Head shape

Protecting your baby’s head shape

Health professionals within Australia, as well as internationally, have witnessed a dramatic rise in the number of infants presenting with misshapen heads that have required treatment.

‘Plagiocephaly’ (play-gio-keff-alee) is a term used to describe a misshapen and/or asymmetrical head shape, which may also include the ears and face. This does not affect the development of the baby’s brain, but, if not treated, it may alter a baby’s physical appearance by causing uneven growth of the child’s face and head.

It is common for a newborn baby to have an unusual head shape. This can be caused by the position of the baby in the uterus (womb) during pregnancy or by the baby’s head moulding during the birthing process. Your baby’s head shape should remould to a normal shape within six weeks after birth. By six weeks of age, your baby should also be able to turn their head equally to the left and right. Your baby may strongly favour turning their head in one direction.

What causes a misshapen head?

A misshapen head can be caused in the first 6–8 weeks after birth, when your baby applies constant pressure on one part of the head by:

• Lying in one position too much of the time (particularly on the child’s back).
• Always turning the child’s head to the same side when lying on its back.

The bones of a newborn baby’s head are thin and flexible, and the head is soft and easy to mould. A localised ‘flat spot’ at the back and/or side of the head can develop very quickly in a young baby. If continual pressure is applied on this ‘flat spot’, further flattening may occur and your baby may develop a misshapen head.

How can you tell if your baby has a misshapen head?

• Back of head is round on both sides.
• Ear position is level.
• Front of head is even on both sides.

Misshapen head:

• Significant flattening on one side of the back of head.
• One ear is more forward than the other.
• One side of the front of head is more forward than the other.

A small localised ‘flat spot’ on the back of the head is not a misshapen head. It will, however, require watching.

Further information

If you have concerns about your child’s head shape or notice your baby will only turn its head to one side when lying on its back, at six weeks of age, you should seek advice. Contact your child health nurse at your infant or community centre, or locate your local APA paediatric physiotherapist at www.physiotherapy.asn.au/findaphysio

The brochure ‘How to protect the head shape of your baby’ provides practical hints, for families and carers of young infants, to promote the importance of placing young infants in different positions to avoid the risk of a misshapen head. Ask your physiotherapist how you can obtain a copy of the educational brochure.