What Causes Flat Head Syndrome in Babies

Flat Head Syndrome, also called positional plagiocephaly, is a condition in babies where one part of the head becomes flat or misshaped. It is quite common and usually happens during the first few months of life. Most of the time, it is not dangerous and can be treated with simple steps. Let’s understand what causes this condition in babies in simple and clear words.

1. Sleeping Position

One of the main causes of Flat Head Syndrome is a baby spending too much time lying on their back. Since babies' skulls are soft and flexible, pressure on one spot can cause it to flatten. Doctors recommend that babies sleep on their backs to prevent Sudden Infant Death Syndrome (SIDS), which is very important. But if a baby always lies with their head turned to one side, that side may become flat over time.

2. Limited Movement (Torticollis)

Some babies are born with a tight neck muscle, a condition called torticollis. This makes it hard for the baby to turn their head. As a result, the baby may keep their head turned in one direction most of the time. This can lead to flattening on one side of the head. Torticollis is often noticed when a baby always looks in the same direction, even when being fed or carried.

3. Premature Birth

Babies who are born early (premature) have softer skulls than full-term babies. They also spend more time lying in one position in the hospital, especially in the neonatal intensive care unit (NICU), as they are too weak to move their heads often. This makes them more likely to develop flat spots on their heads.

4. Multiple Births (Twins or More)

When a mother is pregnant with twins or more, there is less space in the womb for the babies to move. This can cause one or more babies to be in the same position for a long time, pressing their head against the mother’s pelvis or other babies. This pressure can lead to flattening of the head even before birth.

5. Baby Gear Use (Car Seats, Swings, and Carriers)

Modern baby gear like car seats, swings, rockers, and carriers are helpful, but too much use can lead to Flat Head Syndrome. These devices hold a baby's head in the same position, often pressing against the back of the skull. If babies spend long hours in such gear, they may develop flat spots on the back or side of their heads.

6. Lack of Tummy Time

“Tummy time” means placing your baby on their stomach while they are awake and supervised. It helps babies strengthen their neck, shoulder, and back muscles. Babies who do not get enough tummy time tend to lie on their backs more often, increasing the risk of flat head syndrome. Tummy time also encourages babies to move and change positions, which helps shape their head properly.

Read More: Understanding Flat Head Syndrome in Babies: Is There a Way to Correct it Without a Helmet?

7. Birth Process and Head Shape

During birth, especially if it is a long or difficult delivery, pressure on the baby’s head can cause temporary flattening or molding. This is usually normal and goes away on its own. However, in some cases, the head may stay misshaped if the baby continues to lie in the same position after birth.

How to Reduce the Risk of Flat Head Syndrome

While it is important for babies to sleep on their backs, you can take steps to prevent flat spots on their heads:

  • Change the baby's head position during sleep. Alternate the direction your baby faces in the crib each night.

  • Increase tummy time during the day when your baby is awake and supervised.

  • Hold your baby more often, instead of letting them lie in car seats or swings for long periods.

  • Encourage movement by placing toys on different sides so the baby turns their head both ways.

  • If your baby has torticollis, ask your doctor for physical therapy to help strengthen their neck muscles.

Final Words

Flat Head Syndrome is common in infants and, in most cases, can be corrected with simple changes at home. Ensuring your baby gets enough tummy time and is repositioned regularly—while still following safe sleep guidelines—can help reduce pressure on the back of the head. If you notice flattening or your baby always turns to one side, talk to your pediatrician for guidance.

Early care makes a big difference. At the NJ Craniofacial Center, experts provide evaluations and personalized treatments for babies with Flat Head Syndrome. By understanding the causes and seeking timely help, you can support your baby’s development and promote a healthy, well-shaped head. 

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