RPM Physiotherapy

What is Baby Flat Head and How Can it be Treated?

Baby Flat Head (Positional Plagiocephaly)

by Sandra Ghaly, PT


What is it?

During the first few months of life, a newborn’s skull is soft and flexible. Positional plagiocephaly is a flattened spot on the skull that can occur if your baby looks to one side more than the other. The constant pressure on one side of the head can cause a flattened spot that worsens over time as the baby more easily rests on the flat spot. It is important to note that plagiocephaly has not been shown to affect brain development, but can alter the shape and look of your baby’s face and head.

Why does it happen?

When a baby lies on his/her back, the head turns to one side because the neck muscles are weak. Sometimes, the baby develops a head turning preference, where he/she will always turn their head to either the right or the left. This causes a flat spot on one side of the head. If this continues, the baby can develop a torticollis, which is a tightening/shortening of the neck muscle on the opposite side of the head turning. Premature babies have an increased chance of getting a flat spot since their bones are softer.

How can I prevent my child from developing a flat head/what should I do if my child already has a flat spot?

The most important thing you can do to prevent or improve your child’s flat spot is tummy time. Placing your child on their tummy while they are awake and supervised is very important in developing neck, shoulder and back muscles. It also helps your child keep their head in the middle and off the back of their head. Try tummy time several times per day, aiming for at least 30 minutes total per day. You can place a rolled tower underneath their shoulder to keep their elbows in line with the shoulders if the baby has a difficult time lifting their head. Alternate side-lying is also a good play position for your baby.

If you notice your child already has a flat spot on the back of their head, you can follow the suggestions below to help improve it:

  • Limit time in the car seat: car seats and swings may cause your baby to always rest on one side of their head. Avoid letting your baby sleep in a car seat inside the house.
  • Carrying positions: avoid positions that allow your baby to rest on one side of his/her head constantly. For example, if you bottle feed your baby, make sure to switch the arm that holds the bottle daily so your baby is forced to turn it’s head to both sides equally. Wearing an infant carrier on your body supports the baby in an upright position and takes weight off the back of the head
  • Position of toys: alternate the placement of your baby’s toys and interests to that your baby turns their head equally to both sides to play
  • Change the head of the bed everyday: your baby likes to look at interesting things, such as a mobile or when the parent comes in the room. Change where your baby’s head lies every night so that they practice turning to both sides to look towards their interests. Babies should be put on their back to sleep.

*If the flattening persists or if you notice that your baby’s head is tilting to one side, make an appointment to see your doctor – your baby may need to be referred to physiotherapy for an assessment and other suggestions*

If you are concerned your infant may have plagiocephaly, you can book an appointment, in home or in clinic with Sandra through our website or by calling (416) 572-0479.

About Sandra

Sandra Ghaly graduated from Dalhousie University with a Masters degree in Physiotherapy after completing her Bachelor of Kinesiology degree with honours from McMaster University. She has worked with a variety of clientele but has developed a true passion in working with both the paediatric and women’s health populations. Sandra has extensive experience assessing and treating a variety of paediatric conditions and most recently has become certified as a pelvic health physiotherapist. She also has additional training in acupuncture and kinesiotaping. Sandra finds great value in guiding each individual through a tailored rehabilitation program to optimize their function and quality of life. In her free time, Sandra enjoys yoga, pilates, traveling and spending time with family and friends.

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