Keeping Your Baby’s Head Round

Plagiocephaly is a general term used to describe asymmetry of the head.  Since the American Academy of Pediatrics in 1992 recommended having babies sleep on their backs to decrease the incidence of sudden infant death syndrome, many babies have developed flattening of the backs of their heads, posterior plagiocephaly.

Most of these flat heads are the result of repeated positioning of the infant head on one side, either as a result of baby preference, inability to turn the head in the other direction, or flattening that occurred in utero or during birth.  Prevention is a good idea.

Almost all of these little flattened heads “round out” nicely with careful attention to proper positioning over several weeks.  If you cannot see improvement, please let me know.  A helmet might be in order.  Below are some recommendations for repositioning:


Place your baby’s head on opposite ends of the bed on alternating nights.

Arrange the room so that where your baby likes to look is in the desired direction.

After your baby is asleep, you might be able to sneak the head to the desired position.

Play Time:

Increase the amount of probably-not-too-popular “tummy time.”  Most babies will grow accustomed to it the more they are exposed to it.

Reduce the amount of car seat, swing, or carrier time if it allows the baby to rest on the wrong side of their head.

Monitor for neck stiffness or tightness and notify me if discovered.


Alternate or preferentially use your arm that keeps the head off the flat side while feeding.

Try to encourage your baby to turn their head as much as possible away from the flat side whenever feeding.

Changing Diapers:

You might be able to change diapers standing on the side that encourages your baby to look at you and away from the side that is flattened.


Car Seats: A rolled towel or a firm commercial baby head supporter can be positioned to prevent pressure on the flattened side of the head.

If the seat must be on one side of the car, choose the one that encourages the baby to look away from the flattened side of the head.

Carriers: Use a papoose carrier that holds the baby in front of you and that minimizes forces on the head.

Pillows: Several companies manufacture specially designed pillows and rolls that assist optimal positioning.

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