Plagiocephaly and Torticollis in Infants: Prevention Tips and Treatment Options

Plagiocephaly and torticollis are conditions often seen in infants and may be related in some cases. 

1. Plagiocephaly (sometimes called “flat head syndrome”) is a condition where a baby’s head develops a flattened shape, often on one side, due to prolonged pressure. This can happen when a baby consistently rests their head in the same position, sometimes due to limited movement or positional preferences. Plagiocephaly can vary from mild to more pronounced cases that may affect the head’s symmetry. 

2. Torticollis is a condition where an infant has a tight or shortened neck muscle, causing the head to tilt to one side. This can lead to limited range of motion, making it hard for the baby to turn their head fully. Since the baby may keep their head in the same position, this can also contribute to or worsen plagiocephaly. 

To help prevent plagiocephaly, parents can encourage healthy head and neck positioning and strengthen their baby’s neck and core muscles through daily activities, starting from birth. Here are some key strategies: 

1. Tummy Time 

• What It Is: Tummy time involves placing babies on their stomachs while they are awake and supervised. This position strengthens neck, shoulder, and core muscles, helping them develop better head control and reducing the time spent on their backs. 

• How Much: The American Academy of Pediatrics recommends starting with short sessions of 3-5 minutes, 2-3 times a day, gradually increasing to a total of around 60-90 minutes daily by the time babies reach 3 months old. 

• When to Start: Tummy time should begin from birth, as soon as parents and baby feel ready. Starting early helps babies get accustomed to the position and prevents them from developing a strong preference for lying on their back. 

2. Alternate Head Positions 

• Change the direction your baby faces when lying down, sleeping, or sitting in carriers to encourage equal movement on both sides. 

• Alternating the arm you use to hold the baby can also help keep their head from favoring one side. 

3. Limit Time in Car Seats, Swings, and Other Devices 

• Avoid extended periods where the baby’s head is against a flat surface, such as in car seats or swings, which can contribute to flattening. If the baby falls asleep, transfer them to a flat, firm sleeping surface like a crib. 

4. Encourage Active Movement 

• Encourage your baby to turn their head in both directions by using toys, sounds, or your face as encouragement. This can help build neck strength and prevent a preference for one side over the other. 

5. Cuddling and Upright Holding 

• Holding babies upright when possible can help relieve pressure from their heads. Wearing your baby in a carrier can also encourage head and neck movement. 

By making these practices a routine part of daily activities, parents can reduce the chances of plagiocephaly and support their baby’s overall physical development. 

Cranial remolding helmets are sometimes recommended for infants with moderate to severe cases of plagiocephaly that haven’t improved with other approaches. These helmets are designed to gently reshape the baby’s skull over time as they grow, guiding their head into a more symmetrical shape. 

What should parents do if they’re concerned? If parents notice their infant’s head shape is uneven or they’re having trouble turning their head, they should speak with their pediatrician. Pediatricians can evaluate and, if necessary, refer them to a specialist, such as a pediatric physical therapist or a cranial specialist, for further assessment.