Deformational plagiocephaly can occur while a baby is still growing in the uterus. It can also develop after birth.
Causes Before Birth
Before delivery, a baby drops into the mother’s pelvis. If it happens too early, the baby’s head might rest against a flat surface, where it can build pressure and cause flattening. Infants at greater risk for this occurrence include unusually large babies, breech babies and multiple birth babies.
Other causes of deformational plagiocephaly before birth include:
- Pressure inside a uterus that is either too small or crowded (in a multiple birth pregnancy).
- Unusual fetal positioning inside the uterus.
- A uterus that contains too little amniotic fluid.
Causes After Birth
After birth, deformational plagiocephaly can occur if a baby frequently lies in the same position. As the head begins to flatten, it naturally rests on that flat area, potentially worsening the problem.
The American Academy of Pediatrics (AAP) Task Force on Infant Positioning and Sudden Infant Death Syndrome (SIDS) recommends placing infants on their backs to sleep. This recommendation has led to a dramatic reduction in cases of SIDS. Gillette Children’s Specialty Healthcare fully supports this recommendation.
However, since AAP introduced the “Back to Sleep” program in 1992, baby flat head syndrome has become more common because babies are spending more time on their backs, in one position. To help lower the risk of deformational plagiocephaly while also protecting against SIDS, our craniofacial team recommends frequent “tummy time” during waking hours and play to balance out positioning.
Plagiocephaly and Prematurity
Babies born early might be at greater risk for deformational plagiocephaly because their skull bones are softer than those of full-term babies. Additionally, premature babies often remain in a fixed position during their longer hospital stay, increasing the likelihood of a flat spot developing.
Plagiocephaly and Torticollis
Babies often develop plagiocephaly as a result of muscular torticollis, a condition in which a muscle on the side of the neck is short or tight. Torticollis can limit a baby’s ability to turn toward the affected shoulder, causing them to consistently hold their head in one position. Over time, this one-sided positioning can flatten one side of the head.