Positional Plagiocephaly – goodbye to helmets?

By Dr Tommy TranGeneral07 Oct 2015


Positional plagiocephaly  is a very common condition that results in an asymmetrical head shape. It does not cause any developmental problems or effect your baby’s brain. It occurs because the skulls of newborns are made up of plates that enable them to pass through the birth canal. If babies lie on the one spot for too long, it result in a flattening in that area of their skull. In some babies can cause their ear and cheek bone to push forwards on one side.

Due to the back to sleep campaign to prevent SIDS (sudden infant death syndrome), the incidence of plagiocephaly has increased. The most common ways to avoid positional plagiocephaly is to ensure your child has adequate tummy time. This encourages their development and takes the pressure off the one area of their skull. It is important to differentiate between plagiocephaly from craniosynostosis which is a premature fusion of the growth plate. This can often be assessed by your GP or paediatrician.

Most children with mild plagiocephaly do not require any treatment. There is a natural tendency towards improvement as infants learn to sit up. Physiotherapy can often be helpful to provide advice about positioning, stretches and handling techniques.

There has been controversy of late about the role of helmets. Last year a study in the British Medical Journal studied 84 children and suggested that there was limited benefit in using helmets after a 3-4 year follow-up.  Another study in March this year looked at over 4000 children with plagiocephaly and suggested that a trial of conservative management with positioning and physiotherapy is often effective, and reserving helmets for children who do not respond.

As usual if you have any concerns please speak to your GP or paediatrician.



Renske M, van Vimmeren L, Groothuis-Oushoorn C, Van der Ploeg C, Martin I, Boere-Boonekamp M (2014) Helmut therapy in infants with positional skull deformation: randomised controlled trial  British Medical Journal 348:g2741

Steinberg J, Rawlani R, Humphries L, Rawlani V and Vicari F (2015) Effectiveness of conservative therapy and helmut therapy for positional cranial deformation. Plastic and reconstructive surgery 135:833042

RCH – Melbourne clinical practice guideline


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