What Is Plagiocephaly?

It typically falls into two categories:

• Craniosynostotic plagiocephaly: Caused by the premature fusion of skull sutures (craniosynostosis), usually requiring surgical correction.
• Deformational plagiocephaly: The more common type, caused by external forces on the skull, such as prolonged lying in one position or in-utero constraints.

Since the “Back to Sleep” campaign in 1992 encouraged babies to sleep on their backs to reduce SIDS, the incidence of positional plagiocephaly has dramatically increased—affecting up to 48% of infants by 7–12 weeks of age (Hutchison et al., 2004).

Why It Matters

While often viewed as a cosmetic issue, research has shown potential links between plagiocephaly and:

• Delayed motor development (Collett et al., 2013)
• Visual tracking issues (Boere-Boonekamp et al., 2001)
• Facial or mandibular asymmetry (Moss, 1997)
• Auditory processing challenges (Stellwagen et al., 2008)

Early detection and treatment are key to avoiding complications, especially as the infant brain and skull are rapidly growing during the first year of life.

How Is It Diagnosed?

Diagnosis typically involves:

• Clinical visual assessment and measurements of cranial symmetry
• Evaluating cervical range of motion to identify torticollis or neuromuscular restriction
• Ruling out craniosynostosis via imaging when necessary

One key diagnostic factor is identifying head-position preference or limited rotation, which correlates strongly with the development of plagiocephaly (Van Vlimmeren et al., 2007).

Treatment Options for Plagiocephaly

An integrative approach often yields the best results. Research supports combining repositioning, therapy, and when appropriate, manual intervention to restore head shape and symmetry.

Plagiocephaly Treatment Guide

• Repositioning & Tummy Time
  • ⭐⭐ Moderate to High Effectiveness
  • Best for mild cases, especially if started before 4 months old
  • Evidence: Supported by multiple studies as the first-line strategy (Laughlin et al., 2011)
• Physical Therapy
  • ⭐⭐⭐ Moderate Effectiveness
  • Best for infants with torticollis or muscle imbalances
  • Evidence: Torticollis treatment improves cranial symmetry and postural preference (Mawji et al., 2014)
• Helmet Therapy (Cranial Orthosis)
  • ⭐⭐⭐ Moderate Effectiveness (low-quality evidence)
  • Best for moderate-to-severe cases aged 5–8 months
  • Evidence: Shows greater improvement in head shape than repositioning, but research quality is variable (Steinberg et al., 2015)
• Chiropractic Care
  • ⭐⭐⭐ Promising (case studies + moderate evidence)
  • Best for all severities when cervical motion is limited
  • Evidence: A 2020 systematic review by Ellwood et al. found manual therapy—including chiropractic—more effective than repositioning for improving cranial asymmetry
• Manual Therapy (Osteopathic, Cranial, etc.)
  • ⭐⭐⭐ Moderate Effectiveness
  • Often used in combination with repositioning or chiropractic
  • Evidence: Cranial techniques and manual therapy improve both skull symmetry and neck function (Cerritelli et al., 2015)

How Chiropractic Care Can Help

Chiropractors trained in pediatric care apply gentle, specific adjustments to the cervical spine and cranium. Since plagiocephaly often coexists with torticollis or subluxations that restrict neck mobility, chiropractic adjustments may:

• Restore full cervical range of motion
• Reduce muscle tightness or imbalance
• Encourage symmetrical movement and posture
• Facilitate more even skull growth by preventing pressure on one area

In a 2021 case series by Fludder and Keil, 92.2% of infants with plagiocephaly also presented with cervical restrictions. Chiropractic care focused on improving mobility and posture led to observable improvements in head shape and range of motion.

A similar case study by Alcantara and Ohm (2010) described resolution of plagiocephaly and feeding issues following upper cervical chiropractic adjustments.

Is Chiropractic Safe for Infants?

Yes—when provided by trained professionals. A review published in the journal Explore (Todd et al., 2015) concluded that adverse events related to pediatric chiropractic care are rare and typically mild (e.g., transient fussiness or fatigue).

Studies also emphasize the importance of light-force techniques, such as those used in cranial adjusting, SOT (Sacro Occipital Technique), and Activator Method.

In Summary

Plagiocephaly is increasingly common—but highly treatable. Early intervention is key. Repositioning, physical therapy, and helmeting all have roles to play. Chiropractic care—when performed by pediatric specialists—offers a gentle, effective option to restore cervical mobility and encourage balanced development.

If your baby consistently favors one side, has a flat spot, or struggles to turn their head evenly, don’t wait. Chiropractic care may be the missing link in a truly integrative solution.

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This blog is for educational purposes only and not a substitute for professional medical advice. Consult a healthcare provider before starting any new treatment. Outcomes and experiences discussed may vary. For immediate medical concerns, contact your physician.