Cranial Technologies

5 Ways to Assess your Baby's Head Shape at Home

At a young age, a baby's head is very soft and is prone to developing flat spots.

Often referred to as positional plagiocephaly, flat spots are usually caused due to the baby spending long periods of time on their backs.

Fortunately, it's very treatable — and knowing the signs to look for is the first step.

What does a normal baby head shape look like?

Since parents spend so much time with their little ones, it can be difficult to notice an abnormal head shape.

To better distinguish, we must first understand what a normal head shape looks like.

Of course, "normal" can (and will) look different between every baby. However, these characteristics offer a general guideline of what to look for:

  • The head is 1/3 longer than it is wide
  • The ear canals are in alignment with one another
  • There is no visible asymmetry or disproportion of the facial features

And for our more visual learners out there, here are some photo references.

Baby getting a head shape assessment from a clinician

Normal head shapes at 3-9 months old

Normal head shape — 3 months old

Normal head shape — 3 months old

Normal head shape — 6 months old

Normal head shape — 6 months old

Normal head shape — 9 months old

Normal head shape — 9 months old

A baby head shape assessment you can do at home

Over time, both the occurrence and severity of plagiocephaly in infants has increased.

As a result, many parents now include head shape checks into their daily routines.

As you follow the steps below, please keep in mind that this is not an official assessment to diagnose plagiocephaly. Rather, these tips will help you better understand your baby's head shape and the signs to look for.

Quick Tip:
Bath time is a great opportunity to do these checks since your baby's hair will be wet and the head shape can be clearly seen.

Step 1. Check the top of the head

Place your baby in yours or someone else's lap so you have a good view of the top of their head.

You may notice flatness on either one side, or the entire back of the head. Your baby may also have a combination of these different traits, which is usually more common.

Head shapes comparing normal to plagiocephaly from above

What to look for

  • Flatness on one side of the head
  • Resembles a parallelogram-like shape
  • Ears are out of alignment with one another
  • Head is wider than it is long
  • Back of the head appears flat rather than curved

Step 2. Check the profile view

Now let's look at things from the profile view.

Normally, the back of the head is curved and both sides of the head will match both in symmetry and proportion. So for this step, we'll want to focus on the back of the head, and the forehead.

Head shapes comparing normal to plagiocephaly from the profile view

What to look for

  • One ear is closer to the shoulder than the other
  • One side of the head appears more curved than the other
  • The head is shortest in length from front to back
  • Head is tall in the back with flatness
  • The forehead is sloped
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Step 3. Ear alignment test

Typically, asymmetry of the facial features is caused by plagiocephaly.

The ear alignment test, AKA the Argenta Method is a great way to check for misalignment from a visual standpoint.

Graphic showing how the Argenta test is done

How to perform an ear alignment test (The Argenta Method)

  • Hold the baby in your own lap, sitting upright.
  • Gently place your index finger at each of the ear canals (as pictured above).
  • Make sure that you're looking directly down at the head. This will give you a good angle to properly check for any misalignment.
  • Imagine that there is a straight line between your fingertips - do you notice any misalignment?
  • Look for any misalignment between the index fingers.

Usually, a more noticeable misalignment indicates a more severe degree of plagiocephaly.

However, it's important to keep in mind that flat spots won't always cause asymmetry in the facial features. Therefore the ear alignment test is usually a good indicator for plagiocephaly, but may not always paint the full picture.

Step 4. Check the front of the head

I'm sure we've all seen the old YouTube videos where someone takes a photo of their face every day for 3 years. And we're usually left realizing how easy it can be to miss the small details that make a lot of change to our appearance over time.

The point is, since you see your baby’s face every day, it can be easy to miss gradual changes to their facial features. So, for step 4 we're going to check the shape of their head from the front.

Place your baby in front of a mirror or have them face you while sitting in someone else's lap.

Head shapes comparing normal to plagiocephaly from the frontal view

What to look for

  • One eye is smaller than the other, or one cheek is fuller
  • The head height is not level, or there is sloping
  • Eyes are not level to one another
  • The mouth is asymmetric, or appears "slanted"
  • Face appears small relative to the size of their head
  • Head appears wide, and the widest part is just above the ears
  • The tips of the ears protrude

Step 5. Check from below

For the final step, lay your baby flat on his or her back with their face looking directly up toward the ceiling.

From here, we can check for any sloping in the forehead. This angle also offers a good opportunity to see if the head appears wide on one or both sides.

Head shapes comparing normal to plagiocephaly from below

What to look for

  • Forehead is sloped
  • Face is sloped and appears lopsided
  • Eyes and ears are not level
  • One cheek and side of the face are fuller than the other
  • Head is abnormally wide
  • Widest part of the head is just above the ears
  • The forehead is flat and not rounded
Baby boy in doc band smiling next to teddy bears

Your baby's head shape — When to worry?

Both age and severity of the head shape are two factors that have a significant impact when treating flat spots.

Repositioning at 0-3 months of age

Since the head is very soft at a young age and grows rapidly, an uneven head shape can be common. Generally, for younger babies experts will recommend that parents use these techniques to help alleviate pressure to the head:

  • Repositioning the head when the baby is sleeping or in a convenience device like a stroller or car seat. This is especially helpful if they tend to favor a particular side during these activities.
  • Tummy time is when the baby is placed on their stomach while awake, and supervised by a parent or guardian. This helps them develop core motor skills and the strength necessary to roll over, crawl, sit, and eventually stand. More importantly for flat spots, it helps strengthen the neck muscles, allowing them to reposition their heads on their own.
  • Holding your baby is another way to help reduce pressure to the head at a young age. It also allows your baby to spend less time in restrictive devices.

What if flat spots do not go away?

Unlike other conditions, plagiocephaly can only be treated for a short window of time. The skull hardens and brain growth typically slows by age 2, at which point the shape of the head is mostly set for life.

While repositioning can sometimes correct mild flatness in babies up to 4 months old, research shows that moderate to severe plagiocephaly is unlikely to self-correct.

When is the right time to seek help?

The truth is that there is no right or wrong answer to when parent's should be concerned about flat spots.

Visiting with a professional is always going to be the best course of action. And the one that gives you the most experienced insight into your child's condition.

We proudly offer free head shape evaluations handled by our highly-trained clinicians who see hundreds of plagiocephaly patients each year.

Yes, they're 100% free and require no commitment to treatment whatsoever!

Schedule Your Free Evaluation Here

What parents are asking

Will plagiocephaly go away on its own?

Due to the increasing severity of head shapes today, our research has not shown self-correction in most cases. Remember that an external force was present to cause the deformity, therefore an external force must also be present to correct it. Once your baby is sitting up and moving about, the skull will continue to harden without any external force directing the head’s growth into a symmetrical shape.

For children less than 4 months old, supervised tummy time and repositioning techniques can sometimes be enough to correct an abnormal head shape.

How do I know if my baby needs helmet therapy?

Please note that this assessment is not meant to replace the diagnosis of a medical professional.

If you’re concerned about your baby’s head shape, you can schedule a free evaluation at the clinic location nearest you.

Is plagiocephaly preventable?

Simple at-home practices including supervised tummy time and repositioning techniques are known to prevent and improve abnormal head shapes up until about four months of age. Additionally, limiting the use of convenience devices, such as car seats, infant carriers and swings, is also recommended.