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Positional plagiocephaly occurs when an infant's skull becomes flattened in one area due to persistent pressure in that region. A baby's skull is made up of several bony sections joined by fibrous material called sutures. The plates do not fuse together until later in life, so during the first few months of life, the skull is normally quite soft and therefore easily deformed. Sleeping in the same position or spending extended amounts of time in swings and car seats can contribute to the condition.
Plagiocephaly occurs more often in premature infants because their skulls are even softer than full-term infants and because of the intensive medical treatments that may be necessary in the first few weeks of life which often keeps them in a recumbent position without the normal periods of being out of the crib.
Public awareness campaigns about SIDS (sudden infant death syndrome) have increased dramatically in the past 15 years. To avoid SIDS, parents are warned to put children to sleep on their backs. The result has been an almost a 40 percent decline in rates of SIDS, but a 6-fold increase in positional plagiocephaly. The American Academy of Pediatrics continues to recommend that infants sleep on their backs, but parents can combat plagiocephaly by making sure that children get plenty of supervised active time while they are awake.
Positional plagiocephaly is usually easily treated using a combination of exercises, variations in sleep position, increasing daytime "tummy-time" or using a helmet or headband to re-shape the head. Another cause of flattened head is craniosynostosis or prematurely fused sutures -- which often requires surgery to repair -- so it is important to get the correct diagnosis.
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