CINXE.COM

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Deformities" /><meta property="og:description" content="When a baby spends a lot of time in one position, it can cause the shape of their head to flatten or change. This is called a positional skull deformity. Learn more about different misshapen head types in babies, and how to help prevent positional skull deformities." /><meta property="og:type" content="article" /><meta property="og:article:published_time" content="2016-02-12T00:00:00" /><meta property="og:fb:app_id" content="115427621803" /><meta property="og:url" content="https://www.healthychildren.org/English/health-issues/conditions/Cleft-Craniofacial/Pages/Positional-Skull-Deformities-and-Torticollis.aspx" /><meta property="og:site_name" content="HealthyChildren.org" /><meta property="og:image" content="https://www.healthychildren.org//SiteCollectionImagesArticleImages/plagiocephaly_baby_lay.jpg?RenditionID=3" /><meta property="og:image" content="https://www.healthychildren.org/_layouts/15/AAP.HealthyChildren/images/hc_favicon_square.png" /><meta name="publish_date" content="2016-02-12"><meta name="publish_image" content="https://www.healthychildren.org//SiteCollectionImagesArticleImages/plagiocephaly_baby_lay.jpg?RenditionID=3"><title> When a Baby’s Head is Misshapen: Positional Skull Deformities - HealthyChildren.org </title> <script type="text/javascript"> var _fV4UI = true; </script> <link rel="shortcut icon" href="/_catalogs/masterpage/Assets/images/hc_favicon.ico?rev=1" type="image/vnd.microsoft.icon" /><span AuthenticationResctriction="AnonymousUsersOnly"> <link rel="stylesheet" type="text/css" href="/_catalogs/masterpage/Assets/less/css/ms-searchpaging.min.css?v=4.0" /> </span> <link rel="stylesheet" type="text/css" href="/_layouts/15/1033/styles/corev4.css?rev=KyQnJ1I7G2kvTD29d4%2F1gw%3D%3D" /><link rel="stylesheet" type="text/css" href="/Style%20Library/en-US/Themable/Core%20Styles/controls.css?v=4.0" /><script type="text/javascript">// <![CDATA[ var g_SPOffSwitches={}; // ]]> </script> <script type="text/javascript" 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target="_self">Autism</a><a href="/English/health-issues/conditions/chest-lungs/Pages/default.aspx" target="_self">Chest ＆ Lungs</a><a href="/English/health-issues/conditions/chronic/Pages/default.aspx" target="_self">Chronic Conditions</a><a href="/English/health-issues/conditions/Cleft-Craniofacial/Pages/default.aspx" target="_self">Cleft ＆ Craniofacial</a><a href="/English/health-issues/conditions/COVID-19/Pages/default.aspx" target="_self">COVID-19</a><a href="/English/health-issues/conditions/developmental-disabilities/Pages/default.aspx" target="_self">Developmental Disabilities</a><a href="/English/health-issues/conditions/ear-nose-throat/Pages/default.aspx" target="_self">Ear, Nose ＆ Throat</a><a href="/English/health-issues/conditions/emotional-problems/Pages/default.aspx" target="_self">Emotional Problems</a><a href="/English/health-issues/conditions/eyes/Pages/default.aspx" target="_self">Eyes</a><a href="/English/health-issues/conditions/fever/Pages/default.aspx" target="_self">Fever</a><a href="/English/health-issues/conditions/flu/Pages/default.aspx" target="_self">Flu</a><a href="/English/health-issues/conditions/from-insects-animals/Pages/default.aspx" target="_self">From Insects or Animals</a><a href="/English/health-issues/conditions/genitourinary-tract/Pages/default.aspx" target="_self">Genitals and Urinary Tract</a><a href="/English/health-issues/conditions/head-neck-nervous-system/Pages/default.aspx" target="_self">Head, Neck ＆ Nervous System</a><a href="/English/health-issues/conditions/heart/Pages/default.aspx" target="_self">Heart</a><a href="/English/health-issues/conditions/infections/Pages/default.aspx" target="_self">Infections</a><a href="/English/health-issues/conditions/learning-disabilities/Pages/default.aspx" target="_self">Learning Disabilities</a><a href="/English/health-issues/conditions/seizures/Pages/default.aspx" target="_self">Seizures</a><a 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href="/english/tips-tools/find-pediatrician/Pages/Pediatrician-Referral-Service.aspx" target="_self">Find a Pediatrician</a></li><li><a href="/English/tips-tools/HealthyChildren_Magazine/Pages/default.aspx" target="_self">Healthy Children Magazine</a></li><li><a href="/English/tips-tools/healthy-children-podcast/Pages/podcast.aspx" target="_self">Healthy Children Podcast</a></li></ul><ul><li><a href="/English/tips-tools/HealthyChildren-Texting-Program/Pages/default.aspx" target="_self">Healthy Children Texting