Plagiocephaly 101: Understanding Flat Head Syndrome in Babies

Noticing a Flat Spot

Many parents first notice a flat area on their baby’s head while bathing, brushing hair, or during tummy time. It can be worrying — but you’re not alone.

Plagiocephaly, often called flat head syndrome, is very common and usually correctable. At Avalon Wellness & Performance, we help families understand why it happens, how to support natural correction, and when gentle hands-on therapy can help.

What Is Plagiocephaly?

Plagiocephaly describes an asymmetry in the shape of a baby’s head — typically a flattening on one side at the back or back-center.

It’s important to know that the skull bones in infants are soft and moldable — they’re meant to adapt during birth and through early growth. That flexibility makes babies resilient but also more susceptible to shape changes caused by position, muscular, or fascial tension.

Why Does It Happen?

There’s no single cause, but several common contributors often overlap:

• Positioning: Babies who prefer looking or sleeping to one side develop uneven pressure points on the skull.

• Torticollis (twisted neck): Tight or shortened neck muscles can limit how far a baby turns their head, reinforcing one-sided pressure.

• In-utero positioning or birth strain: Space constraints, breech position, or assisted deliveries can create subtle tension patterns and nerve compressions.

• Time spent on the back: Since the Back to Sleep campaign began, flat head cases have increased — but safe sleep remains essential. The goal isn’t to avoid back sleeping, but to balance it with supervised tummy time and varied positions throughout the day.

Is It Just Cosmetic?

The short answer is no. Persistent flattening can sometimes influence:

• Headaches — yes, babies can experience headaches too

• Facial symmetry (ear or eye position)

• Jaw alignment and feeding

• Eye tracking or head-turning preference

• Early motor development and rolling patterns

Long-term concerns may include scoliosis, visual disorders, TMJ dysfunction, and sensorimotor or sensory processing challenges.
That’s why early awareness and gentle intervention matter.

When to Seek Support

Consider seeking a professional assessment if you notice:

• A flat area that isn’t changing over time

• Baby always looks the same direction when lying down

• Difficulty turning the head both ways equally

• Visible asymmetry in the forehead or ears

• Extreme resistance to tummy time

An experienced Pediatric CranioSacral Therapy (CST) or Osteopathic Manual Therapy (OMT) practitioner can gently evaluate cranial mobility, neck motion, whole-body restrictions, and developmental balance.

How Gentle Manual Therapy Can Help

Through light, non-invasive touch, practitioners can:

• Ease soft tissue tension that limits movement

• Encourage natural cranial mobility and symmetry

• Support better neck and body alignment

• Guide parents with repositioning and developmental strategies

Sessions are baby-led, comfortable, often soothing, and can be done while your baby rests, feeds, or is held by a parent.

At-Home Tips for Parents

Here are a few simple steps you can start today:

• Offer supervised tummy time several times a day — this can include short, supervised naps.

• Alternate feeding positions (switch arms when bottle- or breastfeeding).

• Vary head direction in the crib and car seat.

• Hold your baby upright frequently throughout the day to reduce pressure time.

When Helmets Are Recommended

In moderate to severe cases, or when early interventions haven’t been enough, a cranial orthotic helmet may be prescribed. These gently guide growth and are most effective between 4–12 months.

However, many babies benefit from conservative care first — especially when muscular and cranial tension patterns are addressed early.

Final Thoughts

Plagiocephaly is common, manageable, and nothing to feel guilty about. Your baby’s skull is designed to grow, reshape, and adapt. With the right combination of awareness, positioning, and gentle support, most babies improve beautifully — without invasive measures.

At Avalon Wellness & Performance, we specialize in CranioSacral Therapy and Osteopathic Manual Therapy for infants, helping restore comfort, symmetry, and healthy development from the very start.