Complete Guide To Treating Plagiocephaly From A PT

Baby with head turned left on back

Comprehensive Guide to Treating Plagiocephaly 


Plagiocephaly, or flat head syndrome, is a common condition that affects up to 1 in 5 infants. It happens when an infant’s skull becomes flattened in one area due to pressure from two sides for a prolonged period of time. If left untreated, it can cause facial asymmetry and other physical issues. That’s why it’s important to treat plagiocephaly as soon as possible. 

This article will provide an overview of the treatments available for plagiocephaly, along with information on how to identify and manage the condition. We’ll talk about causes, prevention tips, and when it’s necessary to seek medical help. 

Understanding Plagiocephaly 

What is plagiocephaly?

Plagiocephaly affects both the shape and alignment of a baby’s head. It is caused by pressure on an infant’s soft skull, which can occur from being positioned in one direction for too long or even when lying face down. The flattening usually occurs in the back or sides of the head and can cause facial asymmetry. It’s important for parents to watch for signs of plagiocephaly and seek medical attention if needed. 

Discussion on the causes and symptoms of plagiocephaly

The main cause of plagiocephaly is pressure on the baby’s skull. This can be from long periods of being in one position, such as sleeping face down or having a tight swaddle. Other causes can include low muscle tone in the neck, multiple births, and congenital conditions. Symptoms to look out for include an asymmetrical shape to the head or face and difficulty turning their head due to stiffness in their neck muscles. 

Importance of Early Detection 

The importance of early detection in the successful treatment of plagiocephaly

It’s important to detect plagiocephaly as soon as possible in order to start the necessary treatments. Early detection and intervention can help prevent long-term issues with physical development, such as asymmetry of the face or head shape. It’s also important for parents to monitor the symptoms of plagiocephaly and contact their doctor if there is any concern. 

When and how plagiocephaly is usually diagnosed

Plagiocephaly is usually diagnosed at a well-baby checkup or when the parents notice irregular head shape or facial asymmetry. The doctor will perform an examination to check for flattening and measure the baby’s head circumference. If plagiocephaly is suspected, the doctor may order additional tests such as an ultrasound or X-ray to determine if there are any underlying conditions that could be causing it. 

Non-Invasive Treatment Options 

Repositioning techniques and their effectiveness

Repositioning techniques involve positioning the baby’s head in various ways to reduce pressure on specific areas of the skull. This technique is usually recommended as a first line of defense for mild plagiocephaly cases. It involves changing the baby’s position frequently throughout the day and using supportive pillows or wedges to help keep their head in the right position. It is important to consult a doctor before trying any repositioning techniques as they can be dangerous if done incorrectly. 

Physical therapy exercises for plagiocephaly

Physical therapy exercises can be used to help babies with plagiocephaly improve their physical development. These exercises involve stretching and strengthening the neck muscles, as well as helping the baby learn to roll over and hold up their head. A physical therapist may also recommend exercises to encourage the baby to move their head in different directions, which can help reduce flat spots on the head as well. 

Use of Cranial Orthotic Devices 

Information about cranial helmets.  

Cranial helmets, also known as orthotic devices, are a common treatment for plagiocephaly. These helmets are custom designed to fit the baby’s head shape and provide support and protection while applying gentle pressure to reshape the skull. The helmet should be worn at all times, except when bathing or sleeping, in order for it to be most effective. Cranial helmets are a safe and non-invasive treatment option, but should only be used after consulting with a doctor to make sure it is the right choice for your child. 

When to consider cranial helmets and what to expect from the treatment

Cranial helmets should be considered when other treatments such as repositioning techniques or physical therapy exercises have not been successful. The helmet is typically worn for three to six months and the results can vary, with some children seeing significant improvements while others may not see much change. It is important to talk to your doctor about what to expect from the treatment and if it is the right choice for your child. 

Surgical Interventions 

When surgery might be necessary

In some cases, surgical intervention may be necessary to correct plagiocephaly. Surgery should only be considered when other treatment options, such as the use of a cranial helmet or repositioning techniques, have not been successful. Surgery involves reshaping the skull and is typically reserved for more severe cases of plagiocephaly. It is important to talk to your doctor about all of the risks associated with surgery before making any decisions. 

The surgical procedures used to treat severe cases of plagiocephaly

Surgical intervention for plagiocephaly involves reshaping the skull and moving or removing some of the bones in order to restore an even shape. The procedure is sometimes combined with a cranial helmet for additional support. The surgery typically requires general anesthesia and can take up to four hours depending on the severity of the condition. It is important to discuss all risks associated with surgery with your doctor before making any decisions. 

Surgical intervention 

The primary benefit of surgical intervention for plagiocephaly is that it can restore the shape and symmetry of the skull. This can have a positive effect on both physical appearance and brain development, as an unevenly shaped head can lead to developmental delays. Surgery also offers the opportunity to correct any underlying medical conditions, such as craniosynostosis, which may have caused the plagiocephaly in the first place. 

Role of Specialists in Treatment 

Specialists involved in treating plagiocephaly

Treating plagiocephaly can be a complex process and require the involvement of multiple specialists. The primary physician involved in diagnosing and treating plagiocephaly is usually a pediatrician or a neurologist. Other specialists may include an orthopedic surgeon, plastic surgeon, physical therapist, occupational therapist, and/or speech-language pathologist. 

How to choose a reputable provider for plagiocephaly treatment

It is important to do your research and reach out to providers that specialize in treating plagiocephaly. Ask for references, read reviews from other parents who have used their services, and make sure they are familiar with the latest treatment methods. Make sure to ask questions about their experience and qualifications, as well as any potential risks or complications associated with the chosen treatment. 

Home Care Tips 

Tips for parents to manage plagiocephaly at home

Parents can take an active role in treating plagiocephaly at home. Some tips for parents include: using a flat pillow or no pillow when sleeping, minimizing the amount of time their baby spends in car seats and baby carriers, alternating toys between the left and right sides of the head, providing tummy time to help stretch the neck muscles, and ensuring that the baby has plenty of “supervised” awake time on their stomach. 

Importance of regular follow-ups with healthcare providers

Regular follow-ups with a healthcare provider are essential for treating plagiocephaly. Follow-up appointments are necessary to monitor the baby’s progress and determine if additional treatment is needed. The physician will also be able to assess any potential risks or complications associated with the chosen treatment plan.   

Long-term Outlook 

The long-term outlook for children with plagiocephaly is generally positive. With early diagnosis and treatment, the head shape can often improve over time. Plagiocephaly itself does not usually affect a child’s development or cause any physical complications. However, it is important to monitor a child’s progress closely and consider additional treatments if necessary. 

Although plagiocephaly itself does not typically affect a child’s development, it is important to monitor for any potential psychological impacts. Plagiocephaly can sometimes lead to teasing or bullying in school-aged children. It is also important to be aware of any underlying medical conditions that may have caused the plagiocephaly and could have an impact on child development. 


Treating plagiocephaly is an important part of ensuring a healthy start for babies. Early diagnosis and treatment can ensure that the head shape improves over time and that any potential risks or complications are minimized. It is also important to monitor a child’s development closely and consider additional treatments if necessary. With early diagnosis and appropriate care, most children with plagiocephaly have a positive long-term outlook.