Newborn laying on side in Daddy's hands

Since the American Academy of Pediatrics introduced the “Back to Sleep” Campaign in 1992, where children are placed on their backs to sleep, there has been an increase in infants spending less time on their tummy. 1 Whilst this has helped reduced the incidence of Sudden Infant Death Syndrome (SIDS), infants are now developing “Flat Head” or Deformational Plagiocephaly1. The skull (cranial system) of babies is soft and heavy, a lack of active movement and head turning encourages flattening at the back of their heads.

What are the Signs and Symptoms?

Deformational Plagiocephaly, “Flat Head”, can easily be observed when you look directly at the top of your baby’s head when they are laying on their back (best to bring your eye level down to be in line with baby’s head). Their face may be asymmetrical also. What you may notice is they keep their head turned to one direction both while sleeping and playing and refuse to turn the other way or when counter positioned, will move back to their preferred position. They may also feed better on one breast and tend to not like tummy time.

What can you do?

There are studies which suggest infants with a Deformational Plagiocephaly have neuro-developmental delays.2,3,4,5 It is very important to have your infant appropriately assessed and managed. Management will vary depending on the nature and severity of the deformity. One of the things I always recommend is for parents to provide tummy time opportunities for their baby. Supervised, active tummy time, as discussed in my previous blog, encourages the baby to look up and is more effective in helping with the correction of Deformational Plagiocephaly.

Early diagnosis and intervention is best, as the majority of cranial growth is in the first 12 months of life and the greatest amount of improvement is achieved during this time.

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  1. Branch, L.G., Kesty, K., Krebs, E., Wright, L., Leger, S., & David, L.R. (2015) Deformational Plagiocephaly and Craniosynostosis: trends in diagnosis and treatment after the “back to sleep” campaign. The Journal of Craniofacial Surgery. 26(1),147-50. doi: 10.1097/SCS.0000000000001401.
  2. Collett, B.R., Starr, J.R., Kartin D., Heike, C.L, Berg, J., Cunningham, M.L., & Speltz M.L. (2011). Development in toddlers with and without deformational plagiocephaly. Archives of Pediatrics and Adolescent Medicine. 165(7), 653-658. doi: 10.1001/archpediatrics.2011.92.
  1. Collett, B.R., Gray, K.E., Starr, J.R., Heike, C.L., Cunningham, M.L., & Speltz, M.L. (2012). Development at age 36 months in children with deformational plagiocephaly. Journal of the American Academy of Pediatrics. 131(1), 109-115. doi: 10.1542/peds.2012-1779
  1. Speltz, M.L., Collett, B.R., Stott-Miller, M., Starr, J.R., Heike, C., Wolfram-Aduan., King, D., & Cunningham, M.L. (2010). Case-control study of neurodevelopment in deformational plagiocephaly. Journal of the American Academy Pediatrics. 125(3), 537-542. doi: 10.1542/peds.2009-0052
  1. Kordestani, R.K., Patel, S., Bard, D.E., Gurwitch, R., & Panchal, J. (2006). Neurodevelopmental delays in children with deformational plagiocephaly. Plastic and Reconstructive Surgery. 117(1), 207-18.