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The Role of Physical Therapy in Addressing Infant Flat Head Syndrome

Posted on Oct 11, 2023

The human head, like a delicate sculpture, requires proper alignment to develop harmoniously. However, infants are susceptible to a condition known as flat head syndrome or positional plagiocephaly. This condition is characterized by an abnormal flattening of the back or side of the skull due to prolonged pressure on one area. While there are three types of flat head syndrome – plagiocephaly, brachycephaly, and scaphocephaly – they all share the common feature of cranial asymmetry. The occurrence of this syndrome in infants can be attributed to various factors such as prenatal positioning, limited movement during sleep, or restricted neck mobility.

Addressing infant flat head syndrome is crucial as it may lead to potential complications including facial asymmetry and developmental delays. Amongst the medical professionals involved in its management, pediatric physical therapists play a significant role in identifying and treating this condition. Through their expertise in assessing musculoskeletal development and implementing appropriate interventions, physical therapy aims to restore optimal head shape and facilitate overall motor development.

In this blog, we will explore the role of physical therapy in addressing infant flat head syndrome while also discussing the best time for babies to seek therapeutic intervention. By examining current research and clinical practices, we can gain valuable insights into how physical therapy contributes to mitigating the impact of this condition on infants’ health and well-being.

What Is Infant Flat Head Syndrome?

Infant flat head syndrome, also known as positional plagiocephaly, is a condition characterized by asymmetrical flattening of the skull due to prolonged pressure on one particular area. This condition typically occurs in infants who spend excessive amounts of time lying on their backs or in one position. The prevalence of infant flat head syndrome has increased significantly since the American Academy of Pediatrics (AAP) recommended that infants be placed on their backs to sleep in order to reduce the risk of sudden infant death syndrome (SIDS).

The 3 Types Of Flat Head Syndrome

The three types of flat head syndrome: plagiocephaly, brachycephaly, and dolichocephaly. Plagiocephaly is characterized by a flat spot on one side of the baby’s head, causing an asymmetrical appearance. Brachycephaly refers to a wide and short head shape, while dolichocephaly involves a long and narrow head shape.

types of flat head syndrome


This is when one side of the back of the baby’s head becomes flat. It’s as if someone took a book and pressed it on one side of the baby’s head.


Here, the back of the head becomes flat, making the head wider. Imagine a baby wearing a very wide hat – that’s kind of how it looks.


This is the least common type. It’s when the baby’s head becomes longer, sort of stretched out from front to back.

Why Does Flat Head Syndrome Occur in Infants?

Infants may develop flat head syndrome due to prolonged pressure on certain areas of their skull, resulting in an asymmetrical or elongated shape. This condition, also known as plagiocephaly or brachycephaly depending on the specific presentation, is primarily caused by external factors that affect skull growth and development.

What Are The Complications From Flat Head Syndrome?

Complications from flat head syndrome could be as follows:

  • Flathead syndrome can lead to long-term effects on appearance and motor skills.
  • Though often harmless, untreated cases pose complications.
  • A primary complication is cranial asymmetry, making the skull misshapen.
  • This can alter facial features, such as a flattened forehead.
  • Changes may impact self-esteem in older children.
  • Motor development may also be affected.
  • Skull misalignment can disrupt neck muscle functions and head control.
  • This might delay milestones like rolling over and walking.
  • Physical therapy can help address these issues.
  • Techniques focus on head alignment and strengthening neck muscles.
  • Early intervention is vital to minimize long-term impacts.

By addressing these complications early on through physical therapy interventions, healthcare professionals aim to minimize long-term effects on both physical appearance and motor development for infants with flat head syndrome.

How Does A Pediatric Physical Therapist Identify Flat Head Syndrome?

To address flat head syndrome, pediatric physical therapists play a crucial role in identifying and providing appropriate interventions. They possess specialized knowledge and skills to assess an infant’s head shape and determine whether further intervention is necessary. Physical therapists utilize various assessment tools such as cranial measurements, observation of movement patterns, and evaluation of muscle strength and range of motion.

In addition to their clinical expertise, pediatric physical therapists collaborate with other healthcare professionals to ensure comprehensive care for infants with flat head syndrome. This may involve working closely with orthotists to create custom-fitted helmets or bands that promote proper skull growth.

Does Physical Therapy Treat Flat Head Syndrome?

Yes, pediatric physical therapists can effectively correct cranial asymmetry linked with positional plagiocephaly. Physical therapy improves infants’ motor skills, helping rectify skull shape imbalances. Therapists use techniques like repositioning, encouraging babies to lie on their less favored side, thereby equalizing pressure on the head. They also introduce stretching exercises targeting tight neck muscles and strengthening activities to boost neck and shoulder muscles for better head alignment. Additionally, they guide parents on safe sleep postures and recommend supportive tools. While results differ among individuals, research indicates that such interventions significantly enhance cranial symmetry in infants with this syndrome.

Also Read: How Pediatric Therapy Centers Address the Psychological Aspects of Craniofacial Disorders

Best Time For Babies To See A Therapist For Flat Head Syndrome

Physical therapy is a promising solution for infants with flat head syndrome. While we’ve explored its effectiveness, understanding the best time to start therapy is crucial. The earlier the intervention, the better the outcomes. Factors like the extent of cranial asymmetry and the infant’s age guide the timing. The American Academy of Pediatrics suggests seeking therapy if repositioning doesn’t work within six weeks or if severe flattening continues. Babies usually start sessions between three to six months old, as their neck muscles are developing. Still, older infants can benefit too. Ultimately, early therapy is pivotal for best outcomes in craniofacial development.

Schedule Your NJ Craniofacial Center Appointment Now

For timely evaluation and treatment of cranial asymmetry, make an appointment at the NJ Craniofacial Center. Specializing in flat head syndrome in infants, this center adopts a holistic approach, with physical therapy playing a pivotal role. The center thoroughly evaluates every infant’s head shape and flat head syndrome severity, ensuring personalized care tailored to each child’s needs.

During your visit, a therapist will gauge factors causing cranial asymmetry, like neck muscle issues. They’ll craft a specialized treatment plan, which could involve stretching, repositioning, or tummy time guidance. Regular check-ups will track your child’s progress and tweak the therapy if needed. So, for expert care in addressing flat head syndrome, the NJ Craniofacial Center is the go-to place. Early intervention can boost ideal cranial development and lessen potential complications.


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