My baby has a flat spot?

Many babies develop flat spots on their heads—often called plagiocephaly—in the first few months of life. Because a baby’s skull bones are still soft and flexible, and they spend much of their time on their backs or in reclined positions, a little flatness is common. In many cases, it’s mild and improves naturally with growth and movement—but sometimes, that flatness needs a bit of extra attention.

Things to look for:

• A visibly flattened area on the back or side of the head

• A tendency to turn or rest the head in one direction (called positional preference)

• Tightness in the neck muscles, also known as torticollis

• Subtle asymmetry of the ears, eyes, or jaw, which can happen when one side of the head flattens more than the other

Why it happens

Plagiocephaly often develops because babies spend long stretches in the same position—like lying on their backs to sleep (which is still the safest way to sleep). Time spent in swings, car seats, or loungers can add to this pressure on one part of the head. Sometimes, tight neck muscles or a preference to look one direction can make it even harder for babies to shift positions naturally.

What you can do at home

For mild cases, small changes can make a big difference. Try:

• Tummy time several times a day to build neck and shoulder strength

• Alternating head position when laying your baby down to sleep

• Encouraging looking both ways during play or feeding

• Holding or babywearing more often to reduce time on the back of the head

Consistency with these small adjustments can help your baby’s head shape even out over time.

When therapy can help

If your baby’s flatness is more pronounced—or if you notice tightness, difficulty turning their head both directions, or uneven facial features—a pediatric physical therapist can help. At Milestones Therapy & Wellness, we focus on:

• Tracking head measurements using calipers and pictures

• Improving neck range of motion and releasing tension

• Building neck strength through guided exercises

• Encouraging symmetrical movement patterns during play

• Supporting parents with positioning ideas that fit your baby’s daily routine

Early intervention can make a big difference—not just in head shape, but in how your baby moves, plays, and develops overall. Addressing these concerns early helps prevent long-term asymmetries and supports balanced, healthy growth. Acting fast with head shape changes is imperative since we can avoid a helmet only those first few months- if you're concerned, talk to a therapist today.