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Deformational Plagiocephaly (Abnormal Head Shape)

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What Is Deformational Plagiocephaly?

The term deformational plagiocephaly (pla-gee-o-se-fa-lee), is derived from Greek, plagio meaning oblique and cephale meaning head. This term is used to describe the shape of a head that has become misshapen due to external forces.

What Causes Deformational Plagiocephaly?

There are a number of risk factors associated with deformational plagiocephaly.

The most common known risk factor of deformational plagiocephaly is back sleeping. In 1992, the American Academy of Pediatrics (AAP) recommended that infants be slept on their backs to reduce the risk of SIDS. Consequently, many lives have been saved! However, as a result, a number of craniofacial surgeons and neurosurgeons around the country began to document a dramatic increase in the number of infants presenting with deformational plagiocephaly. Many studies were published that documented the link between sleeping infants on their backs and the development of deformational plagiocephaly. (See Research Articles)

In an effort to prevent deformational plagiocephaly, we would never recommend sleeping your baby on their stomach. Specialists involved in treating deformational plagiocephaly support the American Academy of Pediatrics recommendation which now goes a step further and recommends frequent rotation of your child’s head.

Prior to back sleeping, deformational plagiocephaly was more commonly related to a restrictive intra-uterine environment, congenital muscular torticollis and/or prematurity.

Restrictive Intrauterine Environment

This causes the fetus to not have enough room to move, thus they stay in one position. This may occur because the baby is in a breech position, they are a very large baby, or one of twins or multiples (triplets etc), the mother has a small pelvis or malformed uterus, or an abnormal amount of amniotic fluid.

Congenital Muscular Torticollis (CMT)

This is a condition where a neck muscle called the sternocleidomastoid (ster-no-cly-do-mas-toyd) is very tight or restricted on one side. This causes the head to always tilt to that side and often turn toward the opposite direction. It is a culprit in the development of deformational plagiocephaly because it causes the infant to constantly turn their head in one direction. Thus the back of the head on that side gets very flat and the face progressively becomes asymmetrical.


If an infant is born premature, they are not moving very much on their own andare often in a dependent position (typically side to side) for extended lengths of time. Their head is also very soft and susceptible to deformational forces. Therefore, these infants are at risk for developing an abnormal head shape that is often long and narrow. It is difficult to prevent this at times, because the health and potential survival of the premature infant may depend on this type of positioning. Many NICUs (neonatal intensive care units) use special mattresses to avoid this. However, they can benefit from becoming aware of the potential deformation of the head and utilize positioning techniques throughout the NICU stay.

If you feel your baby shows any signs of an abnormal head shape, contact us online, or call Dr. Stephen Beals at 602.266.9066.