Concerned about your baby’s head shape?
At Unbreakable Physiotherapy, we support families with gentle, evidence-based care for babies with a flat spot or change in head shape. If you’re unsure whether your baby needs help, we’re here to guide you with clarity and reassurance.
What is plagiocephaly?
Plagiocephaly refers to a change in the shape of a baby’s head, usually appearing as a flat spot at the back or on one side. This often happens when a baby spends lots of time lying in one position, especially in the early months when the skull is soft and growing rapidly.
Plagiocephaly is very common, especially since the introduction of back-sleeping guidelines, and it does not affect brain development. However, if left untreated, it can lead to facial asymmetry and may persist into later infancy. In some cases, it has also been associated with delays in motor development.
Some of the common signs you might notice include a flat area on one side or the back of your baby’s head, one ear sitting further forward than the other, a fuller cheek or slightly uneven forehead, and a preference for turning their head to one side. You might also notice a head tilt or some difficulty during tummy time.
Causes of a flat spot
It’s very common for babies to develop a flat area on their head in the early months of life. This usually happens when the head rests in the same position for long periods, especially while babies are sleeping or lying on their back. Their skulls are soft and still growing, which makes them more sensitive to pressure.
Flat spots can develop for a few different reasons. Some babies naturally prefer turning their head one way, and others may have a bit of tightness in their neck muscles that makes it harder to move evenly. Babies who were born early often have softer skulls and may spend more time lying flat in hospital or at home. The way a baby was positioned during pregnancy, like being in a breech position or sharing space with a twin, can also play a role.
Most of the time, these changes in head shape are mild and improve with time, movement and simple strategies. If you’re ever unsure, we’re here to help.
What you can do at home
There are plenty of simple ways to support your baby’s head shape – and most of the time, it’s just about tweaking what you’re already doing.
Tummy time is your best friend when it comes to preventing or treating plagiocephaly. Start from birth with short, frequent bursts while your baby is awake and supervised. Even just a few minutes at a time helps build strength and relieves pressure on the back of the head. Not all babies love it straight away, so it’s worth trying different positions – like lying on your chest or across your arm. At Unbreakable Physio, we’ve got plenty of tricks to help make tummy time more enjoyable for parents and babies.
Sleep is when your baby stays in one position the longest, so switching up sleeping positions can make a big difference. Try alternating the direction your baby lies in their bassinet (for example, head at opposite ends each night) so they naturally look both ways. Babies are usually drawn to find their caregiver, so they’ll tend to turn toward wherever you usually are.
Make the less-used side more exciting. By placing toys, faces or sounds on your baby’s non-preferred side during play or nappy changes, you’ll encourage interest and movement in that direction – helping to build strength and balance neck mobility over time.
If you’re not sure how to get started, we’re happy to show you these techniques in a way that fits your baby and your routine.
When to seek help
The ideal time to begin addressing a flat spot is before 6 months of age when the skull is growing rapidly and repositioning is most effective. The earlier treatment begins the sooner resolution can be achieved.
If you’re noticing asymmetry, a head-turning preference, or difficulty with tummy time, it’s best to have your baby assessed early. No referral is needed.
How Unbreakable Physiotherapy can help
We offer a gentle, family-centred approach that supports your baby’s development while helping improve head shape naturally.
We provide:
- A full assessment of head shape, neck movement and development
- Identification of any underlying neck tightness (torticollis)
- Screening for associated conditions requiring follow up
- Repositioning and play-based strategies for home
- Tummy time support and alternative options where this is challenging
- Education tailored to your baby’s needs and your goals
Our goal is always to begin with the least invasive option and support your baby’s development in a way that suits your values, routine and goals.
Will my baby need a helmet?
In most cases, helmets are not needed. Current evidence suggests that for the vast majority of infants, helmet therapy does not improve outcomes beyond what can be achieved with early physiotherapy and repositioning strategies.
Where a helmet may be indicated, assessment and prescription can be completed by the Royal Children’s Hospital Plagiocephaly Clinic at no cost to families. Usually, there is no need to pay privately for helmet therapy.
At Unbreakable Physiotherapy, we can assess your baby and refer you to the RCH Plagiocephaly Clinic if specialist input or helmet therapy is required.