Head Shaping Issues In Infants


Head shaping problems is a very common issue amongst infants. When babies are born their skull is not fully joined together (fused), this is to allow for the baby’s head to be able pass through the birth canal. As newborns skulls are softer, they are more susceptible to developing head shaping problems because of this pliability of the skull. Common head shaping issues include conditions such as plagiocephaly, brachycephaly and craniostenosis.

Plagiocephaly is when the baby develops a flat spot on one side of the head due to prolonged compression on the skull. When the baby develops a flat spot on across the back of the head this is referred to as brachycephaly. Risk factors include increased time spent on back/positioning, head turning preferences, issues with the child’s neck muscles such as torticollis (tight SCM neck muscle), first born child, prematurity and in the presence of developmental delays. With timely and appropriate treatment, non-stenotic plagiocephaly and brachycephaly have the ability to resolve, resulting in a symmetrical head shape.

Other times infants can develop head shaping issues such as in craniostenosis. Craniostenosis occurs when there is a premature fusion (closing) of one or more cranial sutures. Premature closure can occur in any of the suture lines sagittal, metopic, coronal or lamboid. When the suture lines fuse early your child’s head may appear asymmetrical or you may be able to feel a ridging over these growth plates. The risk factors for craniostenosis is not well known but it can be said to be linked to genetic component or fetal exposures from the maternal environment e.g. the mother is exposed to certain medications. Unlike in other head shaping conditions, an untreated craniostenosis can affect baby’s brain development as it can restrict the skulls ability to grow. Therefore, a diagnosis of craniostenosis requires referral to specialist paediatric neurologists.

Your physiotherapist and Dr can help you in determine the cause of your baby’s head shaping or head turning preferences and provide you with strategies to address these concerns. Your physio may provide strategies to help promote tummy times, exercises to encourage the appropriate development of muscle strength and motor skills. Physiotherapy can also assess other areas of concern including hip checks, feet assessments and check your babies motor development. Your physio can also provide guidance and appropriate/timely referral to paediatric specialist clinics if required such as in the case of craniostenosis.

Take home Points!

  • Since the ‘Back to sleep’ campaign was introduced there has been a significant reduction in the rates of SIDS (Sudden Infancy Death syndrome). Therefore, important to put baby on their back to sleep reduce the risk of SIDS.
  • Encourage skills that help develop your child’s motor mile stones
  • Encourage tummy time

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