Positional Plagiocephaly (PP), which includes flat head syndrome, is a condition in babies whereby their heads develop an abnormal shape usually due to external pressure, often related to the position that they sleep in. Now, researchers believe that in babies around six months of age, PP may actually impair cognitive and motor development.

PP has become increasingly common in babies due to the fact that more of them are positioned on their backs when they sleep. This position has become standard practice because back-sleeping decreases the risk of Sudden Infant Death Syndrome (SIDS). As a result, thousands of lives have been saved. However, because babies spend more time on their backs, there is an increased risk for PP to occur.

The study, published in the journal Pediatrics, is the first to suggest a link between PP and possible developmental delays, and could set the stage for early screening and intervention. It is important to note, however, that the researchers focused on one particular point in time (6 months), and these delays may not hold true as the baby continues to grow. More research needs to be done looking at children between 18 months and 3 years in order to see if any causal relationship persists.

The authors also point out that their findings are in no way a call for parents to stop placing their babies on their backs. The simple fact  is that back-sleeping saves lives. Since the advent of the national Back to Sleep campaign, which recommends that babies sleep on their backs for the first year of their lives, the rate of SIDS has declined by as much as 50%.

However, the increased awareness has coincided with a commensurate increase in PP, though experts indicate that sleeping position is not the only cause of PP. Babies spend a great deal of time in strollers and car seats, both of which can contribute to the condition.

Doctors also stress that developmental delays may not be the direct result of PP, and that a reverse correlation may in fact exist. In other words, it may be that children with developmental delays are more inclined to end up with flat heads because of their impaired ability to alter their position, especially over longer periods of time.

PP affects nearly 1 in 6 infants, most often as flat head syndrome. The head of newborns is soft and pliable, consisting of separate bones that fuse and harden over time to form the skull. The baby's soft skull allows the head to fit through the birth canal, and it also allows the skull to accommodate the rapid brain growth that occurs in the first year of life. Because of the compression that can occur during the birthing process, it is not unusual for a baby’s head to be misshapen after birth. This deformity is perfectly natural and should disappear after several weeks.

In certain situations, intervention is required, which can be as simple as changing the position in which the child sleeps. Special pillows can be employed to facilitate this process. Also, supervised "tummy time" on the baby's stomach will not only vary the pressure on the head, but help build neck muscles. If necessary, special helmets or hats can be worn to modify the shape of the head.

It is important to keep in mind that these guidelines should only be employed under the guidance of your pediatrician.

If you have questions or concerns about PP, talk to you child’s doctor, and for more information, check out the website Baby Center.