How Osteopathy Can Help with Plagiocephaly
How Osteopathy Can Help with Plagiocephaly
Plagiocephaly (flat head syndrome) occurs when an infant’s skull develops a flattened area, typically due to prolonged pressure on one spot. Though often considered a cosmetic issue, early intervention is essential to encourage normal skull development and reduce the likelihood of associated concerns. Paediatric osteopathy is a gentle, hands-on therapy can be a powerful ally in managing and preventing plagiocephaly. Below, we’ll explain plagiocephaly, why it happens, and how osteopathy supports healthier head shape development.
Understanding Plagiocephaly
Plagiocephaly most commonly appears as an asymmetrical flattening on one side of a baby’s head. The skull may flatten uniformly at the back (brachycephaly) or appear elongated along the sides (scaphocephaly/dolichocephaly). Because an infant’s skull is soft and malleable, even moderate pressure over time can lead to flattening.
Key Signs
● A noticeable flat spot on one side or the back of the head
● The baby persistently favours one position during sleep or rest
● Uneven ear alignment or mild facial asymmetry
● Slight bulging of the forehead on one side
Early detection is essential. Treatments are most successful in the first six months when the bones are most easily reshaped.
Common Causes and Risk Factors
● Sleeping Position: Babies who remain on their backs without repositioning can develop a persistent flat spot.
● Car Seats and Swings: Restrictive devices limit head movement, increasing pressure on one part of the skull.
● Premature Birth: Preterm infants have softer skulls and often spend prolonged periods lying down in the NICU.
● Multiple Births: Reduced space in the womb can result in prenatal flattening.
● Limited Movement: baby torticollis and osteopathy neck muscle tightness.
Osteopathy for Plagiocephaly: Why It Helps
Osteopathy addresses more than just the head, it involves assessing and treating the whole body to ensure better alignment, balanced movement, and relaxed muscles. This holistic approach can accelerate improvements in head shape.
1. Gentle Cranial Techniques
● Cranial osteopathy involves light pressure on the skull and surrounding tissues to reduce strain and guide the bones toward a more symmetrical shape.
● Some evidence (Panza et al., 2024) suggests that osteopathic treatment may help correct or improve plagiocephaly without resorting to more invasive measures.
2. Overall Posture and Alignment
● An osteopath evaluates whether the baby’s spine, rib cage or pelvis might contribute to uneven skull pressure.
● Adjusting and gently mobilising these areas encourage more unrestrained movement, allowing the head to rest in varied positions.
3. Parent Education
● Your osteopath will show you repositioning techniques, explain tummy time best practices, and suggest holding and feeding positions that reduce constant pressure on any one area of the head.
● This guidance ensures parents can continue therapy at home for optimal results.
4. Session Format and Frequency
● During an appointment, the osteopath will usually examine your baby’s head shape, alignment, and overall posture.
● They’ll apply gentle cranial manipulations (often perceived as light holds or subtle movements) to release tension and improve balance.
● Many parents notice changes after a few visits, but the frequency of treatment varies depending on the baby’s needs.
Practical Tips for Parents at Home
While osteopathy helps address underlying restrictions, parents can take immediate steps to support a healthy head shape:
● Encourage Tummy Time: A few short sessions each day can strengthen your baby’s neck and shoulders, reducing time spent with pressure on the skull. The American academy of paediatrics suggests 2 to 3 times each day for 3 to 5 minutes for newborns. Work up to 15 to 30 minutes each day by 7 weeks.
● Alternate Sleep Positions: Place your baby so they turn their head to a new side each night or change the orientation of their crib.
● Limit Time in Car Seats, Swings, and Bouncers: Prolonged use can force the head into one position.
● Switch Arms While Feeding: Whether bottle or breastfeeding and cranial osteopathy, alternate arms to promote neck rotation to both sides.
Helmet Therapy vs. Osteopathic Care
If repositioning and manual therapy do not sufficiently improve your baby’s head shape by around 5-6 months, some clinicians might recommend a cranial remoulding helmet. These helmets exert gentle pressure to guide skull growth. However, many cases respond very well to osteopathy and diligent repositioning, particularly if started early. Helmets are typically advised for moderate to severe plagiocephaly after 5 months. We can measure your baby’s head to assess the severity of the plagiocephaly.
FAQs About Osteopathy and Plagiocephaly
1. Is osteopathy safe for infants?
Yes. Paediatric osteopathy uses light touch and noninvasive techniques for babies’. It’s generally considered very safe.
2. How soon should I start osteopathy?
Ideally, begin assessment as soon as you notice signs of plagiocephaly. Early intervention often yields the best outcomes.
3. Will my baby still need a helmet?
Many mild to moderate cases improve without a helmet if parents use repositioning strategies and seek osteopathic care early. However, more severe flattening may require helmets.
4. How long does it take to see improvement?
Every baby is unique. Some parents report seeing positive changes in just a few sessions, while others may need longer. Consistency at home (tummy time, repositioning) also plays a significant role.
5. When is it ‘too late’ to correct plagiocephaly?
The skull remains pliable throughout the first year, so rounding is possible. The most improvements typically occur between 6 and 8 months (when babies spend less time lying down). Changes can still happen afterwards, but starting osteopathic treatment as soon as possible is always better. If the case is severe, helmet therapy is generally recommended from 5 to 6 months.
6. Does osteopathy hurt my baby?
Not at all. Osteopaths use gentle movements. Babies often appear relaxed or even sleep during sessions.
When to Seek Professional Help
Consider an osteopathic assessment if:
● Repositioning and tummy time have not improved your baby’s flat spot.
● You see worsening asymmetry or facial imbalance.
● Your baby seems uncomfortable or has difficulty moving their head in one or both directions.
● You’re uncertain whether your baby’s skull flattening is mild, moderate, or severe.
Final Thoughts
Plagiocephaly is generally manageable, especially when recognised early. Osteopathy provides a noninvasive and holistic avenue that can help correct head shape, improve overall posture, and relieve muscular tensions, giving your baby the best chance for healthy growth and development.
If you suspect your baby has plagiocephaly or you simply want professional guidance, consider booking a paediatric osteopathy session. Together, you and your osteopath can craft a plan to encourage comfortable movement, balanced alignment and a more symmetrical head shape for your little one.
References
Kim, J-H. Yum, T-H. Shim, J S. (2019) Secondary Cervicothoracic Scoliosis in Congenital Muscular Torticollis Clinical Orthopaedic Surgery Aug 12;11(3):344–351 Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC6695322/
Panza et al (2024) Positional plagiocephaly: results of the osteopathic treatment of 424 infants. An observational retrospective cohort study Italian Journal of Pediatrics Sep 7;50(1):166. Available at: https://pubmed.ncbi.nlm.nih.gov/39243064/
The American Academy of Paediatrics (2023) Back to sleep tummy to play Available at: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/back-to-sleep-tummy-to-play.aspx#:~:text=You%20can%20start%20the%20day,each%20day%20by%207%20weeks.
Matthew is a specialist in paediatric osteopath who is passionate about supporting babies with plagiocephaly. He has studied at the prestigious Osteopathic Centre for Children.