Plagiocephaly is the term doctors use to describe a misshapen skull, including a flat spot on the back or side of the skull. The term positional plagiocephaly is used when the flat spot is caused by an infant lying on one side for too long. The flat spot occurs because infants’ skulls are still soft and malleable. External force on the skull over time, such as lying on the back, can cause the skull to change shape.

Since 1992, the American Academy of Pediatrics has recommended that infants be placed on their backs for sleep. This recommended has dramatically lessened the occurrence of sudden infant death syndrome (SIDS), but the incidence of positional plagiocephaly has increased. There are more than 200,000 cases of positional plagiocephaly in the U.S. each year.

When an infant is placed in the same position day and night, her head contacts the surface of the mattress in the same spot. Over time, as a small flat spot forms, she will favor that spot for her head, slowly worsening the issue.

Plagiocephaly doesn’t cause brain damage or interfere with the child’s development. In fact, a flat spot on an infant’s head is generally not a concern as they may grow out of it. A pediatrician or nurse can assess whether a flat spot on your child’s head needs treatment.

If a doctor determines that a child’s plagiocephaly needs treatment, he or she will likely start by determining the root cause of the issue. If tight or weak muscles are stopping the infant from moving his head, physical therapy may be the treatment. If the plagiocephaly is positional and the child is younger than 5 months old, the doctor may show the parents how to shift baby’s position so that the skull evens itself out. For children older than 6 months old, a special helmet may be prescribed to slowly change the shape of the skull.


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