Positional Plagiocephaly

What is Positional Plagiocephaly

Positional Plagiocephaly, also called Flat Head Syndrome, is common among newborns and older babies. This flat spot on the back of the baby’s head is often the result of the baby laying on its back for a long period of time without shifting the position of its head.

In many cases, the positional plagiocephaly will go away on its own after a few months. For most babies with positional plagiocephaly, there are no facial defects or negative impact to brain development.

There are severe cases of positional plagiocephaly that only go away with medical treatment. This is called congenital Positional Plagiocephaly.  Some of these more serious cases of positional plagiocephaly can include the following symptoms:

  • Mis-matching ears
  • Flat areas of the head
  • An uneven forehead
  • Bony ridges throughout the head
  • Asymmetrical facial features

To diagnose this condition, your child’s doctor or nurse practitioner will check your child’s head for features like:

Two sides of the face that do not match each other (asymmetry)

Your child’s healthcare provider will also check your child’s development. Some children with this condition have mild developmental delays. Read about Seattle Children’s research into the link between delayed development and positional plagiocephaly.

Positional plagiocephaly can sometimes look like a condition called craniosynostosis. These conditions need very different kinds of treatment. Our team is experienced in looking for the signs that help us tell these conditions apart.

Treating Positional Plagiocephaly

Positional Plagiocephaly can be easily treated and prevented by the careful monitoring of your bay’s sleeping position. Keeping your baby active and sitting upright in your lap will change the position of their head and keep the baby from resting on one particular side of their head for long periods of time.

Those with Congenital Plagiocephaly or those with severe Positional Plagiocephaly will require some sort of treatment.

The most common treatment for severe Positional Plagiocephaly and Conditional Plagiocephaly is helmet therapy.

With helmet therapy, a child (who is older than 6 months of age) is fitted with a tightly fitting helmet he or she is to wear most of the day and night. The length of helmet therapy will be determined on the severity of the flatness of the child’s head. Most children wear a helmet for 4-5 months before their flat spot disappears.

For certain extenuating circumstances, surgery may be required.

It is common for babies to have flat spots on their heads as their bones are growing and developing. Positional Plagiocephaly isn’t a cause of concern unless the flatness of the head doesn’t go away and more serious conditions, such as facial deformities, occur.

At the Cleft & Craniofacial Institute of Utah, we diagnose and recommend individualized treatment for each Positional and Congenital Plagiocephaly case.

Untreated Positional Plagiocephaly

While the majority of Positional Plagiocephaly cases resolve itself and doesn’t require medical treatment, serious conditions can occur with cases of Congenital Plagiocephaly if left untreated. Unlike Positional Plagiocephaly, Congenital Plagiocephaly is caused by the premature fusion of skull bones.  Some of the conditions associated with Congenital Plagiocephaly include:

  • Possible severe, permanent head deformities
  • Seizures
  • Increased pressure inside the head on the brain
  • Developmental delays

These and the possible psychological conditions can occur in individuals with untreated Congenital Plagiocephaly.

Additional Information

If your child’s head flat spot doesn’t go away on its own after a few months, contact the Cleft & Craniofacial Institute of Utah. Your child may have a severe case of Positional Plagiocephaly or have Congenital Plagiocephaly and medical treatment may be necessary.

Our Expertise

Cleft Lip/Palate

 Cleft lips and palates are one of the most common birth anomalies that affect about 1/600 newborn babies in the United States and around 1/500 in the state of Utah.  Clefts can range from quite mild to fairly severe.  Most of the time they are an isolated anomaly, but are also associated with a number of gentic syndromes.  Depending on what structures are involved dictates the complexity of the treatment plan.   Our team works together with you to make a customized plan for  your baby.  Even the most severe of cases should be able to be treated with only a few surgical interventions by a well coordinated and efficient team.






The skull is made up of several different bones that are joined together by growth plates called "sutures."  Craniosynostosis is a condition where one or more of these sutures fuse prematurely causing an abnormal head shape, decreased cranial volume, and the possiblilty of raised intracranial pressure.  The treatment of craniosynostosis is surgical and the goals of surgery are to increase the volume of the skul and to correct the abnormal appearance of the head shape.  There are two methods of surgical correction: open vault reconstruction and strip craniectomy.  Dr. Griner's extensive training allows him to perform these complex procedures without the need for blood transfusions and spending only 1-2 nights in the hospital. 



There are many syndromes that can affect the shape of the head and face and include Aperts, Crouzon, Pfieffer, Treacher Collins, and many others.  Most of these syndromes include many other complex anomalies and need to be treated in a coordinated approach in order to reduce the number of operations the child will need.  These syndromes are rare and require specialists that are very familiar with the intricacies of each syndrome.  Dr. Griner's unique training provided him with extensive experience with craniofacial syndromes and makes him the premier choice to guide the management of your child's needs in Utah.





Ear Deformities

Ear deformities range from mild changes in shape to the complete abscence of an ear and deafness.  Mild deformities can be treated in the first few weeks of life while others will require reconstructive surgery and hearing aids.  No matter the severity, our specialists work together to provide normal appearance and improved hearing.


From the Blog

Parenting a Cleft Child: Selecting a Surgeon

You stare at that ultrasound, taking in the news that your baby has a cleft lip and/or palate. You’re referred to a specialist to confirm that diagnosis. You see the specialist, baby’s cleft is confirmed. You don’t know how to feel or what questions to ask. It all...

read more

Staged palate repairs

Staged palate repairs were implemented to try and reduce the chance of stunting the upper jaw growth and needing to have it surgically advanced later in life, while at the same time allowing normal speech to develop.  We know from several studies that the growth of...

read more