What is plagiocephaly.....and what to do about it. 


For nearly three decades, back sleeping has been recommended as the safest position for infants. One of the adverse side effects, however, is head flattening. Conservative estimates are that 25-40% of infants who sleep on their back will develop some degree of asymmetrical (plagiocephaly) or symmetrical (brachycephaly) head flattening. These changes occur when the infant’s head grows against a flat mattress or other sleeping surface. Infants who are most at risk are those who demonstrate limited head mobility in the first few months of life, usually as a result of congenital muscular torticollis (CMT). CMT is a tightness of the neck muscles that arises in utero and forces affected infants to position their head to one side.













Consistent contact between one area of an infant’s head and the firm, flat mattress displaces growth away from the mattress and, over the course of weeks, a flat spot can develop. This process is analogous to how a pumpkin flattens when it grows in a field. Flattening can progress until the infant acquires independent head mobility, typically around age 4-5 months. Once the flattening stops progressing, subsequent head growth can make the shape look better, but residual flattening and facial asymmetry can persist well into adulthood. The best course is to avoid flattening before it becomes an issue.                                                                                      

There are only two options to offset this developing problem. The first, repositioning, is unpredictable and largely ineffective in babies with CMT (which is almost every infant with flattening). It is also very impractical for exhausted parents to wake up every 1-2 hours to alter their infant's head position. The easier and more effective choice is simply to change the sleep surface from flat to concave, since the head cannot become flat if it grows on a rounded surface! There are many pillows sold for this purpose, but they are largely ineffective and can actually cause flattening because they do not accommodate head growth and are not shaped like an infant’s head. They also pose a safety risk because they violate safe sleep recommendations against soft, loose items in the crib, and all pillow designs create dangerous neck flexion, which can restrict the baby’s airway, We created the Perfect Noggin to overcome all of these limitations. Its patented, adjustable, soft foam liners are anatomically shaped to fit your infant’s head shape, and the platform design maintains the safest and most ergonomic head-neck- torso alignment. But the best feature of all is that it really works!