Children's Hospital Colorado
Craniofacial Center

Plagiocephaly

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What is plagiocephaly?

Plagiocephaly, also known as positional plagiocephaly or deformational plagiocephaly, is a condition in which a specific area of a baby's head is flattened — usually either the entire back of the head or one side on the back. It’s different from lambdoid craniosynostosis although both conditions involve changes in skull shape. By itself, a flattened spot on a baby’s head is generally not a concern, but it can impact movement and development. 

What causes plagiocephaly?

Plagiocephaly is caused by uneven forces on a baby’s head, either before birth or during the first year. Babies have softer skulls and if a baby rests on the same spot, the skull can flatten.

Who gets plagiocephaly?

Many factors before and after birth can contribute to flattening of the back of a baby’s head. Babies with less room to develop in the mother’s uterus are more prone to positional plagiocephaly. This crowding can happen if there are multiple babies or if the mother has a condition of the uterus such as fibroids.

Babies born prematurely are at an increased risk of head flattening from external forces because their skull bones are softer and less developed. Babies with developmental delays or medical problems that make it harder for them to change position may move their heads less often. Resting on the same spot can lead to head flattening.

Some babies may simply keep their head turned one way most of the time. This can lead to flattening on one side. A baby’s positioning preference may also be due to torticollis (tight neck muscles) or visual problems. Babies who spend long periods of time in swings, bouncers or car seats may develop flattening across the entire backs of their heads or on one side of the back of their head.

The American Academy of Pediatrics recommends that infants sleep lying on their backs to prevent sudden infant death syndrome (SIDS). As a result of this advice, flattening on the back of babies’ heads became more common.

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