Flat head syndrome (plagiocephaly and brachycephaly)

• Under supervision, give your baby time on their tummy during the day and encourage them to try new positions during play time, but make sure to follow safe sleep guidance, they should always sleep on their back to reduce the risk of SIDS. 
• Switch your baby between a sloping chair, a sling and a flat surface – this ensures there isn’t constant pressure on one part of their head. 
• Change the position of toys and mobiles in their cot – this will encourage your baby to turn their head on to the non-flattened side. 
• Alternate the side you hold your baby when feeding and carrying them. 
• Reduce the time your baby spends lying on a firm flat surface, such as car seats and prams – try using a sling or front carrier when practical. Read more about using a sling safely here.

Mild flattening will usually improve over time, but it can take a couple of months to notice any improvements.  

Helmets, headbands and mattresses designed to relieve head pressure are not recommended and can be uncomfortable and distressing for your baby. 

There are two main types of flat head syndrome, plagiocephaly and brachycephaly. 

Babies with plagiocephaly may have: 

• Flattened heads on one side, which may look asymmetrical. Their heads can look like a parallelogram from above. 
• Ears that appear to be misaligned. 

• Foreheads which seem to be bulging on the flattened side. 

In brachycephaly: 

• The rear of the head is flattened, this might cause the head to widen 
• Occasionally, the forehead appears to bulge.

Your baby will have their head circumference (size) measured at birth and at their 6-8 week baby check. If there are any worries regarding head shape or size, you can discuss this with your health visiting team and a plan may be made to take further measurements.   

You should also speak to your GP or health visiting team if your baby: 

• seems to have an unusually large head. For example their head is too big to fit hats for their age group and/or being unable to fit their head through a babygro that fits their body. 

• has a bulging fontanelle (soft spot). 

• has eyes looking downwards (sunsetting) 

• Your baby has difficulty turning their head or has a strong preference for turning their head to one side. 

• Your baby has an unusual head shape or has very prominent uneven ridges which have not got better or have got worse, despite repositioning suggestions described above. 

• has prominent veins on their head, alongside one or more of the above symptoms 

• Very occasionally, a flat head can be caused by the skull plates forming your child’s head joining together too early. There is a medical name for this, craniosynostosis, and it requires specialist review and management. 

Please speak with your health visiting team or GP if you have any concerns. They will examine your baby’s head and be able to advise you.  

Sometimes you may be referred you to see a physiotherapist, or if they suspect that the skull plates have fused too early, a paediatric specialist. 

You can also find some more detailed information on the NHS website by clicking here.