It is a common misconception that a baby’s flat head is merely a cosmetic issue. That they will grow up with a flatter shaped head, but that aside, they grow up perfectly normal. This is such a heartbreaking misconception for me, since I know this is far from the truth, and all I desire is for children to be giving their BEST start to life.

(Edit to add TRIGGER WARNING: since posting this blog on my previous website, I have received many an email from mothers saying this information upset them, because their child has a flat head and the hospital has told them there are no long term side effects of plagiocephaly. If this article does trigger you, I hope you start to delve deeper and seek more information on what the research is stating about flat heads in babies. I am simply sharing the research I have read and do not intend to insult anyone with a baby who has a flat head).

What is positional plagiocephaly?

Positional plagiocephaly, aka flat head syndrome, has become more prevalent since the SIDS Back to Sleep campaign in the 80s. This is because babies began spending more time on their backs, leading to a flat spot on the back of the heads. It is most commonly seen in those babies who have a preference to turn their head one way. I’m sure if your baby has plagiocephaly, you have tried putting toys on the other side, or a mirror, or making noise over the other side to get your baby to turn their head the other way.. these are the most common recommendations I hear and while they do help to get the baby’s head turning, they are often not enough.

A baby's skull bones are softer than adults, and have little joints between them called sutures. Babies are designed this way to allow easier passage through the birth canal, as well as the ability for the head to grow until it reaches adult size. During a vaginal birth, babies’ skull bones squish closer and overlap so that the baby can exit the birth canal as easily as possible. So having a baby who is a few days old with obvious lumps or bumps on their head is a very common and normal occurrence after birth. As the baby’s head grows to adult size, those birth-related lumps and bumps even themselves out. And this is typically where the idea comes from that babies will grow out of their flat spot.

“Why is my baby turning their head only one way?”

In my experience, a baby who prefers to turn only one way does not do so out of pure preference, and typically there is an underlying reason for their positional preference. Osteopathic research has demonstrated that babies may experience spinal musculoskeletal trauma during the birth process - so I wonder how many babies with flat heads have some kind muscle or joint of pain? What if their head preference is to allow themselves to be comfortable and pain free? Maybe their cranial bones were overlapped a little too much and need a bit of help realigning after the birth.

What are the effects of a flat head in a baby?

There is mounting research associating flat heads during infancy with a myriad of developmental and brain changes. I have accumulated some of the research for you, and put it into one package. (Please, if you're that way inclined, ask me for the list of articles I have referenced - I will happily oblige! This information was correct as of July 29, 2019 and as research changes this information may require updating).

Documented short term effects of plagiocepaly

At 8.5 months of age (average) –
- 20% had some mild psychomotor delays
- 13% had some significant psychomotor delays
- The average for delays in the general population is 7%
Before any intervention, infants with deformational plagiocephaly show significant delays in both mental and psychomotor development
Changes in muscle tone and motor function (ie delayed milestones) noted from 6 months onwards

Documented long term studies on plagiocephaly

Increased risk of auditory processing disorders in almost 100%
Increased risk of visual processing disorders – 35%
Increased risk of requiring learning assistance
Increased requirement of a special class, eg. Reading recovery
At 5 years of age, 33% had received learning assistance
- 14% were in a special class
39.7% with persistent deformational plagiocephaly had received special help in primary school
- Only 7.7% of siblings required similar help
Delayed language acquisition at 3.5 years of age in 51%
Continued developmental issues during preschool found in children who had delays in infancy and plagiocephaly

Does plagiocephaly change a baby’s brain for life?

I want to highlight that any kind of delay in your child’s development does not necessarily mean it’s a lifelong diagnosis. There are many brain exercises programs that stimulate and support healthy brain development, whether your baby had a flat head or not.

In practice, I see many children with mild to severe delays and in all cases, some positive change to their quality of life can be achieved. It does depend on each child, what the parents’ goals are, and also how compliant they are with homework or dietary changes.

The brain has this amazing quality called neuroplasticity, where you can train it to make new connections, and perform new tasks. Even as adults, our brains thrive on novelty, learning new things, and being stimulated. An understimulated brain will start to prune off it’s unused neurons (brain cells), and a brain that is stimulated will make new connections. Brains that are stimulated to the point of fatigue will struggle to grow new connections, and therefore it is always best when dealing with any brain delays to work with a professional who can gauge when the brain and nervous system is about to fatigue. It is after all like any other system, and you need to increase the load slowly.

Chiropractic and plagiocephaly

One study has compared a group of infants (4 months of age and older) with neck dysfunction, and those with no neck problem. They assessed the children using the Ages and Stages Questionnaire (ASQ) and found the following:

Neck dysfunction - 41% had one or more delays
No neck problem - 29% had one or more delays
The greatest number of delays was seen in:
- Gross motor domain (18%)
- Problem solving (17%)
- Personal–social (15%)
- Fine motor (14%)
- Communication (7%)

Now it’s very possible that babies have neck dysfunction without plagiocephaly. It’s also possible that babies have a flat spot without neck dysfunction. However, it is clear in the research that both plagiocephaly and neck dysfunction has been linked to delays in brain development (how this actually happens is still unclear).

Chiropractic for flat heads or babies who turn their head one way does not have to be about “cracking spines” or doing anything that might cause your baby discomfort. In my practice, a baby with a flat head receives a full neurological examination, a retained neonatal reflexes assessment, a tongue tie assessment (and referral if required), a measure of the size of the plagiocephaly (as certain sizes of flat heads do require assessment for helmets), and applied kinesiology testing for any additional imbalances.

Chiropractic for children has an exemplary safety record, and is an alternative option to “watch and wait”, which may have been the advice you have been given. If you’re looking for a natural and gentle option for your baby’s flat head, you may like to consider chiropractic care.