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Understanding Flat Head Syndrome in Infants: Causes, Prevention, and Treatment

Introduction: Flat head syndrome, medically known as positional plagiocephaly or brachycephaly, is a condition where an infant's head becomes flattened or misshapen, often due to prolonged pressure on one part of the skull. This condition has become increasingly prevalent in recent years, sparking concerns among parents and healthcare professionals alike. In this blog post, we'll delve into the causes, prevention strategies, and treatment options for flat head syndrome.


Causes: Flat head syndrome typically occurs when an infant spends extended periods of time lying on their back, which is recommended for reducing the risk of sudden infant death syndrome (SIDS). This prolonged pressure on the back of the skull can result in flattening or asymmetrical shaping.


Other contributing factors may include:

  1. Limited neck movement: Infants with limited neck mobility, often after more difficult to assisted births or conditions such as torticollis, are more prone to developing flat head syndrome. This is the most common cause we se in clinic.

  2. Premature birth: Premature infants may have softer skulls, making them more susceptible to flattening.

  3. Multiple births: Twins or triplets may have limited space in the womb, increasing the likelihood of developing flat head syndrome.

  4. Sleeping position: Placing infants in the same position consistently during sleep can lead to pressure on specific areas of the skull.


Prevention: While some factors contributing to flat head syndrome may be unavoidable, there are several preventative measures parents can take to reduce the risk:

  1. Supervised tummy time: Encouraging supervised tummy time when the infant is awake and alert can help alleviate pressure on the back of the skull and promote healthy development.

  2. Positional changes during sleep: Rotating the direction in which the infant's head faces while sleeping can distribute pressure more evenly across the skull. We also recommend straightening the arm of the side you want to turn baby's head to and bend the other which adopts the ATNR primitive reflex helping keep baby in this position.

  3. Babywearing: Carrying infants in slings or carriers can reduce the amount of time spent lying on their backs.

  4. Limit time in baby gear: Minimize the use of devices such as car seats, swings, and bouncers, which can contribute to prolonged pressure on the skull.

Treatment: In many cases, flat head syndrome resolves on its own as the infant grows and becomes more mobile. However, if the flattening is severe or does not improve over time, treatment options may include:

  1. Repositioning techniques: Pediatricians or physical therapists may recommend specific repositioning techniques to encourage more even head growth.

  2. Helmet therapy: In more severe cases, helmet therapy may be prescribed (not offered on the NHS). These custom-fitted helmets apply gentle pressure to the protruding parts of the skull, allowing the flattened areas to round out naturally.

  3. Paediatric osteopathy: For infants with underlying neck muscle tightness or limited range of motion, physical therapy exercises may be beneficial in improving mobility and reducing pressure on the skull.

Conclusion: Flat head syndrome is a common condition among infants, but with proper awareness and preventative measures, its impact can be minimized. Parents should prioritize supervised tummy time, vary sleeping positions, and limit time spent in baby gear to promote healthy skull development. In cases where intervention is necessary, consulting with healthcare professionals can provide guidance on the most appropriate treatment options. By understanding the causes, prevention strategies, and treatment options for flat head syndrome, parents can support their infant's healthy growth and development.


If you would like to have your infant assessed by one of our team please get in touch and book an appointment with one of our paediatric osteopaths.



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