Plagiocephaly, or flat head syndrome, is a malformation of the baby's skull that can occur due to postural causes, an injury that in most cases is due to the recommendation by specialists to always sleep on the back to prevent sudden infant death syndrome.

In 1992, the American Academy of Pediatrics (AAP) recommended that babies should always sleep in a supine position, i.e., on their backs. This solution has led to an injury known as positional or postural plagiocephaly, which currently affects 47% of babies worldwide, according to the latest studies by this prestigious pediatric organization.

Why does plagiocephaly occur?

Babies' skulls are very malleable as the cranial bone is not yet fully formed, which means that any prolonged external pressure or a certain sustained posture can cause a deformity that is visible to the naked eye.

The causes of plagiocephaly or flat head syndrome can occur during pregnancy or childbirth, but most commonly originate from prolonged exposure to the same position of the baby's head when sleeping. This is known as postural or positional plagiocephaly.

Sometimes, the position of the baby in the uterus is one of the possible causes of cranial deformity: prolonged engagement or breech position puts pressure on the baby's head. It also has an influence when there is a disproportion between the size of the baby and the mother's pelvis. Or if it is a multiple pregnancy, a post-term pregnancy, or an overly large fetus (macrosomic).

Once the baby is born, the main cause of flat head syndrome is the baby's head always being supported in the same position for long periods of time.

If the baby does not suffer from plagiocephaly due to neonatal causes, a very simple way to prevent positional plagiocephaly is to alternate positions throughout the day. If the baby lies on their back for many hours, they are more likely to develop a head deformity due to this prolonged position.

How can this be prevented?

Another tip is to increase tummy time and alternate play surfaces, such as the crib, stroller, and baby carrier. It is important for the baby to have the opportunity to look both ways while lying down or awake.

It is also important that the mattress on which the baby sleeps reduces pressure on the baby's head by providing many points of support. This is what the mattresses in the ECUS Kids Care® range offer, with pressure reduction of up to 70%, which has earned them European health registration by the AEMPS.

If your baby's plagiocephaly does not improve despite following all of these tips, consult your pediatrician or pediatric physical therapist. A professional can recommend additional measures to prevent positional plagiocephaly and determine if any specific treatment is needed.