Program</a></li><li><a href="/English/MotorDelay/Pages/default.aspx" target="_self">Motor Delay Tool</a></li><li><a href="/english/tips-tools/newsletters/pages/default.aspx" target="_self">Newsletters</a></li><li><a href="/English/healthy-living/fitness/StopWatch-Tool/Pages/default.aspx" target="_self">Physical Activity Checker</a></li><li><a href="/english/tips-tools/symptom-checker/pages/default.aspx" target="_self">Symptom Checker</a></li><li><a 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class="btn-search" /> </div> </div> </div> </div> </nav> <div class="clear"> </div>  <section class="page-content"> <div id="hcMainContainer"> <div class="left-col-container col-xs-3 col-sm-3 col-md-3 col-lg-3"> <h5 class="title rail-left-title"> Health Issues </h5> <div class="rail-left"> <div class="vertical-nav-header-top"></div> <div id="ctl00_cphLeftNav_QuickLaunchNavigationManager"> <div class="vertical-navigation"> <table id="zz1_QuickLaunchMenu" class="ms-navSubMenu1 zz1_QuickLaunchMenu_7 zz1_QuickLaunchMenu_2" cellpadding="0" cellspacing="0" border="0"> <tr onmouseover="Menu_HoverRoot(this)" onmouseout="Menu_Unhover(this)" onkeyup="Menu_Key(this)" id="zz1_QuickLaunchMenun0"> <td><table class="ms-navheader zz1_QuickLaunchMenu_4" cellpadding="0" cellspacing="0" border="0" width="100%"> <tr> <td style="width:100%;"><a class="zz1_QuickLaunchMenu_1 ms-navheader zz1_QuickLaunchMenu_3" href="/English/health-issues/conditions/Pages/default.aspx" 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</div> </div> <div class="layout-content">  <div class="article-social-container"> <div class="article-social-left"> <div class="reader-listen-container"> </div> </div> <div class="article-social-right">  <div class="sharethis-inline-share-buttons"></div>  </div> </div> <div id="read_content" class="fontScalerWrapper"> <h1 class="page-title">When a Baby’s Head is Misshapen: Positional Skull Deformities</h1> <div class="middle-bottom-wpz"> <menu class="ms-hide"> <ie:menuitem id="MSOMenu_Help" iconsrc="/_layouts/15/images/HelpIcon.gif" onmenuclick="MSOWebPartPage_SetNewWindowLocation(MenuWebPart.getAttribute('helpLink'), MenuWebPart.getAttribute('helpMode'))" text="Help" type="option" style="display:none"> </ie:menuitem> </menu> </div>  <div id="ctl00_cphPageContent_EditModePanel1"> <div class="article-image"> <span class="img-desktop-responsive"> <img alt="When a Baby’s Head is Misshapen: Positional Skull Deformities" src="/SiteCollectionImagesArticleImages/plagiocephaly_baby_lay.jpg?RenditionID=3" width="468" style="BORDER: 0px solid; "> </span> <span class="img-mobile-responsive print-no"> <img alt="When a Baby’s Head is Misshapen: Positional Skull Deformities" src="/SiteCollectionImagesArticleImages/plagiocephaly_baby_lay.jpg?RenditionID=3" width="468" style="BORDER: 0px solid; "> </span> </div> </div> <div> <div id="ctl00_cphPageContent_ctl00_label" style='display:none'>Page Content</div><div id="ctl00_cphPageContent_ctl00__ControlWrapper_RichHtmlField" class="ms-rtestate-field" style="display:inline" aria-labelledby="ctl00_cphPageContent_ctl00_label"><p>When a baby spends a lot of time in one position, it can cause the shape of their head to change. This is called a positional skull deformity. <br></p><p>For about 20% of babies, a positional skull deformity occurs when they are in the womb or in the birth canal. More often, it happens in the first 4 to 12 weeks of life. This is when babies are not able to sit up or move on their own. By 6 months of age, many babies become more <a href="/English/MotorDelay/Pages/default.aspx">mobile</a> and can turn their heads on their own more regularly.</p><h2>What causes a baby's head shape to change?</h2><p>A <a href="/English/ages-stages/baby/Pages/Your-Babys-Head.aspx">baby's skull</a> has soft, bony plates that haven't yet fused together. The bony plates can move a bit, which helps the baby's head to pass through the birth canal. The plates also allow room for the brain to grow during the first year of life. </p><p>There are many things that can cause a positional skull deformity, such as:</p><ul><li><p> <strong>Preferred head position. </strong>Some babies like sitting or sleeping with their heads turned a certain way. </p></li><li><p> <strong>Not enough tummy time. </strong><a href="/English/ages-stages/baby/sleep/Pages/back-to-sleep-tummy-to-play.aspx">Tummy time</a> is for babies who are awake and being watched. It helps babies master basic milestones like head lifting, turning over, sitting up, and crawling.</p></li></ul><ul style="list-style-type:disc;"><li><p> <strong>Twin or triplet. </strong>Cramped or unusual positions in the womb can lead to changes in head shape.