Positional Plagiocephaly

The first line of treatment is often to keep the baby off the flat part of the head as much as possible by repositioning the head during sleep, while still keeping the baby on his or her back. At night and during nap time, place a roll of fabric under the shoulder and hip of the flat side and attach it to your baby's bed clothes with pins or tape, so your baby can't roll away.

In addition, keep your baby off the flat area by:

  • Increasing "tummy time," when you play with your baby on his or her stomach
  • Avoiding the car seat unless you're in the car, and using a baby front pack instead of a stroller
  • Positioning the car seat so your baby will turn off the flat side when looking out the window
  • Placing toys and mobiles so they attract your baby's attention to turn off the flat side

Repositioning usually works well when started early, before 6 months of age. If the deformity persists, helmet therapy may be recommended. For helmet therapy, a specialist constructs a custom helmet that fits the child's head snugly except for where the head is flat. As your child's brain grows, the skull fills in the flat area and becomes rounder.

If your child's positional plagiocephaly is caused by torticollis, we may recommend specific exercises to perform every time you change your baby's diaper. The exercises consist of stretching your baby's chin toward the opposite shoulder 10 times and tipping the ear to the opposite shoulder 10 times.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.

Related Information

UCSF Clinics & Centers

Craniofacial Center
1825 Fourth St., Fifth Floor, 5C
San Francisco, CA 94158
Phone: (415) 476-2271
Fax: (415) 476-9513
Appointment information