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Because a newborn’s skull is very malleable at birth, it is susceptible to forces placed upon it. The American Academy of Pediatrics launched the Back To Sleep campaign in 1992, and it has been a huge success in preventing Sudden Infant Death Syndrome (SIDS). (Babies should always sleep on their back, alone, in a crib or bassinet.) With that, however, comes increased pressure on the back of the skull while the baby is sleeping. This can cause misshaping in the front/back/sides of head, even shifting the ears, cheeks and eyes. Flat head syndrome is now affecting 50% of our babies. The good news is with more awareness it can be prevented but then easily corrected with early intervention. This is where we come in!


3 different Types of headshapes

plagiocephaly website


  • Parallelogram shape
  • One ear more forward than the other
  • Asymmetries in forehead
  • One cheek fuller than the other
  • Key feature: asymmetry
brachycephaly website


  • Trapezoid shape
  • Flattening across back of head
  • Increased parietal width
  • Sloping of forehead
  • Head appears tall in the back
  • Key feature: wide
scaphocephaly website


  • Rectangle shape
  • Long and narrow
  • Flattening on both sides of the head
  • Key feature: narrow
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When Would I See It?

Believe it or not, skull asymmetries can be caused by in utero positioning, so sometimes you will notice it at birth. Most parents recognize headshape differences by 2 months of age. Our goal is to have parents of newborns watching the head shape from Day 1 so they can seek treatment or modify their day-to-day activities immediately.

How Will I know?

The best way to monitor a headshape is with pictures . You are looking for volume differences in the front and back of the head. Our recommendation is to take pictures once a week (birds eye view) so flattening can be identified quickly. Watch the back of the head, as this is where you’ll see the flattening first.

Why Does This Happen?

Plagiocephaly affects newborns for many reasons including:

  • Sex of the baby (more common in males)
  • Firstborn
  • Supine sleeping
  • Prematurity
  • Intrauterine crowding
  • Decreased tummy time
  • Increased use of containers
  • One sided handling
  • Neck muscle tightness/torticollis
Does my infant need a helmet2
baby exercises
What can i do

to help my baby?

There are some simple things a parent can do to help with baby’s flat head. Try these for a week or two, and if you’re not seeing noticeable improvement, a therapy referral is probably your best bet. (Remember, there is a small window of opportunity so the “wait and see” approach is not recommended.)

  • More supervised tummy time
  • Limit container usage (bouncy seats, boppy loungers, swings, DockATot, carseat)
  • Encourage baby to look in the non preferred direction
  • Change position in crib
  • Switch feeding/carrying positions

How Do I Know If My Baby Needs Therapy?

To correct a flat head, a force has to be applied. This force can come from strategic repositioning and/or a helmet. Positioning should always be your first line of defense. We know how to round out those noggins- NO HELMET NEEDED. Baby Begin has thousands of success stories, and yours can be one too.

Here is a quick risk assessment to help determine if your baby needs therapy for flat head syndrome.

  • Does your baby always seem to be looking or sleeping with his head in the same direction?
  • Does your baby resist turning his head the other way?
  • Is it difficult for your baby to stay repositioned?
  • Does your baby dislike tummy time?
  • Does your baby spend more than 3 hours a day, combined, on an incline surface/container (car seat, swing, bouncy seat)?
  • Does your baby’s head seem to be flat in the back or flatter on one side?

If you answered yes to any of the questions above…

Areanne and baby
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