In July, a photo of a family wearing helmets to support the youngest member of the family went viral. According to media reports, the 4-month-old was being treated for plagiocephaly.

Madonna Physical Therapist Michelle Crouse, MPT/ATP, has more information about what it is.

What is Plagiocephaly?

Plagiocephaly is a combination of a flat spot that occurs on the side of the head and on the back of the head on the flattened side.  This can cause the forehead and ear to move forward on the flattened side. 

What causes Plagiocephaly?

Plagiocephaly may be caused by the following:

  • Premature birth and positioning in the NICU
  • Congenital muscular Torticollis
  • Repetitive positioning in the crib, car seat, bouncy seat or swing paired with too little tummy and floor time. 
  • Craniosynostosis – this is a premature closing of the soft spot and joints of the skull; although rare, should be evaluated by the physician in all cases of plagiocephaly.

When should I be concerned?

Most babies’ heads are not perfectly round at birth.  But the head shape should become more uniform within a few weeks of birth. 

Talk to your doctor if:

  • Your baby’s head is not getting more round
  • Your baby holds his/her head in one position and cannot turn in the opposite direction
  • You notice the flat spot worsening

How is Plagiocephaly treated?

Physical therapy may be prescribed to educate you on how to position your baby to relive the pressure on the flat side of the head.  The physical therapist (PT) can also evaluate for torticollis, and then prescribe appropriate treatment as needed.  Both strengthening and stretching exercises are often recommended in cases of plagiocephaly.  Additionally, the PT can assess the need for a cranial remolding helmet to help reshape the skull.

A cranial remolding helmet is a custom-made orthotic that is formed by the orthotist and worn for 23 hours a day by your baby.  The helmet provides off-setting pressure to gently remold the skull to a more round shape. 

Contact your physician for a physical therapy referral if you are concerned about the presence of plagiocephaly.