What is Flat Head Syndrome?

What is Flat Head Syndrome?

Flat head syndrome is the umbrella term for a flat head condition which can appear in babies or infants due to continued pressure applied to a particular area on the head in infancy. The deformity may be present at birth or become apparent during the first few months of the infant’s life.

There are two types of flat head syndrome:

Plagiocephaly: a deformation of the head marked by an oblique slant to the skull surface, usually the side of the head, which in severe cases can also result in facial, cheek, jaw and ear asymmetry. The most common form is called positional plagiocephaly. The flattening usually occurs in the parietal region, above and behind the ear. Facial asymmetry may be apparent in the forehead region and the eyes and ears may also be misaligned.

Brachycephaly: occurs when a baby has a wider than normal head with the flattening across the back of the skull. The width of the head is often disproportionate to the depth of the baby’s head. It is quite usual to see a combination of brachycephaly and plagiocephaly, presenting as a wide, asymmetric head shape.

Causes of Flat Head Syndrome
Babies can be at risk of flat head syndrome because their skull remains soft and pliable in the earliest stages of their life. This pliability is because the several plates of bone which fuse the skull together are initially loose, gradually joining as your baby gets older.

Deformities can also occur before your baby is born, this is called positional moulding. The re-moulding of the skull may occur in the uterus due to restricted space in the womb. This frequently occurs in multiple births (i.e. twins or triplets) or those requiring assisted delivery (intrapartum moulding). Deformities can also occurring during birth, as the baby travels through the birth canal. Passage through the birth canal can cause temporary cranial deformity and it is common for the baby to have an oddly shaped during the first few days or weeks after birth. The majority of such deformities improve naturally during the early months of an infant’s life without any need for treatment. The exception occurs when the infant is consistently positioned in a way that exerts pressure on one particular area of the head, turning a minor plagiocephalic deformity into a potential long-term problem requiring treatment. The incidence of flat head syndrome is higher in infants born prematurely as their heads tend to be softer and more prone to moulding.

Paediatricians have reported a sharp increase in the number of children with cranial deformities in recent years, particularly unilateral flattening of the occipital bone at the back of the head. This is generally attributed to the back to sleep campaign, which has dramatically reduced the incidence of cot death or SIDS (Sudden Infant Death Syndrome) but also left many babies with permanent head shape deformities.

Parents should always place their babies on their backs when sleeping. However, during the day when the infant is awake and the parent is with them, they should spend at least half of their waking hours without pressure on the back of the skull to allow it to reshape naturally. If no improvement is seen by the age of five months, flat head syndrome treatment may be worth considering.