What is Plagiocephaly?

What is Plagiocephaly?


Plagiocephaly is a blanket term used to describe what are actually three different types of skull deformations: plagiocephaly, brachycephaly, and scaphocephaly. Torticollis is another related condition which often goes hand in hand with plagiocephaly.


Plagiocephaly, commonly known as Flat Head Syndrome, is a condition that causes a flattened appearance in a baby’s head or face. Plagiocephaly can also be called deformational plagiocephaly or positional plagiocephaly.

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Brachycephaly is characterized by a flattened appearance on the back of the head. It is typically caused by extensive back sleeping. The head flattens uniformly and appears wider and shorter. An increased head height is also common in infants with brachycephaly.

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Scaphocephaly, also called Dolichocephaly, describes a head with a long, narrow shape. It is particularly common in premature babies who spend time in the NICU.

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A high percentage of babies with plagiocephaly also have torticollis (commonly called “wry neck”). Plagiobabies may favor one side of their head, which shortens or tightens the sternocleidomastoid (SCM) muscle, limits their range of motion and causes the head to turn or tilt to one side.

Torticollis can also be caused by placement in utero, lack of space in utero (often present with large baby, small mother, or multiples) or trauma during the birth process.

Causes of Plagiocephaly

How does plagiocephaly develop? An infant’s skull has several plates of bone that are separated by fibrous joints called sutures. The sutures fuse as the child grows and develops, and around two years old the previously soft, malleable skull becomes one solid piece of fully formed bone.

Note: Early diagnosis and treatment of plagiocephaly are important. Ideally you are able to start treatment while your baby’s skull is still soft, making it much more receptive to reforming into a natural shape in a shorter amount of time.

If your infant’s rapidly growing skull attempts to expand and is met with some type of repeated or extended resistance, the result is flattening of the head or face. The resistance can occur either prenatally in the mother’s womb or after birth with an external force after birth such as a bed or other flat resting surface.

After birth, most occurrences of plagiocephaly result from sleeping regularly in one position or spending a great deal of time sitting in the same position, such as in a car seat/infant car carrier, bouncy seat or swing.

Risk Factors

Plagiocephaly occurs more often in premature infants whose skulls are even more pliable than other babies. These babies may spend a great deal of time lying down as they receive treatment for other medical complications. It also seems to be more common in boys.


Most parents begin to notice a flattening effect on their baby’s head at about 6-8 weeks of age.

The American Academy of Pediatrics recommends that pediatricians screen infants at 2-3 months of age to ensure the baby’s skull is growing and forming in its proper shape. Your child’s physician can diagnose your child with plagiocephaly and may refer you to a specialist and/or cranial orthotic device manufacturer.

The physician can diagnose plagiocephaly with a thorough physical exam and medical history; tests such as X-rays or CT scans are not typically necessary.