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Occipital Plagiocephaly and Brachycephaly 

What is Occipital Plagiocephaly?

Occipital plagiocephaly is flattening of one side of the back of the baby’s head.

What is Occipital Brachycephaly?

This is a flattening across the back of a baby’s head.

How does this head flattening happen?

Babies’ skull bones are very soft until they are about a year old. If a baby lies in one position for a long time, the soft skull bones can become flat. This can develop over a few weeks or months. Putting babies to sleep on their backs has greatly reduced SIDS (Sudden Infant Death Syndrome), but some babies develop a flat area on their heads.

Some babies:

  • Like to turn their heads to the same side when sleeping or sitting in a car seat or swing
  • Are born with flat areas on their heads from their position in the womb. For example, twin babies don’t have as much room to change position
  • Keep their heads to one side because of a neck muscle problem, called ‘torticollis’
  • Have softer skull bones (like premature babies)
  • Do not turn their heads from side to side very much when sleeping or reclining 

Can head flattening cause problems?

Most of the time, having a flat spot will not affect a baby’s brain growth or development. But a rounded head shape helps a baby’s appearance.

What does it look like?


Your baby will have a flat area at the side of the head.
Your baby may also have:

  • Changes to the face on the flat side of the head•
  • One ear that sticks out


Your baby’s head will be flat across the back. Your baby may also have:

  • Widening of the face
  • Increased height at the back of the head
  • Ears that stick out on both sides

Head shapes: Looking down on a baby’s head

If your baby’s head has a flat area...

Keep your baby off the flat area as much as possible. This will help your baby’s head to go back to a rounder shape.

For sleep:

  • Place your baby on her back for sleep. Babies who sleep on their backs have a reduced risk of SIDS (Sudden Infant Death Syndrome). Propping your baby on her side can increase the risk for SIDS. At about 5 months, babies can turn over onto their tummies by themselves. When this happens, you don’t have to move your baby onto her back again.
  • Move the crib so that your baby turns his head away from the flat area when she looks toward the door. Place toys and mobiles so your baby wants to turn away from the flat side.
  • Tummy time. Give lots of supervised tummy and side lying time, when your baby is awake. This helps develop strong neck, shoulder and arm muscles. Find toys that your baby likes to play with on her tummy or side.
  • Use your arms! Instead of walking with your baby in a car or infant seat, carry your baby close to your body in your arms or a cloth carrier you can wear.
  • ‘Exersaucer ®’! Give lots of supervised time to play in an ‘Exersaucer’, once your baby has good head control


  • Long periods in car seats, baby seats and swings where your baby’s head is in the same position.
  • Pressure on the flat area of your baby’s head when feeding, holding and carrying your baby.
  • Encourage neck movement toward the non-flat side:
    • Carry your baby on your hip, so that she must turn away from her ‘favourite’ side to see ahead
    • Use your voice and bright toys to encourage your baby to turn his head away from the flat side
      while he is playing, feeding or watching you.


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