Flat Head Syndrome:


Flat Head Syndrome

Q. What can I do if I think my baby has flat head syndrome?

Check out our simple test guide that you can do it at home

Alternatively, you may visit us at Orthopaedia for a non-obligatory free head shape assessment.

Q. How can I tell if my baby’s flat head is severe?

While it may be easy to identify if baby has flat head, the best way to identify the severity is by full evaluation including measurement. Head shape assessment is available at Orthopaedia.

Q. Do I need a referral to make an appointment for head shape assessment?

No, you may call us directly for an appointment.

Q. My baby has plagiocephaly, will it impact his/her brain development?

There is currently no research that plagiocephaly have any lasting harmful effects on your baby’s neurological development.

Q. How can I prevent my baby to develop flat head syndrome?

It is beneficial to encourage regular supervised tummy time and repositioning techniques. View Tummy Time Tools.

Prolong baby’s time in car seat, infant carriers and sling can possibly contribute to flattening of head. Reduction of time spent in these devices is recommended.

Q. Flat head syndrome had never been a concern when we were a baby, why is it heightened awareness now?

Current adult population were born at a time where plagiocephaly is uncommon as babies are placed on their stomach to sleep. However, Sudden Infant Death Syndrome (SIDS)* has led to the launch of the Back to Sleep campaign in US in 1994. Parents are informed of the importance of back sleeping and encouraged to place their babies sleeping on their back instead of tummy. While it has successfully reduced the occurrence of SIDS, there is a significant increase in the number of plagiocephaly (statistics for Asia is not available at this point in time).

*Sudden Infant Death Syndrome (SIDS) referring to the sudden, unexpected death of an infant under 1 year of age is a major cause of death in infants between 1 month and 1 year of age in United States and this happens most often during sleep.

Q. Why are parents encouraged to place their babies to sleep on their back?

The Back to Sleep campaign was launched in US in 1994 to encourage parents to place their babies sleeping on their back in hope to reduce the occurrence of SIDS.

Q. Is it true that baby’s head will round off as he/she grow older?

Flat head syndrome often occurs due to constant pressure on one side of baby’s head during sleeping, hence, supervised tummy time and repositioning can be very effective in correcting 0-4 months old baby’s flat head as they are constantly in sleeping position.

However, when babies above 4 months reach their milestone of constant tummy time, sitting up and moving about, tummy time and repositioning may not be as effective anymore.

Q. What if I leave my baby’s flat head untreated?

Untreated cranial asymmetries have been linked to developmental delay, visual defects, ear infections, middle ear malfunction, jaw bone changes, learning difficulties and other psychomotor delays.

While we do require a longer-term research to support if uncorrected plagiocephaly will influence a child’s neurological development, it is without doubt that cranial asymmetry can have an effect on the child’s social well-being later in life as head will remain misshapen into adulthood.

Q. Can you treat flat head syndrome in older children, above 2 years?

Over the years of treating babies with flat head syndrome, we have received referrals from doctors as well as enquiries from parents seeking treatment for their child(ren) above 2 years of age.

Unfortunately, head shape would have been fully formed by age of 2 and cranial helmet therapy is no longer a treatment option.


Q. My baby has flat head syndrome, is it necessary for him/her to undergo the helmet therapy?

The helmet therapy is not an immediate option for every baby with cranial asymmetry. There are several factors that determine if helmet therapy is an immediate prescription.

Q. How effective is the Cranial Remoulding Helmet?

The results from the treatment is dependent on several factors:

  • The fontanelle (or commonly termed soft spot) is not closed.
  • Compliant of wearing of helmet
  • Speed of baby’s growth development

The golden period for helmet treatment is between 4 and 8 months. The natural head growth is rapid in the first 6 months of life.

Q. How long must my baby wear the helmet for?

Generally, between 3 and 5 months.

The length of treatment is greatly dependent on

  • Compliant of wearing of helmet
  • Severity of flat head
  • Growth rate of baby

Starting treatment early has been shown to reduce overall treatment time as natural head growth is rapid in the first 6 months of life.

Q. When is the best time for my baby to seek treatment?

We treat babies as young as 3 months old. Starting treatment early has been shown to reduce overall treatment time as natural head growth is rapid in the first 6 months of life. The golden period for treatment is between 4 and 8 months old as the fontanelle may start to closed up when they are approaching age of 1. We have also seen babies with fontanelle closing up as early as 9 months old.

Q. Is the helmet pressing against my baby’s head during the reshaping process?

In Japan, square watermelons are grown in glass boxes to encourage cubed shape.

We liken the helmet therapy’s reshaping or correction to the concept of square watermelon for parent’s easy understanding. The wearing of cranial remoulding helmet encourages re-direction of growth towards the flatten side of head. There is no pressing against the baby’s head at all.

Q. Will people stare at my baby?

Generally, people will notice your baby’s helmet because it’s unusual. So we asked parents how do they handle.

Often the people ask if they are able to purchase this helmet, that they thought were for protective purpose. Parents usually take the opportunity to educate them on flat head syndrome and the purpose of the helmet.

Q. Must I get the helmet therapy for my baby?

You might like to note that this is a medical device. If your baby has mild flat head syndrome, we do not prescribe this treatment even if you request for it. We follow a strict clinical guideline for prescription.

However, if severe flat head syndrome with asymmetry is present in your baby, it is completely your decision on the best course of action. Your considerations include:

  • Will you be happy with your child’s head shape and/or facial feature when he/she is 5, 10, 20 years old?
  • Your child’s social well-being later in life, especially if he/she has visible facial asymmetry

Q. Can we buy the helmet off the shelf?

The cranial remoulding helmet is a customized orthosis. The helmet will be ready for fitting approximately 2 weeks from day of scan.

Q. Does my baby sleep with the helmet on?

Yes, most babies adjust to the band quickly, in a matter of days.