Cranial Technologies

Baby getting a head shape assessment from a clinician

5 Ways to Assess your Baby's Head Shape

Noticing a flat spot or an abnormal head shape can concern new parents, but you're not alone.

The goal of this at-home assessment is to help parents better understand their baby's head shape and monitor for any signs of plagiocephaly.

What does a normal baby head shape look like?

Before you begin to assess your baby for flat spots, it's important to distinguish what's normal from abnormal.

And while every baby's head will be unique, the following characteristics are common of a normal head shape:

  • 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

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

Note: It is possible that you may notice a combination of these varying head shapes. This is increasingly more common, specifically with plagiocephaly and brachycephaly appearing together. Variations in shape ranging from mild to severe can also occur. Your baby's head shape may differ from the reference photos provided for each assessment.


At-Home plagiocephaly assessment

Keep in mind that as you walk through the various assessments, it's important to remember that plagiocephaly can present as a variety of head shapes.

In other words, a baby with plagiocephaly may show different signs of abnormality when compared to a baby with brachycephaly.

Head shapes comparing normal to plagiocephaly from above

Step 1. Assess your baby's head shape from above

To assess from above, start by looking down at the top of your baby's head while they're sitting in someone's lap.

Please keep in mind that it is possible your baby could have a combination of the listed traits.

Signs of a plagiocephaly head shape

  • Head is flat on either the back right or left side
  • Head shape resembles a parallelogram
  • Ears are not aligned

Signs of a brachycephaly head shape

  • Head is wider than it is long
  • Back of the head appears flat rather than curved

Head shapes comparing normal to plagiocephaly from the profile view

Step 2. Assess the side view

Next, with your baby still seated on someone's lap, or looking into a mirror.

Normally, the back of the head is curved and both sides of the head will match both in symmetry and proportion.

Signs of a plagiocephaly head shape

  • One ear is closer to the shoulder than the other
  • One side of the head appears more curved than the other

Signs of a brachycephaly head shape

  • The head is shortest in length from front to back
  • Head is tall in the back with flatness
  • The forehead is sloped
Head shape concerns? We can help.
Get a Free Evaluation
Graphic showing how the Argenta test is done

Step 3. Check the ear alignment

The ear alignment test is often a useful indicator to assess for signs of deformational plagiocephaly.

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).
  • Ensure that you're looking directly down at the head to get a good angle.
  • Observe the alignment of your index fingers across the head (On the x-axis, imagining a line straight across).
  • Look for any misalignment between the index fingers.

A more noticeable misalignment indicates a more severe condition.

However, this test may not reveal any disproportion in the facial features as seen with other head shapes.


Head shapes comparing normal to plagiocephaly from the frontal view

Step 4. Assess the front of the head

Since you see your baby’s face every day, it can be easy to miss gradual changes to the facial features.

Place your baby in front of a mirror or look directly at the face while they're sitting in someone else's lap.

Signs of a plagiocephaly head shape

  • One eye is smaller than the other
  • One cheek is fuller than the other
  • Heah height is not level
  • Eyes are not level to one another
  • The mouth is asymmetric

Signs of a brachycephaly head shape

  • Face appears small relative to the size of the head
  • Head appears wide
  • Widest part of the head is just above the ears
  • Tips of the ears protrude

Head shapes comparing normal to plagiocephaly from below

Step 5. Assess the head shape from below

Lastly, lay your baby flat on his or her back with their face looking directly up toward the ceiling. From here, we can assess the angle and shape of the forehead, as well as the overall shape of the head.

Signs of a plagiocephaly head shape

  • 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

Signs of a brachycephaly head shape

  • 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

Cranial remolding therapy - when is it necessary?

A physician will recommend helmet therapy if the condition is severe enough where mild intervention will not correct the issue.

The good news is that mild cases of plagiocephaly can often resolve over time with proper repositioning techniques and supervised tummy time. These physical therapy activities help or encourage the baby to alter their head position frequently so even growth occurs.

Determining the correct course of treatment for your baby will require a proper diagnosis from a medical doctor or plagiocephaly specialist.

Have questions?

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.