Preventing Flat Head Syndrome

As a baby massage teacher, I see more babies than I ever knew I’d want to, and I love it. There’s little as beautiful as seeing that bond between a mother or father and baby. However, it’s not unusual, week after week, to see babies brought into the room in their car seats. They’re taken out and put down on the mats on their backs, and then after the session and after being redressed, are put back in the car seats. As a result, I see many babies, by the time they get to me at six weeks or so, with a bald patch or a flat head – known as flat head syndrome.

There are different types of plagiocephaly – flat head syndrome – but the one that’s been reported in the media recently and is most common is positional plagiocephaly, and is caused by pressure on the skull due to being in the same position for long stretches of time.

Moving a baby from a cot (crib) to a car seat to a play gym and back places pressure on the skull, causing it to flatten. While vaginal birth can often cause a misshapen head anyway, by about six weeks old, the head should be rounded out. If plagiocephaly occurs after six weeks, it is probably due to this pressure.

In a recent Daily Mail article, Kate Chauhan, an orthotist at the Steeper Clinic in Kingston upon Thames, says, “It depends on the severity but if there is a big shift, it can push the face forward and this can mean the ears are out of alignment. This can result in a higher incidence of ear infections. There are also links between plagiocephaly and esotropia — or wandering eye.”

baby sleeping in crib

Ms. Chauhan adds that babies spend too much time curled in a C-shape in car seats and rockers when their body needs to be flat so that it can start to adapt for walking later on. “Every bit of the body is affected if a baby is kept in a sedentary position. That child may get niggles later — lower back problems, knee problems — when they start to play sport. Restricting early movement has an impact on how the eyes develop and this can affect reading and writing, because the eyes can’t grasp what is on the page. They also miss out on sensory experiences and touch.”

The website Babyflathead lists ten tips for preventing and treating baby flat head syndrome. We all know that prevention is better than cure, these are steps you can take even if your baby is already showing signs of having a flat head.

  1. Tummy Time
    Fear of SIDS has made us all terrified of putting our babies to sleep on their tummies. It’s really important to do, however, and the earlier you start, the better. (It also helps with colic and wind, by the way!)
  2. Flat Head Pillow
    The website lists a variety of support pillows with pros and cons.
  3. Limit Use of Swings, Baby Rockers, and Car Seats
  4. Hold and Carry Your Baby
    A sling is a fantastic way to keep your baby close and your hands free. I’ve even taught classes with my baby in my sling, they’re that supportive to your needs. Make sure that you buy a sling that supports your baby’s hips, and not one of the popular but dangerous “crotch dangler” styles.
  5. Sleeping Position
    Alternate which side your baby sleeps on, or use a sleep positioner.
  6. Sitting
    When a baby can hold its head up, it can sit in a Bumbo seat or play nest (but also not for extended periods of time!) to give the head a break and strengthen the neck muscles.
  7. Alternate Feeding Sides
  8. Alternate Sides at Nappy Change
    The logic they use here is that baby will turn his head to look at you, so using different ends of the changing table means baby is looking at you from different sides.
  9. Swimming and Softplay
    Participating in activities that help strengthen babies’ necks will help them get off their backs sooner.
  10. Massage Your Baby
    Apparently stiff neck muscles are a common cause of flat head. Massaging your baby’s head, neck, and back will help release the stiffness.

Remember that there are different types of plagiocephaly, and that they are generally treatable while baby’s head is soft. If these measures aren’t working, however, you will need to ask your pediatrician to refer you to a specialist, and a cranial remoulding helmet might become necessary.

For most babies, however, a combination of the ten steps above should resolve, and preferably prevent, flat head syndrome.


Statements on this website have not been evaluated by the Food and Drug Administration. Products and/or information are not intended to diagnose, cure, treat, or prevent any disease. Readers are advised to do their own research and make decisions in partnership with their healthcare provider. If you are pregnant, are nursing, have a medical condition, or are taking any medication, please consult your physician. Nothing you read here should be relied upon to determine dietary changes, a medical diagnosis, or courses of treatment.

About The Author: Luschka

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Luschka is a mother to two little girls. She is passionate about the principles of Attachment Parenting, and although she admits to learning as she goes, she likes to share what she's learnt with others - possibly because of her experiences in adult education. AP challenges a lot of Luschka's own background, which she loves as it makes her research and study everything. She writes at Diary of a First Child , documenting the journey for those parents who don't live in idyllic isolation, but still want to follow this path with their families.

9 Responses to Preventing Flat Head Syndrome

  1. Sara Carlson  

    I love this. Thanks so much for the info. When we are ever blessed with another pregnancy, I will be keeping this in mind.

  2. Momma Jorje  

    Great info! I have been using the couch or bed for diaper changes, so I’m usually at Spencer’s feet anyway. But I’ve always let Sasha and Spencer sleep on their tummies when they wanted to. (They both made it clear early on that they preferred this position.)

  3. Fiona

    Lots of good info!! My 5 month old has plagiocephaly but hers is due to torticollis which she had since birth. We do all of these things but it is still difficult as in the beginning her head couldn’t really turn the other way. With lots of stretches and exercises we are definitely seeing improvements. We actually carried her almost all the time and put her in a Bumbo most of the time if she had to be put down, plus she naps on her tummy because we can supervise her so the only time she was on her back was sleeping at night but since she has always been such a good sleeper, it meant 12 hours a night on one side even if we went in to turn her every hour, she just turned back due to the torticollis. Luckily this is slowly improving as well.. so it is looking okay for no helmet needed which is great news!

  4. Natalie

    My nephew is a twin, both boys were induced pre term, low-ish birth weights, first children etc… (which are a lot of the risk factors). Due to his position in the womb, (cephalic, half in / half out the birth canal for weeks on end) the older twin was born with Torticollis. He has had a significant flat head and has had to wear a helmet. A referral to a paediatric physio helped in that she gave my brother and s-i-l exercises they could do with him to try and build his strength up on one side of his neck. SO yes, I suppose I am just trying to say some, not all, positional plagiocepahlys have underlying causes and if that is the case, do get it checked out asap to help prevent the severity of the resulting PP.

    • Fiona

      I agree, Natalie. My daughter’s flat head was due to torticollis which occurred from her having ‘dropped’ into my pelvic bones several weeks early. I feel I did everything in helping and preventing it as much as I could have.

    • Luschka  

      100% agree! Some definitely do, but what I’m talking about is really more the babies who never leave car seats – some moms really just don’t know. I know plagiocephaly can be quite common in twins. 🙂