Key points about positional head flattening in babies
- positional head flattening may happen if a baby lies with their head in the same position for a long time
- you can help to prevent this from happening by varying your baby's head position when you put your baby to bed
- always sleep your baby on their back, but from birth, try to turn their head to a different side at each sleep
What is positional head flattening in babies?
Positional head flattening is sometimes referred to as flat head in pēpi (babies). Its medical name is positional plagiocephaly.
It happens because the bones of a young baby's head are soft and flexible, so they can change shape easily. Positional head flattening may happen if a baby lies with their head in the same position for a long time.
Sometimes pēpi are born with a slightly flat area on their head.
An illustration of a baby’s head from above showing an even head shape.
Source: KidsHealth
transcribeTranscript
The illustration shows the top view of a baby’s head and shoulders.
- The baby’s head shape appears even on both sides.
- A dotted green line across the front and back of the head shows that the shape is symmetrical.
- At the bottom of the illustration, the label reads Normal.
At the top left is the KidsHealth logo with the website: kidshealth.org.nz.
An illustration of a baby’s head from above showing positional head flattening on one side.
Source: KidsHealth
transcribeTranscript
The illustration shows the top view of a baby’s head and shoulders.
- The back of the baby’s head is slightly flattened on one side, showing positional head flattening.
- A dotted green line shows the asymmetry, with one side appearing flatter.
- At the bottom of the illustration, the label reads Positional head flattening.
At the top left is the KidsHealth logo with the website: kidshealth.org.nz.
If my baby has a flat head, will it improve?
Research in Aotearoa New Zealand has shown that most pēpi with positional head flattening will improve over time without special treatment But, there are things you can do to help prevent it from happening.
Preventing positional head flattening
You can help to prevent a flat area from occurring by varying your baby's head position when you put your baby to bed.
Always sleep your baby on their back, but from birth, try to turn their head to a different side at each sleep. Don't use pillows in the cot for positioning.
Head and cot position
Place your baby at different ends of the cot at each sleep. You can also change the position of the cot in the room, so that you come to their cot from different sides.
Pēpi often like to look at objects like things on the wall or windows. Changing their cot position will encourage them to look at things that interest them from different sides.
Try and change your baby's head position each time you put them down to sleep.
Play time
When your baby is awake and alert:
- play or interact with them facing you
- place them lying down on their front (tummy time) - be guided by your baby as to how long they can tolerate it
- place rattles or toys that your baby likes to look at in different positions - this encourages them to turn their head both ways.
- always stay with them to keep them safe
Vary the way you hold and carry your baby
Avoid having your baby lying down too much by changing their position throughout the day. You could:
- hold them upright for cuddles
- carry them over your arm, on their tummy or side
- use a sling or carry-pack
When to get medical help for your baby
If you’re concerned about your baby’s head shape, talk to your health professional. You can call Plunketline if you’re unsure what to do.
PlunketLine is available 24 hours a day, 7 days a week, on 0800 933 922 for advice and support for you, your baby and your whānau. Calls are free from cell phones. You do not need to be registered with Plunket to use this service.
Treatment for positional head flattening
Most pēpi with head flattening do not need any treatment. Positional head flattening will usually improve as your baby grows and starts to move their head more by themselves.
If your baby has a flat area on one side of their head, they may start to prefer facing one direction - particularly while they sleep. Your health professional may recommend turning your baby’s head to face the other side during sleep. You can put interesting things on the wall to encourage your baby to face in that direction.
Some whānau may think about using a baby helmet. This is not a recommended treatment for positional head flattening in Aotearoa New Zealand.
Other causes of a flat area on the head
Occasionally, there may be another reason for the flat area on your baby's head.
Tight neck muscle
A tight neck muscle (torticollis) on one side can prevent your baby from turning their head the other way. The muscle is called the sternocleidomastoid muscle. If your baby has this problem, your doctor may refer you to a physiotherapist.
A problem with the skull bones
A very rare cause of a flat head in pēpi is a problem with their skull bones. If you are concerned about an unusual head shape, check with your health professional.
Acknowledgements
Illustrations by Dr Greta File. Property of KidsHealth.
