Plagiocephaly—commonly referred to as flat head syndrome—is one of the most preventable physical conditions seen in infants. It refers to a flattened or asymmetrical area on the back or side […]
Plagiocephaly—commonly referred to as flat head syndrome—is one of the most preventable physical conditions seen in infants. It refers to a flattened or asymmetrical area on the back or side of a baby’s head, often due to prolonged pressure on one spot.
In today’s world of safe sleep advocacy and increased use of baby gear, positional plagiocephaly and brachycephaly have become more common. While the American Academy of Pediatrics (AAP) strongly supports back-sleeping to reduce the risk of SIDS—a recommendation that absolutely must remain—this doesn’t mean babies should be lying on their backs all the time.
As caregivers, nannies, or Newborn Care Specialists, our job is to help families understand how to support both safe sleep and healthy head shape development through simple, consistent habits—starting from day one.
Both conditions are positional—meaning they’re caused by external pressure—and most cases are highly preventable with early and intentional strategies.
A newborn’s skull bones are soft and malleable to accommodate rapid brain growth and birth canal compression. This flexibility also makes them vulnerable to deformational forces—especially when pressure is repeatedly applied to one area over time.
Risk factors include:
Fortunately, most of these factors can be addressed proactively with daily habits that encourage varied positioning and movement.
The key to prevention is early intervention. By incorporating these evidence-based strategies from the beginning, caregivers can drastically reduce a baby’s risk of developing plagiocephaly or brachycephaly:
1. Prioritize Tummy Time
Begin supervised tummy time from the first week of life, even if it's just a few minutes at a time. Gradually increase the duration as the baby grows stronger. Tummy time helps develop neck and shoulder strength and takes pressure off the back of the skull.
2. Vary Head Position in the Crib or Bassinet
Each time you lay the baby down, alternate the direction their head is turned. You can also switch the direction you place them in the crib—babies naturally turn toward light or activity.
3. Limit Time in Baby Gear
Avoid prolonged time in car seats (when not in the car), swings, bouncers, or loungers. These “containers” increase pressure on the same spot of the baby’s head and limit natural movement.
4. Use Upright Time to Your Advantage
Incorporate babywearing, upright holding, and chest-to-chest carrying throughout the day. These positions reduce skull pressure while promoting bonding and postural development.
5. Encourage Side Play and Feeding Variability
During wake windows, place babies on their sides (supervised) for play or stretching. Alternate arms when bottle-feeding or cradling so that babies are not always positioned the same way.
Despite best efforts, some babies may still develop mild flat spots. The earlier you notice and address them, the better the outcome.
Look for signs like:
At this stage, increase repositioning efforts, encourage more floor time, and reduce time in pressure-inducing gear. If you suspect torticollis or if flattening persists beyond 2–3 months, encourage families to speak with their pediatrician. They may recommend physical therapy, repositioning devices, or in some cases, cranial helmet therapy.
Parents are often surprised to learn how early head shape concerns can arise—and how easy it is to make small changes that have a big impact. As professionals, our role is to gently educate without causing alarm.
Helpful points to share include:
The earlier these strategies are introduced, the easier it is to prevent flat spots and avoid costly interventions later.
Want to go beyond the basics and deepen your understanding of plagiocephaly and brachycephaly?
Our Master Mini-Course on Brachycephaly and Plagiocephaly was created specifically for professionals working with infants in the home. This focused training dives into:
If you're caring for infants, this is must-know information. Flat head syndrome is largely preventable—and your knowledge can help a baby avoid unnecessary discomfort, treatment, or medical devices.
Final Thoughts
Preventing plagiocephaly and brachycephaly starts with simple, everyday actions: floor time, upright snuggling, and shifting positions throughout the day. It’s not about perfection—it’s about consistency and awareness.
By taking a proactive, informed approach, caregivers can give babies the best chance at healthy physical development—while still following safe sleep recommendations.For more expert tips and caregiver education, check out our full Newborn Care Blog or explore our focused mini-course on preventing flat head syndrome.
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