KidsMD Health Topics

Plagiocephaly in Children

  • Overview

    The term “plagiocephaly” may sound alarming when you first hear it in reference to your child—but the good news is that plagiocephaly (which is also sometimes called deformational plagiocephaly or positional plagiocephaly) is actually a very common, very treatable disorder. While it causes a flattened appearance in a baby’s head or face, plagiocephaly has no known medical repercussions.

    Plagiocephaly develops when an infant’s rapidly growing head attempts to expand, and meets some type of resistance— either prenatally in the mother’s womb, or after delivery because the baby’s head is pressed against a bed or other flat resting surface. This is analogous to how a stationary pumpkin develops a flat spot in a field: Since it cannot grow into the ground, it conforms to that shape. 

    • A baby’s skull is made up of several sections of bone, connected by fibrous joints called sutures, that fuse later in life. During the first few months of a child’s life, the skull itself is soft and malleable.
       
    • Plagiocephaly occurs when an infant’s soft skull becomes flattened in one area, due to repeated pressure on that particular part of the head.
       
    • Many babies develop plagiocephaly by sleeping regularly in one position, or by spending extensive time sitting in the same position in a car seat or swing.
       
    • Plagiocephaly occurs more often in premature infants whose skulls are even more pliable than other babies. These babies may spend a great deal of time lying down as they receive treatment for other medical complications.
       
    • If your child has plagiocephaly, he most likely won’t need surgery. Fortunately, the condition is usually corrected through non-invasive treatments that include special exercises, variations in sleep position and corrective headbands or molding cups.
       
    • Plagiocephaly is different from craniosynostosis, which involve much more serious malformations of the skull bones and require more in-depth treatments.

    How Boston Children's Hospital approaches plagiocephaly

    When you first receive your child's diagnosis, dozens of questions may spring to mind: How serious is plagiocephaly? Will my child need surgery? Is he at risk for neurological problems? How will this impact our family?

    Rest assured: there is no convincing evidence that plagiocephaly has any effect on a child’s brain development, vision or hearing. Even the facial asymmetry caused by the condition seems to improve as a baby grows. The only lasting effect is on the shape of the infant’s head. 

    Here at Children’s Hospital Boston, we have a long and distinguished history of approaching plagiocephaly and various types of brain and skull malformations that affect newborns, infants and older children. Experts in our Departments of Neurosurgery  and Plastic Surgery may work together to diagnose, treat and follow up children and families affected by plagiocephaly and other craniofacial anomalies. We are even able to diagnose some of these problems while babies are still in the womb.

    Children’s clinicians strive to help parents recognize that plagiocephaly is a very treatable condition with entirely cosmetic effects. Experience has taught us that most children with this disorder respond very well to non-surgical, minimally invasive interventions like:

    • customized, corrective helmets and molding cups
    • sleep position changes
    • special exercises

    Our neurosurgical and plastic surgery experts work closely with other specialists across the hospital to develop a customized treatment approach that meets all of your child's physical, emotional and social needs—a care plan that involves you and your family every step of the way. 

    Plagiocephaly:
    Reviewed by John G. Meara, MD, DMD, MBA and Bonnie Padwa, MD, PhD

    © Children’s Hospital Boston, posted in 2011

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