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Positional Plagiocephaly Program

What is positional plagiocephaly?

It typically appears before an infant is 20 weeks old and can dramatically affect the shape of a baby’s head. Also known as deformational plagiocephaly or flat head syndrome, it is caused by the baby being in the same position for an extended amount of time (a crib, car seat carrier, swing).

Craniofacial Center Positional Plagiocephaly Program- image of baby Sometimes, this condition can be noticed while carrying the baby, the head may feel like it has an irregular shape/ asymmetry. A bald spot may also appear in the area where the infant prefers to rest his or her head. Also, the hair in the area might not lie flat, with hair strands extending outward instead of lying smoothly against the head. When asymmetry is mild to moderate, changes in sleep positioning and activities may help to improve the skull shape without the need for further intervention. Infants with more severe cranial asymmetry may have a chance for improvement and benefit from cranial molding with helmet therapy. Since 1996, the American Academy of Pediatrics (AAP) recommends that babies sleep on their back to reduce the risk of Sudden Infant Death Syndrome (SIDS). Parents are encouraged to always check with their pediatrician first for guidance.
It is recommended that all infants with cranial asymmetry be properly evaluated by a pediatric specialist to rule out craniosynostosis. Unlike positional plagiocephaly, craniosynostosis requires surgery and can be diagnosed by X-ray.

What are the signs of positional plagiocephaly?

Ipsilateral frontal bossing
Anterior displacement of ear on affected side
Flattened occiput on affected side


How does positional plagiocephaly differ from craniosynostosis?

Most children with cranial asymmetry simply have positional plagiocephaly. However, some infants are born with craniosynostosis, which unlike positional plagiocephly, requires surgical intervention. Differentiating positional plagiocephaly from craniosynostosis is done primarily by physical examination, followed by radiographic confirmation. Look for these signs to recognize the difference:
Coronal Synostosis - Left Sided 

Lambdoid Synostosis - Right Sided
Metopic Synostosis

Sagittal synostosis


The Nicklaus Children's Hospital Positional Plagiocephaly Service includes:

  • Plastic surgery evaluation
  • Referrals to Diagnostic imaging, certified orthotics and physical therapy as needed.

For further information or to make an appointment, please call 561-383-7113.

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