When I first noticed a flat spot on my baby’s head, I panicked. Like many parents, I wondered if it was permanent or harmful. After speaking with healthcare professionals and learning from other parents, I realised that flat head syndrome is common, manageable, and in most cases harmless.
This post focuses on treatment and medical guidance. If you are looking for prevention tips such as tummy time, repositioning, and baby carriers, see our earlier guide Simple ways to avoid flat head syndrome.
What is Flat Head Syndrome?
Flat head syndrome, known medically as positional plagiocephaly or brachycephaly, happens when a baby develops a flat spot on one side or the back of the head. It usually develops because babies spend a lot of time lying on their backs, which is still the safest sleep position to prevent sudden infant death syndrome, SIDS.
According to the American Academy of Pediatrics (AAP), up to one in five babies may have some degree of flat head syndrome. Most cases are mild, and the condition rarely affects brain development.
Helmet therapy, sometimes referred to as infant cranial orthosis or cranial molding helmet, is a treatment used in more severe situations to gently shape the developing baby’s head.
Causes of Flat Head Syndrome
Parents often feel guilty when they notice a flat spot. The reality is that it can happen even when you follow safe sleep guidance. Common causes include:
- Back sleeping: recommended for SIDS prevention but may create pressure in the same area.
- Limited tummy time: less time strengthening neck muscles and rotating the head.
- Prematurity: premature babies have softer skulls and often spend longer periods lying in one position in hospital. See NHS guidance on prematurity.
- Multiple births: twins or triplets may be born with small flat spots from sharing limited space in the womb. See NHS advice for multiples.
- Torticollis: tight neck muscles can make babies favour one side and increase pressure on the skull. See Connecting Care for Children torticollis.
Parent Tip: Do not blame yourself. Flat head syndrome is a by-product of following safe sleep guidance, not a sign of poor parenting.
When to Seek Medical Advice
Most babies with mild flattening improve as they grow. However, you should consult a GP or health visitor if you notice:
- A flat spot that is becoming more noticeable
- Uneven ear or facial features
- Your baby struggling to turn their head
- No improvement after repositioning over several weeks
- Developmental delays or unusual head shapes
In the UK, the usual pathway begins with your GP or health visitor. They may recommend physiotherapy for neck tightness or refer you to a specialist craniofacial team if flattening is severe.
Expert Tip: If you are worried, ask for an early review. Even reassurance from a professional can make a big difference to your peace of mind.
Flat Head Syndrome Treatments
At home remedies
At home, the main strategies are tummy time, gentle repositioning, and limiting time in car seats or bouncers. We have a full guide with step by step prevention tips here: Simple ways to avoid flat head syndrome.
Physical therapy
If your baby has torticollis, your GP may recommend physiotherapy. Gentle stretching exercises strengthen neck muscles and help your baby turn their head more freely, reducing pressure on one side of the skull.
Helmet therapy for babies
For moderate or severe cases, helmet therapy may be suggested.
What it is: a lightweight, custom fitted helmet that gently guides the skull into a more symmetrical shape while it is still soft and malleable.
When it is recommended: usually between 4 and 12 months, when the skull is most flexible.
How it works:
- Worn 23 hours per day for several months
- Adjusted regularly by a specialist
- Typical duration 3 to 6 months depending on severity
Effectiveness: helmets are adjusted as your baby grows so the gentle guidance continues without discomfort. They are designed to be lightweight, so babies can feed, sleep, and play as normal. Helmets do not cause pain, although minor skin irritation can occur. They are highly effective for moderate to severe cases but not necessary for mild flattening.
NHS versus private: in the UK, the NHS rarely provides helmets except in unusual cases. Most families who pursue this treatment do so through private clinics.
Pro Tip: Speak to your GP first before exploring private helmet clinics. A professional assessment ensures you only consider a helmet if it is truly needed.
Parent Tip: Many mild cases improve naturally without helmets. Doctors usually recommend them only when flattening is more significant.
Quick comparison of treatments
| Treatment option | What it involves | Best for | Notes |
|---|---|---|---|
| At home care | Tummy time, repositioning, limiting time in car seats | Mild flat spots | Often improves naturally as baby grows and moves more |
| Medical treatment | Physiotherapy for torticollis, GP or health visitor monitoring | Moderate cases or babies with tight neck muscles | Usually available through the NHS |
| Helmet therapy | Custom helmet gently reshapes the head over 3 to 6 months | Moderate to severe cases | Rarely offered on the NHS, usually private clinics in the UK |
Safe Sleep and Flat Head
Even if your baby has a flat spot, the NHS and The Lullaby Trust strongly recommend always placing babies on their backs to sleep. This reduces the risk of sudden infant death syndrome and is the safest sleep position.
Avoid using pillows or sleep positioners marketed for flat head prevention, as these increase suffocation risk. See NHS advice on pillows and duvets. Instead, focus on supervised tummy time and repositioning while awake.
Expert Tip: A firm, flat, waterproof mattress that fits snugly in the cot is safest for every baby.
FAQs
Does helmet therapy hurt?
No. Helmets are designed to be comfortable. Babies usually adapt quickly and show no distress.
How long does helmet treatment take?
Usually 3 to 6 months, depending on severity and growth rate.
Will my baby’s head round out naturally without treatment?
Many mild cases improve as babies grow, especially once they sit up and move more.
Can flat head affect my child’s development?
Positional plagiocephaly is cosmetic only and does not affect brain growth or development.
Is helmet therapy available on the NHS?
Rarely. Most treatment in the UK is through private clinics. Speak to your GP to discuss options.
Conclusion
Flat head syndrome can look worrying, but it is usually harmless and often improves naturally. For many babies, tummy time, repositioning, and time spent upright are enough. When needed, treatments such as physiotherapy or helmet therapy can help.
It is natural to feel anxious when you notice a flat spot, but remember that you are not alone and most babies improve with time. Whether your baby only needs tummy time or is recommended for helmet therapy, you are supporting them in the best possible way. With guidance from your GP or health visitor, you can feel reassured that you are taking the right steps.
