What is Positional Plagiocephaly - Flat Head Syndrome
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What is Plagiocephaly /Baby Flat Head Syndrome?

Positional Plagiocephaly is a condition that affects the skull, making the back or side of a baby’s head appear flattened. It may also involve bulging of the forehead, fullness of the cheek and ear misalignment on the same side as the flattening.

There are two types of the condition – Deformational – where the condition is caused by the birth process itself – and Positional – where it occurs post birth. Positional Plagiocephaly is more common.

Under the broad heading Positional Plagiocephaly there are three main types of asymmetrical head shape associated with the condition:

  • Plagiocephaly
  • Brachycephaly
  • Dolichocephaly/Scaphocephaly

A baby’s skull is made up of several ‘plates’ of bones which at birth are not tightly joined together. They are soft enough to be moulded by outside forces; this means their shape can be altered by pressure, just lying or sitting in the same position against a firm surface can cause flattening usually at the back of a baby’s head.

If you are concerned about the shape of your baby’s head, help and advice is at hand. You can get immediate and free advice from one of our experienced clinicians with our clinical plagiocephaly diagnosis form.


What causes Positional Plagiocephaly?

Positional plagiocephaly can be caused by a number of factors involving positioning, such as extended time spent in a neonatal unit, the birth process, position in the womb and often the infant's preferred sleeping position. It can also be caused by a condition called torticollis.


What is Torticollis?

Torticollis is a condition in which a tight or shortened muscle in one side of the neck causes the head to tilt or turn to one side, resulting in the infant resting its head in the same position. In 2013, we analysed the data from all first appointments in our Kingston clinic and found that 20% of the babies examined had some kind of neck condition that was causing head immobility.


How Common is Positional Plagiocephaly?

Frankly there does not seem to be much consensus on the incidence of Positional Plagiocephaly. The situation is not helped by the fact that the NHS does not measure head shapes either at birth or subsequently. Where head shapes are measured in other countries it is difficult to make comparisons because one is never certain that the same methodology is being used. Great Ormond Street Hospital for Children says: “Some reports estimate that Positional Plagiocephaly affects around half of all babies under a year old but to varying degrees.” GOSH’s summary is supported by a Canadian study published in 2013 which found that 46.6% of a sample of 440 infants at a two-month well child clinic had some form of Positional Plagiocephaly.

Source: The incidence of Positional Plagiocephaly: A Cohort Study:Pediatrics peds.  2012-2009; published online July 8 2013



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