Deformational Plagiocephaly (Flat Head Syndrome)

Deformational plagiocephaly Рwhat a seriously weird word. This is the medical term for flat or wonky heads. It means one side of the skull has flattened and asymmetry of the head and sometimes face as well. 

Interestingly research shows that the number of flat heads cases is increasing and there is also increasing evidence that there are many related conditions including developmental delays in movement and motor coordination (1-3), delays in language and cognitive skills ( 4-6), hearing and visual disabilities ( 7-8). Overall the scientific research is now indicating that plagiocephaly is not just a cosmetic issue (8) to cover up with hair growth. 

How can you tell if your baby is developing a plagiocephaly?

You may notice:

  • Baby prefers to turn head one way more then another
  • Sleeps with head to one side – even if you try to correct it
  • Prefers to feed on one side
  • Bald spot on one side
  • Difference in eye, ear level, assymetrcial facial features. 

What causes it?

Two of the most common causes are intra uterine constraint (common with twins) and birth trauma (eg forceps or vacuum delivery). During birth some babies sustain a strain/sprain injury to the head and neck region leading to an underlying imbalance in the neck or cranio-dural system. This makes it uncomfortable for the baby to turn to one side and hence  they develop a preference to the opposite side. 

Can chiropractic care help?

Our Ohana Chiropractors are skilled in assessing and diagnosing sprain/strain injuries in babies head and neck region. We also use specific callipers to measure the degree of flattening and track its improvement with treatment. (and to rule out the risk if craniosynostosis which is a condition that requires referral and usually surgery.)

Studies have shown the earlier the intervention the better the outcome. This is especially true for cranial and upper cervical work due to the shape and function of these bones which begin to fuse and move differently after 6 months of age. Our chiropractors have spent extra time to be proficient in the correct techniques for babies especially cranial techniques for plagiocephaly. 

More recommendations on plagiocephaly

An important part of the care plan is home advice and here are our top 4 recommendations.

Baby carrying – wearing your baby as much as possible will help reduce the physical pressure of the head on prams and car seats as well as providing vestibular stimulation which helps the balance centres of your Childs brain and stimulate better neck muscle strength and control.

Ball rocking Рusing an exercise ball place the baby on their tummy and gently and slowly rock them forwards and backwards and then side to side. This is another exercise that will stimulate their vestibular system and cerebellar function  leading to improved neurological link to the muscles needed for head control. 

Tummy time – regular bouts of tummy time encourages head control and strength. It also limits the time the back of the head has pressure on the floor. 

Bottle feeding advice – switch arms just like you would breasts. It is easy to fall into the feeding with your dominant hand when bottle feeding. This means one side of babies head always has pressure on it. Plus babies develop their head and eye movements during the feeding phase – that is why there are two breasts. So use both arms and hands parents it is also great brain detraining for you!

Bringing in your infant to see one of our experienced chiropractors is a great first step. Contact us here to make a booking.


1.Ohman et al. 2009. Are infants with torticollis at risk of a delay in early in early motor milestones compared with a control group of healthy infants? Dev Med Child Neural. 51:7; 545-550 

2. Hutchinson BL, Stewart AW, Mitchell EA. 2011. Deformational plagiocephaly: a follow-up of head shape, parental concern and neurodevelopment at ages 3 and 4 years. Arch Dis Child. 96:85-90

3. Speltz ML, et al. 2010. Case-controlled Study of Neurodevelopment in Deformational Plagiocephaly. Paediatrics. 131:1

4. BrentR et al. 2013. Development at Age 36 Months in Children With Deformational Plagiocephaly. Pediatrics. 131:1

5. Kordestani et al. 2006. Neurodevelopmental delays in children with deformational plagiocephaly. Last Reconstr Surg. 117:1;207-218

6. Hutchinson BL et al. 2004. Plagiocephaly and brachycephaly in the first two years of life: a prospective cohort study. Pediatrci. 114: 970-980.

7. Siatkoski et al. 2005. Visual field defects in deformational posterior plagiocephaly. J AAPOS 9:3;274-8

8. Balan et al. 2002. Auditory ERPs reveal brain dysfunction in infants with plagiocepahly. J Craniofac Surg. 13:520-525

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