This describes flattening on one side or back of the head, usually with flattening on the opposite front side of the skull. Plagiocephaly is often accompanied by a misalignment of the ears and facial asymmetries. Plagiocephaly is thought to be caused by force on soft skull bones, such as a restrictive intrauterine environment, back sleeping with the head always rotated to one side, or extended use of baby positioning devices (i.e. infant swings and bouncy seats). Plagiocephaly is also seen in conjunction with torticollis, a tightening of the muscles on one side of the neck. Torticollis causes the head to tilt and rotate with limited motion in the opposite direction.

This describes flattening uniformly across the back of the head, causing a wider and shorter skull shape. Brachycephaly can be caused by sleeping on the back.

This describes a long, narrow shape, with flattening on the sides of the head. Scaphocephaly is common in premature babies who spent time in a neonatal intensive care unit.

Physical Therapy: For babies under 4 months of age, physical therapy and such positioning techniques as “tummy time” during awake hours can be effective in correction. Physical therapy is particularly important if the baby has torticollis and/or developmental delays in conjunction with plagiocephaly.

Cranial Remolding Helmets: If no improvement is noted after physical therapy and positioning techniques, and in the absence of craniosynostosis (a birth defect that results in sutures closing earlier than normal on a baby’s head), your physician may recommend treatment with a cranial remolding helmet. As much as 85 to 90 percent of postnatal cranial growth occurs in the first year of life, with closure of the sutures occurring by the end of the second year. As a result, treatment with a helmet is most effective and most rapid if initiated between 4 and 12 months of age. Infants can be treated with a helmet at 12 to 18 months of age, but there is less correction and a longer treatment time.

Additional resources for strengthening and tummy time tips can be found at www.kidshealth.org.