Flattened Head at the Back: Causes, Symptoms, and Treatment

What is a Flattened Head at the Back?

A flattened head at the back, also known as positional plagiocephaly, refers to a condition where the back of the head becomes flat due to pressure on one side. This condition is most commonly seen in infants who spend a lot of time lying on their backs. The soft skull bones of infants are more malleable, and prolonged pressure can cause the skull to flatten in specific areas. Though typically a cosmetic concern, in some cases, it can lead to developmental delays or other complications if left untreated.

Causes of Flattened Head at the Back

• Prolonged Lying on One Side. Infants who spend a lot of time lying on their backs, especially in one position, are at risk for developing a flat spot on the back of the head.
• Premature Birth. Babies born prematurely may have softer skull bones, making them more susceptible to flattening of the head.
• Limited Tummy Time. Babies who do not spend enough time on their stomachs while awake may not develop the necessary neck and shoulder muscles, increasing the likelihood of positional flattening.
• Multiple Births. Babies born as part of a multiple birth may have less room in the womb, which can contribute to abnormal head positioning and flattening.
• Neck Muscle Tension (Torticollis). If an infant has a tight neck muscle on one side, they may be more prone to turning their head in one direction, leading to flattening on that side of the skull.

Symptoms of Flattened Head at the Back

• Flat Spot on the Back of the Head. The most noticeable symptom is a flat or misshapen area on the back or side of the head, which can vary in size and shape.
• Uneven Forehead or Ears. In some cases, the forehead may protrude more on one side, or the ears may appear misaligned due to the flattening of the skull.
• Asymmetrical Face. The face may appear slightly asymmetrical, with one side appearing flatter or more compressed than the other.
• Limited Neck Movement. Infants with torticollis may have difficulty turning their head from one side to the other, contributing to the flattening.

Treatment for Flattened Head at the Back

• Repositioning Techniques. Parents can help by repositioning their baby regularly, alternating the side of the head on which they lie and using "tummy time" to strengthen neck muscles.
• Helmet Therapy. In some cases, a special helmet can be prescribed to reshape the skull by gently applying pressure to the areas that need to grow more.
• Physical Therapy. If torticollis is present, physical therapy can help to stretch and strengthen neck muscles, improving head movement and reducing the risk of flattening.
• Monitoring and Follow-up. Regular monitoring by a pediatrician or specialist ensures that the condition improves over time and that further intervention is not required.
• Surgery (Rarely Needed). In severe cases, surgery may be considered if the flattening is affecting brain development or causing other complications, but this is extremely rare.