Do Babies Get Flat Heads From Sleeping On Their Back?

Editorial Team

Flat head syndrome also known as plagiocephaly affects 47% of babies. It's a phenomenom that alarms most parents, but it can be prevented and early detection can help in reshaping the baby's head.

Recently there has been new interest in the management of ‘flat head syndrome’ or ‘moulding’ due to new research published in the British Medical Journal.

It showed that treatment with helmets is not any better than leaving alone and letting nature takes its course. Babies can develop a flat head in the first few months of life.  This is because their skull is made up of different plates of bone that are mobile and relatively soft.  There are two main types of flat head:

  • plagiocephaly: this is the most common type and occurs when one side of the head is flattened, this causes the head to look asymmetrical.  If you look at the head from above the ears can look out of alignment.
  • brachycephaly: the back of the head is flattened.  The head is widened and the face can appear broader


The Prenatal Classroom

The soft skull bones flatten due to pressure and once the head has become misshapen in this way, it is more likely that the head will lie in the same place each time, compounding the problem.

Causes of a flat head include:

    • The most common cause is lying on their back while asleep
    • Tightened neck muscles on one side, the baby can only turn their head a certain way. This can be corrected with physiotherapy
    • Craniosynostosis, a rare condition caused when two or more of the sections of the skull fuse together early and are unable to grow and develop normally, leading to an asymmetrical head – this is corrected with surgery.
    • Premature babies often have altered head shapes, as they may have spent many weeks lying on their back or side in an incubator. This corrects as they grow and spend more time in other positions.

Usually, the flattening of the skull is a mild, cosmetic issue and does not cause any problems with a baby’s development.  It usually resolves on its own.

But here are some measures you can take to reduce the incidence of a flat head;

  • Babies should sleep on their backs as this reduces the risk of sudden infant death. But when they are awake let them have some tummy time and be on their sides.
  • When aslep, change their position so that they are not constantly putting pressure on the same part of the head.
  • You can place them in your arms or baby carrier once in a while.
  • When they are older they can sit up supporting themselves

If your baby has already developed a flat head, it may take six to eight weeks of employing these practices for you to notice a change, so be patient.

The other treatment choice is using a helmet or skull band (cranial orthoses). Although research has recently shown that they are not any more effective than positioning and leaving the bones to restructure with time.

The helmets and skull bands are aimed to reduce pressure on the flattened area and to put pressure on areas of bone that bulge out. They are made of a rigid plastic with a foam lining.  Helmets or bands are used on babies between six to twelve months old, when the skull is growing at its fastest. The baby needs to wear the device for up to 23 hours per day for between six weeks and six months, and it must be resized every six weeks to allow for normal growth and to prevent sores.


Helmets and bands have their disadvantages. They can be uncomfortable and hot, especially in the summer months.  They can lead to sores, rashes, sweating and difficulty in giving cuddles due to the bulkiness of the helmet. These helmets and skull bands are expensive (they are not available in Nigeria).

So yes you can help minimise the risk of your baby having a flat head from sleeping on their backand if your baby already has a flat head, it will restructure with time.

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