and talk you through the next steps, including whether repositioning is likely to be enough or whether helmet therapy could help. Get in touch to book a consultation or ask any questions.