Flat Head Syndrome (or Plagiocephaly)

Flat Head in Babies: Positioning, Tummy Time, and When to Seek Help

An independent educational resource prepared by Mark M. Simonian, MD, FAAP

Sources checked: August 13, 2026 | Medical review completed: August 13, 2026

This page is for general education only and does not replace individualized medical advice. This resource does not establish a doctor-patient relationship. For questions about your own child, contact your child's current healthcare professional.

Magnolia Pediatrics, Valley Children's Healthcare

2497 E. Herndon Avenue, Suite 101, Clovis, CA 93611 | 559-538-3070

A flat area on a baby’s head is common and often reflects the position in which the baby spends the most time. Safe sleep remains essential: every sleep should begin on the back, on a firm, flat, non-inclined sleep surface. Position changes and supervised awake tummy time can reduce pressure on one area of the head.

When to Contact Your Baby’s Healthcare Professional

You notice a flat spot, head asymmetry, a persistent preference to look in one direction, or difficulty turning the head equally to both sides. Early assessment can identify positioning needs or torticollis (tightness or imbalance of neck muscles).
The head shape seems increasingly uneven, the forehead or ears appear uneven, or the flattening is moderate or severe despite positioning changes.
Your baby has delayed motor skills, poor head control, unusual stiffness or floppiness, persistent vomiting, poor feeding, a bulging soft spot, a seizure, or any other concerning symptom. Seek urgent care for sudden severe symptoms or an immediate emergency.

Safe Sleep Comes First

Always place your baby on the back for every sleep, including naps. Do not use side or stomach sleeping to treat a flat spot.
Use a firm, flat, non-inclined crib, bassinet, or play yard that meets current safety standards. Keep the sleep space free of pillows, wedges, positioners, nests, loose bedding, and toys.
Do not use commercial pillows, head-shaping cushions, or sleep positioners marketed to prevent or correct a flat head. They can be unsafe for sleep and have not been shown to provide medical benefit.

Simple Steps While Your Baby Is Awake

Begin supervised, awake tummy time soon after coming home from the hospital. Start with short, frequent sessions and build gradually. By about 7 weeks, aim for a total of 15 to 30 minutes each day, if your child’s healthcare professional has not advised otherwise.
Vary the baby’s position during awake time. Hold the baby, use floor play, and avoid long stretches in car seats, swings, bouncy seats, or other devices when they are not needed for travel or safety.
Encourage the baby to turn toward the non-preferred side by changing where you stand, placing interesting objects on that side, and alternating the direction the baby faces in the crib.
During feeding, vary the side from which you hold or bottle-feed the baby. Use calm, comfortable handling and never force the neck through resistance.

Torticollis and Physical Therapy

Some babies have a strong head-turning preference because neck muscles are tight or imbalanced. This is called torticollis and commonly occurs along with positional flattening.
Your baby’s healthcare professional may recommend exercises, early-intervention services, or pediatric physical therapy. A therapist can assess head and neck movement, motor development, and teach safe positioning and stretching activities.
Follow a therapist’s individualized instructions rather than using online stretching videos or forcing the baby’s head into a position.

Will My Baby Need a Helmet?

Most positional flattening improves as babies grow, spend more time upright, and become more mobile. The healthcare professional will follow head shape and development over time.
For moderate or severe flattening that does not improve with repositioning and therapy, particularly by 5 to 6 months of age, a specialist may discuss helmet therapy. A helmet must be prescribed, measured, and fitted by qualified professionals.
Do not purchase an over-the-counter helmet or treat the head shape without an in-person evaluation. The first step is a careful examination to distinguish positional flattening from less common conditions that need different care.

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Sources and Medical Review

Sources checked August 13, 2026. Medical review completed August 13, 2026.