Flat Head Syndrome

Flat Head Syndrome, medically termed Plagiocephaly is a condition characterised
characterized by the flattening on one side of the back of the head. This is due to the distortion of skull plates. 80% of skull growth takes place in the first year of life and slows after the child turns 18 months old. Skull fuses at around 18-24 month of age.

Types of Flat Head Syndrome


  • Most common type of flat head syndrome, also known as deformational or positional plagiocephaly
  • Head shape resembles a parallelogram from top view
  • Facial asymmetry might be present (shift in positions of ears, differing sizes of eyes and/or cheeks)
  • Asymmetrical (misshapen) head shape results from repeated pressure to the same area causing flatness on one side


  • Head is abnormally wider than it’s length.
  • Flattened back of head visible from side view and head shape resembles a trapezoid from above
  • Head can be high at the back causing a bulging forehead visible from side view
  • Widest part of head is just above ears
  • Tips of ears protrude
  • Face appears smaller to size of head

Asymmetrical Brachycephaly

  • Combination of plagiocephaly and brachycephaly
  • Facial asymmetry (where ears and eyes might appear mis-aligned)
  • Head is excessively wider and taller than normal with sloped forehead

Deformational Scaphocephaly

  • Characterised by a long and narrow head shape, often due to constant positioning of the baby on one side
  • Deformity of proportion
  • Premature babies are particularly prone to this as their skulls are fragile and side-lying positions are used in neonatal intensive care for easy access to monitors and other medical equipment

Possible causes includes:

  • untreated torticollis
  • preferred sleeping position
  • premature birth
  • multiple births (e.g., twins, triplets etc.)
  • fetal positions for birth (e.g. inter-uterine, breech etc.)
  • birth trauma 
  • assisted birth and more…

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