Plagiocephaly

What is it?

Plagiocephaly is the term used to describe a misshapen or asymmetrical head shape involving a flat spot at the back of the head. This flat spot is often associated with asymmetry of the forehead and ear. 

In positional plagiocephaly, the head of the baby continues to grow and the babies development is not affected.

Who gets it? 

Plagiocephaly is very common in new born babies and is reported to affect up to 10-30% of babies at six weeks of life. 

Premature babies are more at risk of developing plagiocephaly because they have very soft skulls. Males, first born babies, twins and babies who have limited neck movement (torticollis) are also at greater risk.

What are conditions are associated with plagiocephaly? 

Plagiocephaly is closely associated with torticollis, a condition which involves babies having a restriction in their neck muscles.

What is the natural history of plagiocephaly?

Plagiocephaly usually corrects either spontaneously or with counter positioning techniques. 

While the reported incidence of Plagiocephaly is reasonably high at six weeks of age (10-30%), the natural history of spontaneous improvement is very good, affecting only 3% of children at 2 years of age. 

How do you treat it?

Counter positioning, which involves moving the babies head away from the flattened area is most effective at treating plagiocephaly.

This can be done when your baby is sleeping, when you are playing with your baby and when you are carrying your baby.

Sleeping – position your baby in their cot so they are lying on their back and have their head turned off the flat spot if possible.

Play with your baby in a range of positions, for example, with your baby on their tummy for short periods. Gradually increase tummy time play as your baby gets stronger. You can also try playing with your baby with them positioned lying on their side.

Carrying – a variety of carrying positions can minimise the time your baby spends lying with their head on the flat spot. For example, a baby sling is useful for reducing time the baby spends lying on their back.