</p></li><li><p> <strong>Prematurity. </strong>Lying flat on their backs in the hospital can cause a preemie's head to become misshapen. <a href="/English/ages-stages/baby/preemie/Pages/Preemie-Milestones.aspx">Preemies</a> also have softer bones that are not as fully formed as the bones of full-term babies. </p></li><li><p> <strong>Birth complications. </strong>The baby's position when moving through the birth canal can affect his or her head shape. Some other things that affect a baby's head shape at birth are using forceps, vacuum extraction or even a difficult labor.</p></li></ul><ul><li><p> <strong>Torticollis. </strong>An estimated 85% of babies with <a href="/English/health-issues/conditions/Cleft-Craniofacial/Pages/Head-Tilt.aspx">torticollis</a>, a condition where the neck muscles are tight or imbalanced, have a positional skull deformity. Infants who have torticollis also will need physical therapy. </p></li></ul><h2>3 common misshapen head types</h2><p>A baby's head shape change usually is related to the position in which they spend the most time. Your pediatrician can determine whether your baby's head shape is caused by a positional skull deformity or an uncommon but more serious condition called <a href="/English/health-issues/conditions/Cleft-Craniofacial/Pages/Uneven-Head-Shape-Craniosynostosis.aspx">craniosynostosis</a>. Common positional skull deformities do not require surgery.</p><ul style="list-style-type:disc;"><li><p> <strong>Deformational brachycephaly</strong> is when the head is symmetrically (evenly) flat in the back and wide from side to side. The bone above the ears might seem to stick out. This is often seen in babies who spend a lot of <a href="/English/ages-stages/baby/sleep/Pages/back-to-sleep-tummy-to-play.aspx">time on their backs</a> and do not get <a href="/English/ages-stages/baby/sleep/Pages/back-to-sleep-tummy-to-play.aspx">enough tummy time</a>. </p></li><li><p> <strong>Deformational plagiocephaly</strong> is when the head is asymmetrically (unevenly) flat in the back on one side. The forehead may be more prominent, causing the head to look like a parallelogram. The ear may also shift forward on the flat side. This is often seen in babies who prefer to sleep with their heads turned to one side and those with torticollis. </p></li></ul><ul><li><p> <strong>NICUcephaly</strong> is a common condition in preemies who spend their first few months of life in the <a href="/English/ages-stages/baby/preemie/Pages/How-You-Can-Participate-in-the-Care-of-Your-Baby-in-the-NICU.aspx">neonatal intensive care unit (NICU)</a>. This positional skull deformity causes preemies to develop long, narrow heads. </p></li></ul><h3>A good time to check your baby's head is after bath time when their hair is wet. </h3><ul style="list-style-type:disc;"><li><p><strong>The back of your baby's head</strong> should be evenly round.</p></li><li><p><strong>Your baby's ears</strong> should be even.</p></li><li><p><strong>The width of your baby's head</strong> and forehead should be even and balanced.</p></li></ul><p>If you notice any changes or have any concerns, talk to your pediatrician. </p><p><span style="color:#5c4727;font-size:27.2px;">What if my baby has a positional skull deformity?</span>Positional skull deformities do not affect <a href="/English/ages-stages/baby/Pages/Babys-First-1000-Days-AAP-Policy-Explained.aspx" style="background-color:#ffffff;">brain growth</a> or intellectual development. They are purely cosmetic, and the majority do not require surgery.</p><p>The best treatment is to prevent a positional skull deformity. And when it is found early, simple changes to your baby's position will help. For example: </p><ul style="list-style-type:disc;"><li><p><strong>Avoid too much time in a </strong><a href="/English/safety-prevention/on-the-go/Pages/Car-Safety-Seats-Information-for-Families.aspx"><strong>car seat</strong></a><strong>, bouncy seat, baby swing </strong>or other carrier. These positions put pressure on the back of your baby's head.</p></li><li><p><strong>Increase tummy time. </strong>It is important to put babies on their <a href="/English/ages-stages/baby/sleep/Pages/a-parents-guide-to-safe-sleep.aspx">backs to sleep</a>. But a baby needs supervised time on their <a href="/English/ages-stages/baby/sleep/Pages/back-to-sleep-tummy-to-play.aspx">tummy to play</a> during the day. This also lets your baby exercise their neck, back, shoulders, arms and hips. Start with short spurts of time. Gradually work up to an hour per day in several short sessions. </p></li><li><p><strong>Switch or alternate arms</strong> when holding and feeding your baby.