Noticing a flat spot on your baby's head can be worrying, but it's extremely common — and in most cases it's a cosmetic, positional issue that improves with the right steps. Here's what's going on and what helps.
What is plagiocephaly?
Plagiocephaly is flattening of one part of a baby's soft skull from consistent pressure in the same spot — most often the back or one side of the head. It became more common (a good trade-off) after back-sleeping was recommended to reduce SIDS, and it usually reflects positioning rather than anything wrong with the brain.
Common causes
- Lots of time on the back or in carriers, swings, and car seats.
- A head-turn preference, often from torticollis (tight neck muscles).
- Limited tummy time while awake.
- Sometimes positioning before birth or being a multiple.
Prevention and what helps
- Plenty of supervised tummy time while your baby is awake.
- Alternate which way you position your baby and where you stand to draw their gaze.
- Limit time in carriers, swings, and bouncers when awake.
- Always still sleep baby on their back — and reposition the head within that.
- Address any neck tightness with physical therapy.
Have your pediatrician check the head shape — they'll confirm it's positional, check for torticollis, and advise whether a referral (to PT, or occasionally for a helmet) makes sense. Helmet decisions are medical and time-sensitive.
Worried about a flat spot? Early positioning and PT work best — let's help.
How physical therapy helps
Because flat spots so often go hand-in-hand with a head-turn preference, physical therapy addresses the root: loosening tight neck muscles, building even strength, and coaching families on tummy time and repositioning so the head can round out. Physical therapy is a new service at MTG and we're accepting referrals (required from your child's primary care provider, faxed to 901-589-9001).