Positional Plagiocephaly

The Importance of Re-Positioning and Tummy Time

This is a guest post by Mrs Joanne Drake BSc (Hons) SROrth MBAPO is the Senior Orthotist at The London Orthotic Consultancy.

Positional Plagiocephaly, commonly called ‘Flat-Head Syndrome’, is a condition characterised by a flattening on one side of the back of a baby’s head. It may also involve bulging of the forehead, fullness of the cheek and ear misalignment on the same side as the flattening.

The three different types of Positional Plagiocephaly

What Causes Positional Plagiocephaly?

Newborn babies often have some asymmetry of the head due to the inherent stresses and strains of the birth process. This normally settles in the first few weeks after birth. However, because a baby’s skull is still malleable it can be shaped by external forces. Recent research suggests that the incidence of the condition is now primarily caused by positional factors after birth.

Improving Positional Plagiocephaly by Repositioning

The first option is to try to reposition your baby’s head as much as possible with the aim of encouraging your baby to rest its head on the non-flattened area.

At night time try alternating the end of the cot where your baby lays its head. Turn its head so that it is not lying on the flattened side.

A baby enjoying Tummy Time

Tummy Time Is Important Too

During the day encourage your baby to spend as much time as possible on its stomach. Most babies dislike this initially as they do not have the strength to hold their head up. However it is important to persevere and gradually build up the length of time spent on their tummy. This also helps them build strength in their neck and trunk muscles to progress towards pushing up and crawling.

Tummy time can be made easier for your baby by using a support under their chest enabling them to lift their head more easily. Make tummy time fun by spending time lying down with your baby on top or in front of you. Use interactive toys to entertain them.

Other Ways to Improve Positional Plagiocephaly

You should also consider your baby’s head position whilst carrying, feeding or changing them. Alternate the side you do the activities, as this will encourage them to look and turn in both directions. As your baby’s strength develops you should spend some time carrying them tummy down, as this will encourage them to look up, further developing neck and trunk strength.

Furthermore, modern baby travel systems are conveniently designed to click together so that there is no need to wake your baby when transporting them from the car to the house. Unfortunately this can also mean long periods of time lying on their back with their head against a hard surface. Minimise the time your baby spends in the travel system when not travelling.

Improvements in Plagiocephaly after 3.5 months in a Cranial Remoulding OrthisisImprovements in Brachycephaly after 4 months in a Cranial Remoulding Orthisis

Cranial Remoulding Orthosis

If repositioning does not work, a Cranial Remoulding Orthosis (baby helmet) may be the solution. It is non-invasive and works by applying constant gentle pressure over the areas of the baby’s skull which are most prominent while allowing unrestricted growth over the flattened areas.

This is done using a baby helmet. Baby helmets such as the LOCband have been used for over 25 years to treat babies with flat heads.

Positional Plagiocephaly





About eParenting: eParenting was started by Jacqui O'Brien in 2004. At the time her kids were 1 and 4 and kept her nice and busy. Now they are teenagers and still keeping her pretty busy!








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