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Flat Head Syndrome advice


Flat-head syndrome

Extract from Dr Lowri Kew, Practical Parenting's family GP, Dr Lowri Kew, offering advice on flat-head syndrome – or plagiocephaly - and your baby.

Why does flat-head syndrome occur?

Most babies are born with some head swelling, which usually settles down over the first few weeks of life. However, increasing numbers of babies are developing a flattened side to their head in the first months, usually related to the side they habitually favour when they sleep.

Babies' skulls are made of several bones that aren't rigidly joined and are initially soft enough to be moulded. As they get older, these bones stick together and become more rigid. Imagine a ball of clay that you're pressing down on one side – you'd end up with a flattened side. This is what happens to babies with flat-head syndrome, or plagiocephaly.

The pressure on the skull can happen while your  baby is inside the womb (ie. with twins), but it's more common for the flatness to start appearing a few weeks after birth.

The 'Back To Sleep' campaign, which promotes laying babies on their backs to sleep, has dramatically reduced cot deaths and should always be followed. However, this technique, along with car seats and the fact that babies aren't put on their tummies to play as much as they could be, means your little one's head may suffer uneven pressure.

Do I need to worry about flat-head syndrome?

Flat-head syndrome won't affect your baby's brain growth or develpopment. Most medical practitioners believe it's merely a cosmetic problem.

If the flattening worsens, is severe or your baby's head movements seem limited, ask your GP to check that there's nothing else going on. In a few cases, tightening of the neck muscles limits neck movements to one side, and this can be treated with physiotherapy.

Occasionally, if the flattening is severe or your baby's head doesn't seem to be growing, you may be referred to a specialist to rule out craniosynostosis, a rare condition where the skull bones fuse early.

What can I do about flat-head syndrome?

In time, most cases of flat-head syndrome improve without any medical help, and the majority will become undetectable by other people. You should ensure that your baby sleeps on his back, but re-position his body so that his head rests on the rounded side. In a young baby, re-position his head once he's asleep. With an older baby, move any toys from the end of the cot he sleeps at, as these can block out light, and babies turn to light.

When your baby is awake, make sure he plays on his front as much as possible (known as 'tummy time'). This not only changes the area of the head or body resting on a surface but encourages him to lift his head, which helps his muscle develpoment.

Limit the time your baby spends in his car seat and baby bouncer – carry him in a baby sling or in your arms instead. When feeding, swap the side you hold him on. This is important when bottlefeeding as breastfed babies tend to feed from both sides anyway.

The sooner these measures are taken, the more likely they are to succeed. This is because the skull is softer and more mouldable, and the bones aren't rigidly joined together.

'We rolled a towel into a U shape and put it under the fitted cot sheet, around my son's head. This stopped him sleeping just on his left side every night. Karen, mum to Lewis, 2

Are their any treatments flat-head syndrome?

Some suggest cranial osteopathy, although there's no real evidence that this helps flat-head syndrome. But if you do decide to use cranial osteopathy, ensure the practitioner is trained, registered and experienced in paediatric cranial osteopathy.

Popular in the US, helmets are also gaining popularity in the UK, and many parents have been pleased with the results. However, studies have shown that flat-head syndrome usually lessens naturally with time.

There's no good clinical evidence that helmets make a long-term difference, and their use in the UK is limited. Until recently, they had to be imported, but the first UK-manufactured helmet is now available through the London Orthotic Consultancy. But it needs to be worn 23 hours a day for several months, which is a huge undertaking for child and parent.

For sleep postioners Baby Mattresses Online recommend Rachel  at  who has an extensive range.

Also please see the Steeper Clinic in Surrey for further advice and information. They also have an informative Parent's Guide to Deformational Plagiocephaly brochure available to download.

For more information on flat-head syndrome:

Great Ormond Street Hospital
UK plagiocephaly support group
London Orthotic Consultancy

Page updated 12th Aug 2020, 12:11
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