</p></li><li><p><strong>Alternate which end you of the crib</strong> you place your baby down for sleep. </p></li></ul><p></p><p></p><h2>Are infant "head-shaping" pillows safe? </h2><p>No, head-shaping support pillows for babies are not safe. These products can create an unsafe <a href="/English/ages-stages/baby/sleep/Pages/a-parents-guide-to-safe-sleep.aspx">sleep environment </a>for babies and may contribute to <a href="/English/ages-stages/baby/sleep/Pages/Sleep-Position-Why-Back-is-Best.aspx">suffocation risk</a>. In addition, the U.S. Food and Drug Administration (FDA) <a href="https://www.fda.gov/medical-devices/safety-communications/do-not-use-infant-head-shaping-pillows-prevent-or-treat-any-medical-condition-fda-safety?utm_medium=email&utm_source=govdelivery" target="_blank">says</a> there is no evidence to show that these products are effective for positional skull deformities, <a href="/English/health-issues/conditions/Cleft-Craniofacial/Pages/Uneven-Head-Shape-Craniosynostosis.aspx">craniosynostosis</a> or any other medical purpose.<br></p><h2>Early intervention & therapy for positional skull deformity<br></h2><p>In some cases, your baby's doctor may recommend treatment for positional skull deformity, particularly those with moderate or severe head flattening.</p><p></p><ul><li><strong>Physical therapy.</strong> Your pediatrician may refer your baby for early intervention services and an evaluation from a pediatric physical therapist. The therapist will check your baby for <a href="/English/ages-stages/baby/Pages/Movement-Birth-to-Three-Months.aspx">delayed motor skills</a> caused by poor head and neck control, and for torticollis. You will also learn stretching and positioning exercises to do with your baby at home. Depending on how severe the positional skull deformity is, your baby may need weekly therapy.<br><br> </li><li><strong>Helmet therapy.</strong> If your baby has moderate or severe head flattening that does not respond to treatment by 5 or 6 months of age, they may benefit from <a href="/English/health-issues/conditions/Cleft-Craniofacial/Pages/Baby-Helmet-Therapy-Parent-FAQs.aspx">helmet therapy</a>. Molding helmets work by re-shaping the baby's head. These helmets are fitted by a specialist.<br><br> </li><li><strong>Surgery</strong> should only be considered when all other options have been exhausted. In addition, surgery should only be considered after consulting with a neurosurgeon or pediatric plastic surgeon who specializes in these types of cases.</li></ul> <p></p><h2>Remember</h2><p>Talk with your pediatrician if you have any questions or concerns about your baby's growth and development.</p><h2>More information<br></h2><p></p><ul><li> <a href="/English/health-issues/conditions/Cleft-Craniofacial/Pages/Baby-Helmet-Therapy-Parent-FAQs.aspx">Baby Helmet Therapy: Parent FAQs</a></li><li><a href="/English/health-issues/conditions/Cleft-Craniofacial/Pages/Uneven-Head-Shape-Craniosynostosis.aspx">Uneven Head Shape in Babies: Causes and Treatment of Craniosynostosis</a><br></li><li> <a href="/English/ages-stages/baby/sleep/Pages/The-Importance-of-Tummy-Time.aspx">Tummy Time Activities</a></li><li> <a href="https://doi.org/10.1542/peds.2020-015511" target="_blank">Identifying the Misshapen Head: Craniosynostosis and Related Disorders</a> (AAP Clinical Report)</li><li> <a href="/English/ages-stages/baby/Pages/Your-Babys-Head.aspx">Your Baby's Head</a><br></li></ul><div><br></div><div></div></div> <div id="ctl00_cphPageContent_PublishingPageContentField_label" style='display:none'>Article Body</div><div id="ctl00_cphPageContent_PublishingPageContentField__ControlWrapper_RichHtmlField" class="ms-rtestate-field" style="display:inline" aria-labelledby="ctl00_cphPageContent_PublishingPageContentField_label"></div> <dl id="ctl00_cphPageContent_dlLastUpdated" class="article-details"> <dt><span id="ctl00_cphPageContent_lblLastUpdated">Last Updated</span></dt> <dd><span id="ctl00_cphPageContent_lblDate">11/3/2022</span></dd> </dl> <dl id="ctl00_cphPageContent_dlSource" class="article-details"> <dt><span id="ctl00_cphPageContent_lblArticleSource">Source</span></dt> <dd><span id="ctl00_cphPageContent_lblSource">American Academy of Pediatrics Section on Neurological Surgery and Section on Plastic and Reconstructive Surgery (Copyright © 2022)</span></dd> </dl> <div class="disclaimer"> <span id="ctl00_cphPageContent_lblDisclaimer">The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. 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