What Causes Plagiocephaly?

Plagiocephaly can occur before or after your baby’s birth and can result from:

• Conditions in the womb – restrictions (small pelvis, etc.) or mulitple babies
• Prematurity – cranial bones are softer and more easily deformed
• Sleeping position – (on back) and a limited amount of tummy time
• Torticollis – tightness of neck muscles
• Overuse of carriers – infant seats, swings and strollers

---

Torticollis – tightening of one or both of the main neck muscles which causes the baby to turn and/or tilt the head in one position, which in turn causes flattening of the same side of the head. Torticollis is often associated with deformational Plagiocephaly since the baby cannot comfortably lie in all positions. Treatment with Physical Therapy and a home exercise program as soon as possible is usually necessary. Prematurity – the skull bones are softer in a premature infant, therefore prolonged, frequent positioning on one side may lead to asymmetry. Many extremely premature infants spend extended periods of time in the NICU on ventilators, which increases the risk for deformational Plagiocephaly. Multiple births – may cause a tight intrauterine environment, causing pressure on the skull resulting in asymmetry. Intrauterine pressure/restrictive uterine environment – may be due to the maternal pelvis condition, large baby, or unusual position in uterus. Sleeping position – positioning the baby’s head in the same manner against a mattress or firm surface for a long period of time may cause flattening of the skull bones. There has been a dramatic increase in the number of infants with flattened heads since the American Academy of Pediatrics started the “Back to Sleep Campaign” in 1992. It is important that parents/caretakers frequently change the infants’ sleeping position so the baby does not always turn their head to the same side. Tummy time while awake and supervised is important to begin at a few weeks of age as well. Overuse of infant seats, carriers, swings – these devices are nice for occasional use but please do not substitute them for your baby’s sleeping area as there is no room for natural movement, thus putting your baby at risk for the development of deformational Plagiocephaly.