Noticing a Flat Spot on Your Baby’s Head? Here’s What to Look For

Your baby’s first few months are filled with cuddles, milestones, and precious memories. But for many parents, these early moments also come with questions and concerns, especially when it comes to their baby’s head shape.

Maybe you noticed a flat spot in photos. Or perhaps your baby always turns their head the same way while sleeping or feeding. These subtle signs can be easy to miss, but they can also be the first indication of something called positional plagiocephaly, or infant flat head syndrome.

The good news? Early detection makes a world of difference. Here’s what to look out for, and how to take the next step if you’re unsure.

Positional plagiocephaly is a condition where a baby develops a flat area on one side, or the back of the head, due to prolonged pressure. It’s incredibly common, especially in babies who spend a lot of time lying on their backs or who favour one side.

In some cases, flat spots are mild and improve on their own with repositioning and supervised tummy time during the first few months of life. But for others, the flattening may persist or become more noticeable as the baby grows. In these situations, a head shape assessment may be the next best step in order to have all of your questions answered, learn your options and gain peace of mind.

Below are signs that may indicate early flattening or asymmetry in your baby’s head shape. If you notice one or more, it might be time to explore next steps with a pediatric professional.

1. Flat area on one side of the head: A visible flat spot on the back or side of your baby’s head, especially when viewed from above, is one of the most common early indicators. You might notice it more clearly when washing or brushing their hair.

2. Head tilting or rotation preference: If your baby consistently turns their head in one direction or prefers looking to one side, they may be developing tightness in the neck muscles (often called torticollis), which can contribute to head shape changes.

3. Facial asymmetry: One eye appearing slightly asymmetrical than the other, uneven ears, or a subtle shift in jaw alignment may indicate the head is growing unevenly.

4. One side of the forehead is more prominent: This can happen as the skull compensates for flattening elsewhere. For example, flattening on one side of the back of the head can push the forehead forward on that same side.

5. Ears appear misaligned: In moderate to severe cases of plagiocephaly, one ear may appear farther forward than the other.

6. Flatness that doesn’t improve by 4 months: Mild Asymmetries may resolve with repositioning in the first few months. If the flatness is still present or worsening by the time your baby is 4 months old, further assessment may be needed.

A baby’s skull is made up of soft, malleable bones that grow and expand rapidly in the first year. This flexibility allows for brain growth but it also means the head is vulnerable to flattening when placed in the same position over time.

Common contributing factors include:

• Sleeping or resting with the head always turned to one side

• Tight neck muscles (torticollis)

• Limited tummy time or floor play

• Prematurity (more time lying in hospital or weaker muscle tone)

• Multiples (twins, triplets)

• Extended use of containers like swings, car seats, or bouncers

The first year of life is a crucial time for cranial development. During this period, a baby’s head is still soft and malleable, allowing for gentle redirection of growth. This flexibility is what makes early intervention, whether through repositioning techniques or the use of a cranial remodelling orthosis, so effective.

Rather than focusing on specific percentages or measurements, it’s more helpful to understand that younger babies respond better to head shape correction because of their rapid development and frequent growth spurts. As they get older, their bones naturally begin to harden, making it more difficult to influence head shape without a structured approach.

That’s why timing matters. The earlier a concern is identified, the more options are available and the better the outcomes tend to be.

If you're seeing signs of a flat spot in the first 4 months of life, your next best step is to speak with a pediatric health professional, such as a physiotherapist, chiropractor, or osteopath—who has experience with infant development. They can assess your baby’s head shape and motor function, and offer guidance on exercises or repositioning strategies.

If your baby is 4 months or older and flattening persists despite repositioning and pediatric intervention, a free head shape assessment at ROKband can help determine whether helmet therapy may be beneficial. We use advanced 3D scanning technology to measure and monitor progress with precision.

Conclusion

Every baby’s development is unique, and so is every family’s journey. Identifying a flat spot is not a reflection of anything you did wrong. These changes are common and treatable, especially when caught early.

At ROKband, we’re here to support you with expert care, honest information, and a gentle, non-judgmental approach to your baby’s health.