The facts you need to know about Flat Head Syndrome in babies

The facts you need to know about Flat Head Syndrome in babies

Human head shape shows quite a bit of natural variation, but flat isn’t normal. If your child has a spot that feel flat to the touch on his or her skull, you might have sought help from your pediatrician or family doctor. Curiosity and worry can grow when a diagnosis is made – medical terms somehow always seem to make things more intimidating. Your child’s doctor may have mentioned craniosynostis, a positional cephalic disorder, or other terms including plagiocephaly, scaphocephaly, or brachycephaly. This article will cover what the diagnosis of flat head syndrome or craniosynostosis means for you and your child. We’ll go over some basic information on the cause and effect of positional cephalic disorders and craniosynostosis and common treatment methods.

Causes of infant head flattening

If your child has a flat spot on their skull, there are two causes that may be to blame. The first is a positional cephalic disorder, such as plagiocephaly, brachycephaly or scaphocephaly. The second potential cause is craniosynostosis. Most often, the diagnosis is a positional cephalic disorder. Children who develop positional plagiocephaly, brachycephaly, or scaphocephaly tend to spend a significant amount of time in one position, may have been poorly situated in the uterus before birth, or underwent trauma during the birthing process. Luckily, the majority of cases can be reversed using repositioning exercises, tummy time, physical therapy, or in more severe cases – orthotics.  Treatment is often very easy, because the bones of a baby’s skull are very soft still, and the skull has not taken its final form – the bony sutures remain open in positional cephalic disorders.

Long term effects of flat head syndrome

Unfortunately, there isn’t really much reliable research available on the long term effects of positional cephalic disorders. Medical experts are sharply divided in their views. Some believe that the skull will almost always return to its natural shape by adolescence. The lack of long term studies, and the recent dramatic increase in the prevalence of plagiocephaly, brachycephaly and scaphocephaly has caused others to question this assumption.

The information on the long term effects of this condition is limited as a result of the relative rarity of this condition before the start of the Back to Sleep campaign in the early 1990s. This campaign has helped to save numerous babies from Sudden Infant Death Syndrome, decreasing its prevalence by over 40%. At the same time, however, the number of plagiocephaly, brachycephaly and scaphocephaly cases dramatically increased. While some researchers believe that children who develop a positional cephalic disorder have an underlying condition or problem that makes them more susceptible to developing the condition, research is still struggling to understand why and how the increase occurred. Research on positional plagiocephaly suggests a link between this condition and some developmental delays, but the causal relationship isn’t clear.

Risk factors for head flattening

While placing a child on their back to sleep is the most widely recognized risk factor for positional cephalic disorders, there are other risk factors as well. Male children tend to develop these deformities more frequently than females. Premature babies also have higher rates of positional cephalic disorders, and scaphocephaly in particular. A tight uterine space during pregnancy can also play a role in the development of these conditions.

Craniosynostosis is a condition that can initially be confused with positional cephalic disorders or flat head syndrome. Unlike positional cephalic disorders, however, craniosynostosis is the result of sutures closing in the skull before the appropriate time. The presence of this condition can lead to an appearance which is very similar to positional plagiocephaly, scaphocephaly or brachycephaly. Symptoms may also be very similar. Unfortunately, in cases of craniosynostosis, surgery is often necessary to prevent significant consequences, such as increasing cranial pressure, blindness, seizures, and developmental delays.

A genetic component may be present in cases of craniosynostosis. There are over 150 familial disorders that present the risk of craniosynostosis. Still, the majority of children with this condition do not have family history of the congenital defect.


If there is a chance that your child has either craniosynostosis or flat head syndrome, speak with his or her primary care physician immediately. The window for treatment is small. Successful results are difficult to obtain after one year of age. By age three, the conditions both become very difficult to treat, and surgery becomes significantly more dangerous for craniosynostosis patients. Correction at this point is complicated.


  1. Hi Sarah,

    Some great advice here.

    As you’ve mentioned tummy time is so important. As it does relieve some pressure off the back of the skull.

    It is really nice, that you’ve developed a resource for new parents.

    Keep up the good work 🙂

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