Brachycephaly – what you need to know

Brachycephaly – what you need to know

What is brachycephaly?

A brachycephalic skull is flat in the rear. The head is also often taller in the back than in the front, the baby’s face may be wider than average, and his or her ears may stick out.  The condition frequently occurs in combination with plagiocephaly, and is nearly always the result of positioning of the head of the baby, where pressure is placed on the back of the head for prolonged periods.

What causes brachycephaly?


Sometimes brachycephaly is a congenital condition, which means it exists at or before birth.  According to the National Institutes of Health’s NINDS, brachycephaly occurs when the front bone and side bones join together before the skull is fully developed. There are numerous potential causes for brachycephaly, including metabolic, genetic and developmental disorders. If your child is diagnosed with congenital brachycephaly, make sure that they are evaluated for any associated conditions that your doctor believes are potentially to blame. lists the following potential causes for congenital brachycephaly:

  • 18p chromosome deletion complex
  • Acrocephalosyndactyly type III syndrome
  • Adducted-thumbs mental-retardation syndrome
  • Andermann syndrome
  • Andersen-Fabry (Fucosidosis)
  • Chromosome 20 deletion/Ring síndrome
  • Cleidocranial digital dysostosis
  • Down’s syndrome
  • De Lange syndrome
  • Hallerman-Streiff-Francois Syndrome
  • Larsen Dysmorphic syndrome
  • Scott’s Craniodigital syndrome
  • Smith Magenis syndrome
  • Robert syndrome
  • Weaver syndrome (Marshall-Smith)


Brachycephaly that is not the result of a congenital condition is frequently position-related. This is by far the most common type of brachycephaly.  Often times, as mentioned above, acquired brachycephaly can be seen in children who have also been diagnosed with acquired plagiocephaly.  My son had a combination of brachycephaly and plagiocephaly, which is not unusual at all.

There are two types of brachycephaly: asymmetrical deformational bracyhcephaly (ADB) and symmetrical deformational brachycephaly (SDB). The recent incorporation of laser scanners into diagnostic tests of bracycephaly have helped doctors to distinguish more easily between the two. ADB is also referred to as plagiocephaly with brachycephaly, or brachycephaly with plagiocephaly.

Brachycephaly Risk Factors

Risk factors for congenital brachycephaly are predominantly thought to be genetic, although many cases develop in babies with no family history of brachycephaly. As a result, the study of brachycephaly is a popular area of research at present.

The risks for developing the acquired form of brachycephaly include all of the observed risk factors for plagiocephaly, as well as carrying low in the pelvis during pregnancy, very large birth size (macrosomia), breech birth, and being born to a mother with a bicornuate uterus.

Frequency: Past and Present

A 1996 report claimed that the rates of plagiocephaly and brachycephaly sextupled after the implementation of the Back to Sleep campaign against SIDS. Rates of plagiocephaly and/or brachycephaly, collectively known as ‘flat head syndrome’ were 1 in 300 infants prior to the study and 1 in 60 as of 1996. Currently, some recent studies report a frequency of nearly 5 in 10, which is incredible and highlights the great need for further awareness and education of this condition to all expecting and new parents.

How will this affect my child?

According to, untreated moderate to severe brachycephaly can result in the following complications:

  • Astigmatism
  • Developmental delays (see the section on plagiocephaly)
  • Eating difficulties
  • Learning difficulties
  • Speaking difficulties
  • Loss of vision
  • Higher risk of hearing loss
  • TMJ (mandibular joint dysfunction)
  • Scoliosis
  • Seizure

Most of these conditions are directly related to the structural effects of brachycephaly, and do not have any reflection on your child’s intelligence. As a result, correcting the problem early on can help your baby succeed later in life. Some complications, such as seizures, are potentially serious, and as a result, making treatment all the more important.

Note that these conditions are only normally seen in more severe cases, and the vast majority of infants have mild cases of brachycephaly.  To be sure of the severity of the condition, your child should be evaluated by a specialist who can do accurate head measurements using laser imaging.  This should be done at a very early age, ideally by 3-4 months if you suspect a problem.

Is this condition permanent?

Brachycephaly is usually not a permanent condition. There are natural ways to treat brachycephaly if the condition is caught very early, in the first few months of life.  The most common natural therapies are repositioning and tummy time.  You can find some products available now to help you with this.

There are also FDA- approved treatment options available, such as a baby helmet, that can be used if you are not seeing results with natural treatments.  These still need to be used at an early age, ideally beginning before 8 months old.

If you address the problem early on, there is a good chance that your child can grow up without experiencing any further complications. Early treatment is the key to success, so if your doctor suspects brachycephaly, don’t hesitate to see a specialist and begin corrective therapy as early as possible.

Please leave a comment below