How to assess plagiocephaly, brachycephaly or scaphocephaly?

This page will help you recognize, detect if your baby has plagiocephaly , brachycephaly or scaphocephaly . In case of doubt, it is always advisable to contact your pediatrician, or our team directly.

You may have noticed at bath time as you passed a mirror, or perhaps someone commented on the shape of your baby’s head.

Undoubtedly, an abnormal head shape raises many questions, the first of which is a common one, “Am I really seeing what I think I am seeing?”

A diagnosis of plagiocephaly looks very different from one baby to another, no two cases are the same. It can guide you ( by way of guidance ) through evaluating your baby’s head shape from five different points of view , helping you better understand your child’s condition and choose the right treatment for him or her.

Please note that this evaluation is not intended to replace an evaluation by a medical professional . We invite you to speak directly with one of our expert doctors by scheduling an evaluation.

I. From above

To start, have someone hold your baby in your lap while you stand and look at the top of your baby’s head. From this point of view, what is the general shape of your baby’s head? Normally, the head is about 1/3 as long as it is wide. In flat head syndrome, the head may appear flat on one side, wide at the back, or long and narrow.

Below we have provided examples of abnormal head shapes you may see. Keep in mind that you may not see these forms exactly: variations ranging from mild to moderate to severe and even combinations of these forms may occur.

To start, have someone hold your baby in your lap while you stand and look at the top of your baby’s head. From this point of view, what is the general shape of your baby’s head? Normally, the head is about 1/3 as long as it is wide. In flat head syndrome, the head may appear flat on one side, wide at the back, or long and narrow.

Below we have provided examples of abnormal head shapes you may see. Keep in mind that you may not see these forms exactly: variations ranging from mild to moderate to severe and even combinations of these forms may occur.

normal head shape above

Normal head shape

  • The head is 1/3 longer than it is wide.
  • ears are aligned
above plagiarism head shape

Head shape with plagiocephaly

  • The head is flattened either on the right or left rear side.
  • ears are not aligned
brachi above head shape

Head shape with brachycephaly

  • The head is wider than long
  • The back of the head is flatter than curved
escapho above head shape

Head shape with scaphocephaly

  • The head is long and narrow

II. Profile

Then, with your baby still sitting on someone else’s lap or looking in a mirror, look at the shape of your baby’s head from both sides. Normally, the back of the head is curved and both sides of the head meet. Look for flattened or tilted areas of the head and check to see if one ear is closer to the shoulder than the other .

Then, with your baby still sitting on someone else’s lap or looking in a mirror, look at the shape of your baby’s head from both sides. Normally, the back of the head is curved and both sides of the head meet. Look for flattened or tilted areas of the head and check to see if one ear is closer to the shoulder than the other .

normal shape

Normal head shape

  • The back is curved
  • The two backs of the head are the same
plagiocephaly profile shape

Head shape with plagiocephaly

  • One ear is closer to the shoulder than the other
  • One part of the head is curvier than the other
brachycephaly profile shape

Head shape with brachycephaly

  • The head is shorter in front than behind; that is high in the back
  • Flat head rear
escaphocephaly profie shape

Head shape with scaphocephaly

  • The head is longer in distance at the front than at the back.

III. Ear alignment

By looking at the alignment of your baby’s ears from above, you can determine the severity of the condition.

While holding your baby on your own lap this time, gently place an index finger in each of their ears. How are your fingers aligned? A more noticeable misalignment indicates a more severe condition.

ear alignment

It is especially important to note what you see here. While plagiocephaly is a highly treatable condition, research has shown that the best results are achieved when treatment begins early. Because cranial cap therapy is effective for a short period of time and severe cases of plagiocephaly are more complex to correct, it is crucial that infants with advanced forms of the condition begin treatment as soon as possible.

IV. Front view

Next, we will look at the symmetry of your baby’s face. Since you see your baby’s face every day, the best way to spot the differences between the right and left sides is to hold your baby in front of a mirror and look at his or her reflection. How level are the eyes and the top of the head? Is one cheek fuller than the other? How big is the head in relation to the face ? Examples of what to look for are provided below.

normal front view

Normal head shape

  • The eyes are the same size and are aligned
  • Cheeks are the same size
  • The top of the head is flat
front view plagiarism

Head shape with plagiocephaly

  • One eye is smaller than the other
  • One cheek is smaller than the other
  • The top of the head is not flat
  • Head height is not level
  • The mouth is not symmetrical
brachy front view

Head shape with brachycephaly

  • The face looks small compared to the head
  • the head is wide
  • The widest part is just above the ears
  • The tops of the ears stick out
escape front view

Head shape with scaphocephaly

  • The head is long and narrow
  • The forehead is elongated

V. From below

Lastly, we will look at your baby’s head from below. To do this, lay your baby on his back. With your baby’s face looking directly up at the ceiling, assess the angle and shape of the forehead and the general shape of the head. Is the forehead level or sloped? Round or square? Does the head appear wide or narrow? Use the examples below for context.

norm view from below

Normal head shape

  • Eyes and ears are level
  • The forehead is arched and level
plagiarism view from below

Head shape with plagiocephaly

  • The forehead is tilted
  • The face is tilted and appears deviated
  • The eyes and ears are not aligned
  • One cheek appears larger than the other
brachy view from below

Head shape with brachycephaly

  • the head is wide
  • The widest part of the head is just above the ears
  • The forehead is flat, not rounded
scapho view from below

Head shape with scaphocephaly

  • the head is narrow
  • the forehead is square

The information provided here is indicative.

If you have questions, do not hesitate to contact us, to meet our team with more than 35 years of experience, and to know why Doc Band® and not another orthopedic helmet.