Does your Baby Have a Flat Spot? Understanding Plagiocephaly and How to Help

Does your Baby Have a Flat Spot? Understanding Plagiocephaly and How to Help

As a parent, you notice every little detail about your baby—from their sweet smile to the shape of their tiny head. So, when you notice a flat spot developing on your baby’s head, it’s natural to have questions. Why did it happen? Will it improve on its own? How long might it take to see changes? And what can you do to help support your baby’s healthy head shape development?

The good news is that positional plagiocephaly is common, and many babies’ head shapes improve with time and appropriate support. Research has reported that positional head flattening can affect nearly half of infants at certain ages, although estimates vary depending on how and when head shape is assessed.

Early recognition can make a difference. Simple positioning strategies, supervised tummy time, and guidance from a qualified pediatric professional can help support healthy head shape development. If you’ve noticed a flat spot on your baby’s head, there are steps you can take—and you don’t have to navigate them alone.

Let’s explore what plagiocephaly is, why it happens, and how you can support your little one.

What Is Plagiocephaly?

The word plagiocephaly may sound intimidating, but it simply describes an asymmetrical or uneven head shape. The term comes from Greek roots meaning “slanted” or “oblique” head.

There are different patterns of head flattening:

Positional Plagiocephaly

Positional plagiocephaly occurs when pressure on one area of a baby’s soft, growing skull contributes to flattening on one side of the back of the head. It may develop when a baby consistently rests their head in the same position or prefers looking in one direction. Limited neck movement, including a condition called torticollis, can also contribute.

You might notice:

• A flat spot on the back or one side of your baby’s head.

• One ear appearing slightly farther forward than the other.

• Uneven fullness in the forehead or cheeks.

• A head shape that looks somewhat like a parallelogram when viewed from above.

  
  

Brachycephaly

Brachycephaly describes a head shape that is relatively wide and short, often with flattening across the back of the head. It can develop when pressure is distributed across the back of the skull, often a result of using baby positioners like bouncers too much throughout the day.

Some babies have a combination of plagiocephaly and brachycephaly.

Why Is an Accurate Assessment Important?

It is important to distinguish positional head flattening from craniosynostosis, a less common condition in which one or more of the skull’s sutures—the joints between the skull bones—fuse too early. These conditions can sometimes look similar but require different approaches to care.

If you notice a change in your baby’s head shape, discuss it with your pediatrician. A healthcare professional can assess your baby’s head shape and determine whether further evaluation or referral is needed.

Why Does Plagiocephaly Happen?

During infancy, a baby’s skull is still developing, and the bones are not yet fully fused. This allows room for the brain to grow, but it also means that repeated pressure on one area can influence head shape.

Imagine a soft ball of clay resting on a table. If it stays in the same position for a long time, the area resting against the table may become flatter. Similarly, when a baby frequently rests their head in the same position, pressure can contribute to flattening in that area.

Positional head flattening may be present at birth or develop during the first few months of life. It is often first noticed during the first one to three months, when babies spend much of their time lying down.

Several factors may contribute, including:

• A preferred head position: Your baby may consistently turn their head to one side.

• Limited neck movement: Torticollis, which involves tightness or an imbalance in the neck muscles, can make turning the head in both directions difficult.

• Limited tummy time while awake: Supervised tummy time gives babies opportunities to move their heads and build strength.

• Time spent in the same position: Extended periods in car seats, swings, and other infant seating outside of necessary use can limit opportunities for movement.

• Positioning before or during birth: Some babies develop head-shape differences because of their position in the womb or the circumstances of delivery.

  
  

Your pediatrician should assess your baby’s head shape and development during routine wellness visits. However, parents are often the first to notice subtle changes between appointments.

If you think your baby’s head shape is changing, trust your gut and bring your concerns to your pediatrician. You can ask whether an evaluation by a pediatric physical therapist or another qualified professional would be helpful, particularly if your baby consistently turns their head to one side or has difficulty moving their neck.

A developmental coach with appropriate infant-development training may also help families understand positioning strategies, incorporate movement into everyday routines, and identify when additional clinical evaluation is appropriate. Be sure to choose a provider whose qualifications and scope of practice match your baby’s needs.

How Can You Help Support Your Baby’s Head Shape?

The good news is that many babies with positional head flattening improve as they grow, move more, and spend less time resting on the same area of their skull. The right approach depends on your baby’s age, head shape, neck mobility, and the severity of the flattening.

Here are some strategies to discuss with your care team:

1. Make Supervised Tummy Time Part of Your Routine

Tummy time gives your baby opportunities to strengthen their neck, shoulders, and upper body while reducing the amount of time they spend resting on the back of their head.

Start with short, supervised sessions while your baby is awake, and gradually increase the time as they become more comfortable. You can incorporate tummy time into your daily routine through floor play and other age-appropriate activities.

Important: Always place your baby on their back to sleep, on a firm, flat sleep surface. Tummy time is only for when your baby is awake and directly supervised.

2. Encourage Variety in Head Positioning

During awake time, encourage your baby to look in both directions by changing the position of toys, talking to them from different sides, and alternating the arm you use to hold or feed them when practical.

You can also vary how you carry and interact with your baby throughout the day, creating opportunities for movement and reducing prolonged pressure on one area of the head.

Never use positioning pillows, wedges, or head-shaping devices in your baby’s sleep space. These products can create safety risks.

3. Watch for Signs of Limited Neck Movement

If your baby consistently looks in one direction, tilts their head, or seems uncomfortable turning to one side, mention it to your pediatrician. These may be signs of torticollis or another movement restriction.

A pediatric specialist can assess your baby’s neck movement and provide individualized exercises, handling techniques, and positioning strategies when appropriate.

4. Seek Guidance Early

Early assessment can help identify contributing factors and determine which strategies are most appropriate for your baby. Depending on the degree of flattening and your baby’s progress, your pediatrician may recommend monitoring, repositioning, physical therapy, or referral to a specialist.

There is no single timeline that applies to every baby. Head shape often improves as babies grow and become more mobile, but the amount and speed of improvement vary. If you have concerns, seeking guidance sooner rather than waiting to see what happens can help you understand your options.

You Don’t Have to Navigate Your Baby’s Head Shape Alone

Noticing a flat spot on your baby’s head can feel worrying, but you are not alone. Positional head flattening is common, and there are practical ways to support your baby’s development.

You know your baby best. If something about their head shape or movement concerns you, trust your instincts and talk with your pediatrician. With the right information and individualized guidance, you can feel more confident about the next steps.

Ready for support?

 Book a consultation with our developmental coaching team to learn more about our services, explore practical strategies for your baby’s everyday routines, and determine whether our support is a good fit for your family.

We’re here to help you feel informed, supported, and confident as you navigate your baby’s development.