Related Experiment Video
Updated: Sep 28, 2026
Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
Incidence of cranial asymmetry in healthy newborns
Wiebke K Peitsch1, Constance H Keefer, Richard A LaBrie
1Division of Plastic Surgery, Harvard Medical School, Boston, Massachusetts, USA.
Insights
Early cranial flattening in newborns is common, especially in twins, and can lead to deformational plagiocephaly. Risk factors include assisted birth and male gender, suggesting a need to modify infant sleep recommendations.
Area of Science:
- Neonatal care
- Pediatric neurology
- Craniofacial development
Background:
- The incidence of posterior deformational plagiocephaly has risen with supine infant positioning recommendations.
- Early detection of cranial flattening in neonates is crucial.
Purpose of the Study:
- To detect early signs of cranial flattening in healthy newborns.
- To determine the incidence and risk factors of neonatal cranial deformation.
Main Methods:
- A cross-sectional study of healthy newborns.
- Recorded physical findings, cranial measurements, and pregnancy/birth data.
Main Results:
- 13% of singletons and 56% of twins exhibited localized cranial flattening.
- Risk factors identified: assisted vaginal delivery, prolonged labor, unusual birth position, primiparity, and male gender.
Conclusions:
- Neonatal cranial flattening may precede posterior deformational plagiocephaly.
- Intrauterine factors for flattening mirror those for plagiocephaly.
- Suggests alternating infant head position, allowing side sleeping, and supervised prone time to prevent progression.
Objective:
During recent years, coincident with the recommendation to position infants supine, the incidence of posterior deformational plagiocephaly has increased dramatically. The purpose of our study was to determine whether early signs of cranial flattening could be detected in healthy neonates and to document incidence and potential risk factors.
Design:
A cross-sectional study was performed in healthy newborns. Physical findings, anthropometric cranial measurements, and data on pregnancy and birth were recorded.
Results:
The incidence of localized cranial flattening in singletons was 13%; other anomalous head shapes were found in 11% of single-born neonates. In twins, localized flat areas were much more frequent with an incidence of 56%. The following risk factors for cranial deformation were identified: assisted vaginal delivery, prolonged labor, unusual birth position, primiparity, and male gender.
Conclusion:
We propose that localized lateral or occipital cranial flattening at birth is a precursor to posterior deformational plagiocephaly. The infant lies supine, with the head turned to the flattened area, and is unable to roll. Intrauterine risk factors for localized cranial flattening are the same as for deformational plagiocephaly. To avoid postnatal progression from a localized cranial flattening to posterior-lateral deformational plagiocephaly, we suggest amending the recommendation of the American Academy of Pediatrics on sleep position: Alternate the head position and allow sleeping on the side and, when awake, supervise prone time.
More Related Videos
Related Concept Videos
01:14Cranial Bones: Superior and Posterior View
The frontal bone is the single bone that forms the forehead. At its anterior midline, between the eyebrows, there is a slight depression called the glabella. The frontal bone also forms the supraorbital margin of the orbit. Near the middle of this margin is the supraorbital foramen, the opening that provides passage for a sensory nerve to the forehead. The frontal bone is thickened just above each supraorbital margin,...
01:27Cranial Bones: Lateral View
The temporal bone forms the lower lateral side of the skull. The temporal bone is subdivided into several regions. The flattened upper portion is the squamous portion of the temporal bone. Below this area and projecting anteriorly is the zygomatic process of the temporal bone, which forms the posterior portion of the zygomatic arch. Posteriorly is the mastoid portion of the temporal bone. Projecting...
01:30Neurulation