The Truth About Flat-Head Syndrome

Could your baby develop plagiocephaly? One expert discusses this skull deformity.

It's a big word for a fairly common occurrence: plagiocephaly (pronounced play-gee-oh-sef-a-lee). The term is Greek for oblique or slanted head, and refers to an asymmetrical skull, which can occur because of head molding in nearly 20 to 25 percent of babies.

According to James Laughlin, M.D., a pediatrician in Bloomington, Indiana, plagiocephaly can occur for a couple of reasons. First, it can happen in utero. "The way the baby may be positioned in the womb can cause some molding of the skull," Dr. Laughlin says. Also known as "flat-head syndrome" and "positional molding," plagiocephaly can occur if the baby consistently holds his or her head a particular way when lying down. "If they have a preferential way of wanting to laid or be placed, then that can make the molding or flattening of the head as they're sleeping," Dr. Laughlin says. The shaping generally happens between 2 and 4 months of age.

Dr. Laughlin, who is a Fellow in the American Academy of Pediatrics (AAP), was the primary author of "Prevention and Management of Positional Skull Deformities," which is the AAP's recent policy statement on the issue. Dr. Laughlin says that skull deformities have been on the rise since the 1990s. That's when the American Academy of Pediatrics began instructing parents to place babies on their backs to sleep, to decrease incidences of sudden infant death syndrome (SIDS).

Although it's important to follow these sleeping guidelines, Dr. Laughlin says, parents should be aware of any flattening or changes in the shape of the baby's skull, and contact their pediatrician. Plagiocephaly could be a result of other medical issues, including torticollis, which is shortened or contracted muscles of the neck, or, rarely, craniosynostosis, which is a premature fusion of the skull bones.

According to Dr. Laughlin, there are a number of approaches that parents can take to prevent plagiocephaly, including daily tummy time and encouraging increased head and neck movement. He adds that the consequences of plagiocephaly are primarily cosmetic, and there are no known disabilities associated with the flattened head. In most cases, he says, by time kids are 2 or 3 years old it's difficult to see any evidence of plagiocephaly.

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