Infant plagiocephaly, or flat head syndrome, is a positional flattening of the skull. The French National Authority for Health (HAS) considers it benign and points out that it most often resolves on its own by around the age of two. Prevention is based on simple measures, while never abandoning back sleeping.
What is positional plagiocephaly?
Positional plagiocephaly is a skull deformity caused by prolonged pressure on the same spot. An infant’s skull is soft and molds under pressure. When the head often rests on the same side, one area becomes flattened.
The HAS refers to “positional skull deformities” (DCP). This term includes plagiocephaly and other flattening of the same kind. It is common and, in the overwhelming majority of cases, harmless.
What does the HAS recommend to prevent flat head syndrome?
The HAS recommends placing babies on their backs to sleep while varying the points of pressure on their heads during the day. Children should also be allowed to move freely when they are awake and supervised. These recommendations date from March 2020.
Always place babies on their backs to sleep
Back sleeping remains essential for every sleep. According to the HAS, it is the only way to prevent sudden unexpected infant death. Fear of flat head syndrome should never lead to placing a baby on their stomach to sleep.
Vary pressure points and provide tummy time
While awake, encourage your baby to turn their head from side to side. Alternate the direction they face in the crib and their position during play. Tummy time, while awake and supervised, relieves pressure on the back of the skull and strengthens the neck.
Limit time spent in bouncers and infant carriers
The HAS recommends reducing the time spent in bouncers, carriers, and seats. These supports keep the head pressed against the same spot. The floor remains the best space for moving around and changing pressure points.
Should you use a pillow or flat-head support?
No. The HAS advises against head positioners, flat-head pillows, and head supports. These devices restrict the child’s spontaneous movements. They therefore work against the intended goal.
Prevention relies on free movement, not on an accessory. By moving, babies naturally distribute pressure across their skulls.
Does plagiocephaly affect development?
The HAS is clear on this point: no causal link has been demonstrated. Positional plagiocephaly does not cause delayed neurological development. Nor is it linked to ophthalmological, oculomotor, or vestibular disorders.
This clarification is intended to reassure parents. The deformity is primarily a cosmetic issue that becomes less noticeable as the child grows. It should not cause excessive concern.
When should you consult a doctor?
Medical advice is useful if the flattening worsens despite positional measures. Difficulty turning the head to one side, suggesting torticollis, also warrants an examination. The doctor or pediatrician can then assess the situation.
If the deformity persists, early referral to a specialist center is possible. The use of a cranial orthosis remains exceptional and requires specialist advice.
How should you arrange your baby’s floor time?
Floor time is at the heart of prevention. A clean, flat, cushioned space encourages your baby to move and change pressure points. This is where tummy time and free movement are practiced.
an activity mat provides a suitable surface for these moments of play on the floor. To apply the principle recommended by the HAS, read our article on free movement. The choice of mat material also matters: our foam mat guide details the key safety considerations.
Back sleeping remains the rule for sleep. Our information on safe infant sleep complements this advice. To follow motor development milestones, also see our article on fine and gross motor skills.
Why are flat heads more common today?
Back sleeping has significantly reduced sudden unexpected infant death since the 1990s. This public health measure has saved many lives. As a result, infants spend more time with pressure on the back of their skulls.
That is why the HAS emphasizes daytime activity. The message is not to place babies in a different sleeping position, but to provide more tummy time and floor time. This preserves the benefits of back sleeping while limiting flattening.
In summary
Infant plagiocephaly is common, benign, and most often reversible. The HAS recommends back sleeping, varying pressure points, and floor time. It advises against corrective pillows and reassures parents that there are no effects on development.
Sources
- French National Authority for Health, “Preventing plagiocephaly without increasing the risk of sudden unexpected infant death,” March 5, 2020.
- French National Authority for Health, recommendations “Prevention of positional skull deformities (DCP) and sudden unexpected infant death,” 2020.
