Plagiocephaly describes a condition in which the back or front of a baby’s skull becomes flattened on one side. Plagiocephaly can be congenital (present at birth) or develop in infancy (positional or deformational).

Positional plagiocephaly usually does not cause serious complications or problems. Congenital plagiocephaly accompanied by craniosynostosis can lead to serious complications if left untreated:

• Head deformities, deformities (possibly severe and permanent)
• increased pressure inside the head
• seizures
• developmental delay

What Causes Plagiocephaly?

Positional plagiocephaly develops when a baby usually lies on their back, creating a flat area in that area.

Congenital (born) plagiocephaly is caused by craniosynostosis, a condition in which the seams (joints) between a baby’s skull bones grow too early.

The causes of congenital plagiocephaly are often unknown if it occurs without other symptoms. It may be part of a genetic syndrome such as Pfeiffer or Crouzon, along with symptoms and problems in other parts of the body.

Types of Plagiocephaly

The two types of plagiocephaly are:

• Positional: The most common type is caused by sleeping position. You can read about positional scaphocephaly, one of the other positional head deformity disorders, in our article .
• Congenital: Caused by the closure of a coronal suture extending from the top of the head towards both ears (craniosynostosis).

Symptoms of Plagiocephaly

Symptoms of plagiocephaly vary depending on the type your child may have.

Common symptoms of the positional type may include:

• Flattening on one side of the back of the head
• The ear is pushed forward on the same side of the head.
• head tilted to one side
• Swelling on the forehead on the same side of the head
• Facial abnormalities, including irregular cheekbones, eye sockets, or lower jaw

How is Plagiocephaly Diagnosed?

If your baby’s head is misshapen, your pediatrician will need to determine whether this is due to sleeping position or craniosynostosis. With a physical examination of your child’s head, the doctor can usually distinguish the two conditions.

To confirm craniosynostosis , your doctor may order one or more of these tests:

• X-ray to check for fused (missing) stitches or protrusions along the sutures
• Detailed imaging, especially CT (tomography) scans,
• Genetic testing to check for syndromes that cause craniosynostosis

Plagiocephaly Treatments

Most babies with positional plagiocephaly need only simple treatment, such as:

• Repositioning for sleep so the baby moves his head more often
• Increased “belly time” to improve neck strength and range of motion. You can check out our article for Tummy Time Guide .
• Helmet therapy to reshape the skull for more severe cases

Treatment goals for plagiocephaly caused by craniosynostosis focus on correcting the shape of the skull to reduce pressure within the head and provide adequate room for the brain to grow. For this, one or more of the following treatment options may be recommended:

• Surgery before age 1 to open skull sutures for normal skull and brain growth
• Helmet treatment to reshape the skull