Quick read
Key points
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Plagiocephaly refers to a flattened area on a baby's head, most often on the back or one side, caused by consistent pressure on that part of the skull. It's common because babies' skulls are naturally soft and still developing, and has become more common since babies started sleeping on their backs (a position that has significantly reduced cot death, so remains strongly recommended).
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Topic-specific prevention and risk reduction will be added during the article-specific evidence audit.
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The flattening seems to be getting more pronounced rather than improving
01 · Know
What is Plagiocephaly (Flat Head Syndrome) in Babies?
Plagiocephaly refers to a flattened area on a baby's head, most often on the back or one side, caused by consistent pressure on that part of the skull. It's common because babies' skulls are naturally soft and still developing, and has become more common since babies started sleeping on their backs (a position that has significantly reduced cot death, so remains strongly recommended).
In most cases, it's a cosmetic issue that improves on its own as babies become more mobile and spend less time lying in one position. It doesn't affect brain development.
02 · Understand
Clinical context
Back sleeping is still strongly recommended
Even though back sleeping can contribute to flat spots, it remains strongly recommended because of how significantly it reduces the risk of cot death — the flat spot is managed through daytime positioning changes instead.
03 · Act
When to See a Doctor
- 1The flattening seems to be getting more pronounced rather than improving
- 2You notice your baby's head shape is very asymmetric, or one ear appears pushed forward
- 3Your baby has a strong preference for turning their head to only one side
- 4You have any concerns about your baby's development alongside the head shape
04 · Prevent & manage
Practical steps
Never Change Sleep Position to Address This
Babies should always be placed on their back to sleep, regardless of flat head concerns — managing plagiocephaly is done through daytime positioning changes, never by changing sleep position.
- 1Give plenty of supervised tummy time when awake.This takes pressure off the back of the head and also builds neck and shoulder strength.
- 2Vary your baby's head position during the day.Alternate the direction they face during feeds, play, and in the pram.
- 3Limit time in car seats and bouncers when not travelling.Extended time with the head resting in one position can contribute to flattening.
- 4Change the orientation of toys or mobiles in the cot.This can encourage your baby to turn their head in different directions.
- 5Keep sleeping on the back, always.Safe sleep position takes priority — flat spots are addressed through daytime changes only.
Medical information notice
Health education, not individual medical advice
BarnMD Health Library provides general health education for public health literacy. Reading this article does not establish a doctor-patient relationship and this information is not a diagnosis, prescription, or personalised treatment plan. If you have symptoms or concerns about your health, seek appropriate advice from a qualified healthcare professional. If you develop emergency warning signs, seek urgent or emergency medical attention.
BarnMD Bottom Line
Plagiocephaly is common and usually improves on its own as babies grow and become more mobile.
It's a cosmetic concern, not a developmental one, and back sleeping should never be changed because of it.