New guidelines for diagnosis and treatment of positional plagiocephaly (positional skull flattening) have been issued by the Congress of Neurological Surgeons and endorsed by the American Academy of Pediatrics. These guidelines are largely consistent with our approach:

● The diagnosis is made by clinical examination, with imaging in equivocal cases.

● Most cases can be treated by a change in positioning, alone or with physical therapy. Use of custom-fitted helmets should be restricted to severe or recalcitrant cases.