Can Repositioning Therapy Prevent Flat Head Syndrome?

Can You Prevent Flat Head Syndrome with Repositioning Therapy?

Can You Prevent Flat Head Syndrome with Repositioning Therapy?

When exploring the different forms of treatment for flat head syndrome, many parents are initially advised to try a course of repositioning therapy during the early stages of a baby’s life. But can repositioning therapy prevent flat head syndrome and does it always work?

Official NHS advice advocates repositioning therapy as an effective form of treatment for babies suffering with flat head syndrome. According to the NHS website, it is recommended that you encourage your baby to “try new positions during play time” and “reduce the time your baby spends lying on a firm flat surface, such as car seats and prams”.

The advice given by the NHS is correct insofar as repositioning can relieve pressure on the affected area of a baby’s head. Repositioning therapy is effective in preventing flat head syndrome from worsening and, in some circumstances, can achieve symmetry in milder cases of flat head syndrome. So, as a parent, you should begin by repositioning your baby.

We have also created a blog post on how to make repositioning easier for you and your baby which offers advice and tummy time tips to help you achieve the best results from repositioning therapy, if this course of treatment is recommended for you.

Can Repositioning Therapy Effectively Treat Flat Head Syndrome?

Although repositioning therapy can actively reduce the symptoms of flat head in babies, it does depend on the severity of the flatness. This means that repositioning is not always the best form of treatment for your baby, particularly in moderate and severe cases of flat head syndrome, which often requires helmet therapy in order for full correction to be achieved.

However, providing that you begin repositioning therapy early enough and the flatness is mild, flat head syndrome can usually be returned within the ‘normal’ range before the bones in the skull begin to harden and become less receptive to repositioning.

According to the recent study by JP Steinberg which investigated the effectiveness of repositioning therapy in positional cranial deformation, “complete correction was achieved in 77.1 percent of conservative treatment patients” meaning that nearly 77% of infants with mild plagiocephaly achieved correction without the need for a helmet.

However, nearly 16% of cases required transition into helmet therapy to bring about correction and a staggering 96.1% of infants who received helmets after failed repositioning therapy achieved complete correction.

 So what does this mean?

What is Plagiocephaly and Brachycephaly - tummy time


Repositioning therapy is effective in preventing flat head syndrome from becoming worse and is an advisable form of treatment for earlier and mild cases of flat head syndrome. However, if repositioning therapy is proven to be unsuccessful, due to factors such as advanced age or poor compliance with repositioning techniques, helmet therapy is the best form of treatment to bring about correction.

This is reiterated in a study conducted in 2013 which compared helmet therapy and counter positioning for deformational plagiocephaly, concluding that “helmet therapy resulted in more favourable outcomes in correcting cranial and ear asymmetry than counter positioning on moderate to severe plagiocephaly without compromising head growth”.

Helmet therapy is proven to be safe and effective treatment for moderate and severe cases of flat head syndrome. Many parents choose helmet therapy after a course of repositioning therapy has been unsuccessful. In moderate to severe cases of flat head syndrome, there is a limit to how much correction can be achieved through repositioning alone and this is why repositioning isn’t always the best form of treatment.

For more information on whether to helmet or not to helmet when choosing the best form of treatment for your baby, our informative blog post answers many of the concerns parents have before opting for helmet treatment.

If your baby still has a flat head following a course of repositioning, or if you would like professional advice from a specialist orthotist, we can provide you with a free, no obligation assessment to evaluate the severity of your baby’s head shape and advise you on the best possible course of treatment.

Comments from one of our parents with an older child in treatment are:

I’ve been to see my little boys paediatrician today (again) about his head shape. She commented, ‘Wow it looks so much better than it did when I last saw you in February!’ I told her it was because of my son’s helmet. She asked, ‘So do you think it’s working?’
Well obviously!! Enough rubbish about ‘It’ll get right in time’ or ‘Reposition them whilst sleeping’ or all these fancy pillows that you spend a fortune on. None of it works, believe me we’ve tried it all! But 2 months with a TiMband and you can see a difference!

Technology in Motion has over a decade of experience providing helmet treatment for babies with flat head syndrome and can provide specialist advice and support. Call 0330 100 1800 or contact us via the enquiry form to book an appointment at one of our flat head syndrome clinics situated throughout the UK.

Steinberg JP, Rawlani R, Humphries LS, Rawlani V, Vicari FA. Effectiveness of conservative therapy and helmet therapy for positional cranial deformation. Plast Reconstr Surg, 2015;135(3):833-42

Kim, Se Yon, et al. “Comparison of helmet therapy and counter positioning for deformational plagiocephaly.” Annals of rehabilitation medicine 37.6 (2013): 785-795.

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