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Overview

Deformational or positional plagiocephaly (play-gee-o-cef-a-lee) is flattening of the infant skull due to persistent pressure being applied to one portion of the back of the head. Physical appearance may also include bulging of the forehead on one side or displacement of one ear forward.

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Causes

Some infants are born with deformational plagiocephaly while others acquire the abnormal head shape after birth. Causes include:

  • Restriction in the womb: multiple birth, small pelvis or breech position
  • Premature birth
  • Torticollis (tightness of a muscle in the neck)
  • Sleep position (infant on back)
  • Overuse of infant seats, carriers, strollers and swings

If your baby has an abnormal head shape for more than two weeks, please contact your healthcare professional.

For most babies, deformational plagiocephaly is preventable.

The American Academy of Pediatrics offers simple recommendations that can greatly decrease the likelihood that your child will develop an abnormal head shape: Turning Heads and Tummy Time.

For babies born with an abnormal head shape, following these recommendations may help improve your child’s head shape without further intervention.

Turning heads

Beginning on day one of life, place your child on his or her back to sleep to help prevent Sudden Infant Death Syndrome (SIDS) but alternate, between left and right, which way the head is turned every day so that pressure is distributed evenly (for example: on day one of life, turn your newborn’s head to the left; on day two of life, turn your newborn’s head to the right, and so on).

Supervised tummy time

Beginning on day one of life, provide your baby with supervised tummy time. Start with placing your baby on his or her tummy for 1 minute, 3 times per day and gradually increase to 5-10 minutes 3 times per day. Your baby may be fussy when you start tummy time. This is normal. Your baby will gradually adjust to being on his or her tummy.

If your baby has reflux, a small rolled towel can be placed beneath the upper chest to lessen the pressure on the stomach to make it less likely that your baby will vomit. This should be done on a firm surface.

Please be sure to monitor your baby at all times when he or she has tummy time.

Newborn to 2 months

Tummy time at this age helps your baby develop better head control and upper body strength. Things to try: Lay your baby on your chest.This is not only great for bonding but it encourages your baby to lift his head. You can also place your baby on his stomach while you sit or lay next to him.

3-5 months

Your baby is getting stronger and is able to push up using her arms.Tummy time at this age helps prepare your baby for sitting and crawling. Things to try: Lay with your baby on the floor and interact with her at eye level. Encourage your baby to reach for toys by placing toys and mirrors on the floor.

6-9 months

Your baby is getting very strong and will start using her legs and arms to begin crawling. Things to try: Play “airplane” with your baby by supporting his hips and waist as you lift him up slowly and carefully.You can also place your baby on your bent legs and then move your legs up and down.

Remember to always watch your baby when having tummy time!

Yale School of Medicine

Yale New Haven Health is proud to be affiliated with the prestigious Yale University and its highly ranked Yale School of Medicine.