The shape of a baby’s head may differ in the first months of life, which often generates doubts and concerns among families. This asymmetry, when there is a flatter side or changes in the contour of the skull, is called plagiocephaly. Most of the time, it is related to the position in which the baby remains for long periods, especially when sleeping or always resting on the same side.

Although it is common and, in many cases, reversible with simple measures, plagiocephaly can also have less obvious causes. There is a form associated only with external pressure, called positional plagiocephaly, and another more rare form, linked to the early closure of the cranial sutures, known as synostotic plagiocephaly. Despite having a similar appearance, these conditions they have completely different origins and treatments, which makes specialized evaluation essential.

Asymmetry in the baby’s head requires attention

Plastic and craniomaxillofacial surgeon Dr. Clarice Abreu explains that not every change in the shape of the baby’s head represents a structural problem, but reinforces that the correct diagnosis is essential. “The external appearance may be very similar, but the causes are different. Therefore, any asymmetry needs to be evaluated to rule out more complex conditions”, he states.

Data from the American Association of Neurological Surgeons indicate that positional plagiocephaly became more frequent after the recommendation of babies sleep on their back, an important measure to reduce the risk of sudden death. This scenario requires greater attention from parents in relation to alternating positions throughout the day and encouraging the baby’s movement.

Difference Between Positional Plagiocephaly and Synostotic Plagiocephaly

In positional plagiocephaly, there is no change in the formation of the skull bones. THE treatment involves simple changes to routine, such as repositioning, encouraging supervised tummy time, physical therapy and, in some cases, wearing an orthopedic helmet. In these cases, there is no need for surgery, and the evolution is usually favorable when monitoring is carried out properly.

In synostotic plagiocephaly, the situation is more delicate. Early closure of one or more cranial sutures prevents normal skull growth in that region, which can generate progressive deformities and, in some cases, impact on the development cerebral. Therefore, evaluation by a specialist and, when necessary, imaging tests are essential to define the diagnosis.

According to Dr. Clarice Abreu, the main mistake is trying to interpret the condition just by appearance. “There is no plagiocephaly that does not require medical evaluation. The correct diagnosis is what defines whether we are facing postural adaptation or a condition that may require surgical intervention”, he explains.

When to seek expert evaluation

The difference in head shape is not always noticeable immediately. In some cases, it becomes more evident as the baby grows, which reinforces the importance of pediatric monitoring and parental observation. Progressive changes, persistent asymmetry or rigidity in the skull region are signs that should be investigated.

Early identification makes a direct difference in treatment. In cases positionallows for simple and effective interventions. In structural frameworks, it ensures adequate routing and safe planning. In both scenarios, correct information helps reduce families’ anxiety and contributes to more conscious decisions throughout the child’s development.

By Eluan Carlos