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Positional plagiocephaly

What is positional plagiocephaly?

Positional plagiocephaly is a flattening on one side of the back of the head. It may also involve bulging of the forehead and some asymmetries in the facial features.

What causes plagiocephaly?

With the ‘back to sleep’ campaign to reduce sudden infant death syndrome (SIDS), babies have been sleeping on their backs. This has significantly reduced SIDS but has meant an increase of positional plagiocephaly. It is usually due to external forces on the baby’s skull such as position in the womb, birth process, or the baby’s preferred sleeping position.

It can also be associated with a condition known as torticollis. This is when there is a tight or shortened muscle in one side of the neck. It causes the head to be tilted or rotated to one side. It is important to have suspected torticollis diagnosed and treated by a specialist physiotherapist.

Will the plagiocephaly get better?

The majority of your baby’s head shape does improve with time. This is due to the growth plates in the skull being open in the first year of life and the remodelling potential of your baby’s bones.

How much it improves depends on the severity of the plagiocephaly to start with. It may mean that, although the head shape will improve with time, it may not fully correct itself.

How can I help my baby’s head shape improve?

The aim is to try to reduce the external forces on the flattened side of the baby’s head. Try to offload the flattened side of the head wherever possible.

Positioning your baby to encourage them to actively turn their head to the non preferred side is very important. You can do this when feeding, during play and positions of chairs or cots.

Using tummy time

Another part of the baby’s development is tummy time. By encouraging your baby to play on their tummy you will be helping to take pressure off the flattened side of their head and give their head time for remodelling.

It also helps them develop the strength in the muscles at the back of the neck. If your baby struggles to lift their head off the floor, you can use a small rolled up towel under their chest to help them to lift up and prop themselves on their arms.

You can build up the time they spend on their tummy, from a few minutes to start with. Start tummy time from around the time they are starting to get their head control, and do it every day.

What about when they sleep?

Sleep tips
  • Never put your baby on their tummy to sleep.

During sleeping, your baby’s head will roll to the preferred or flattened side.

  • Do not use any loose pillows, rolled up sheets or toys in the cot to try to prevent the baby from turning their head.
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Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

Resource number: PT9

Resource Type: Article

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