If someone tells you your baby is “soft in the head,” it’s not an insult. It’s the truth. And it means new parents need to make sure their babies get plenty of tummy time so they don’t end up with a head flattened on one side.

Because infants’ skulls are soft, it is not uncommon to have a misshapen head related to the rigors of childbirth, but this usually resolves itself within six weeks of birth.

Some infants develop this condition within the first few months of life, however. The cause: Sleeping or constantly lying on one side, most notably the back.

According to the American Association of Neurological Surgeons, the incidence of this condition — called positional plagiocephaly — has increased five-fold since the introduction in 1992 of the “Back to Sleep” campaign, which was launched to address the rise in sudden infant death syndrome (SIDS) cases.

“While thousands of lives have been saved through this campaign, more babies have developed positional plagiocephaly, much to the concern of very worried parents,” said Dr. Monica Wehby, a pediatric neurosurgeon and AANS spokesperson.

“I see many babies with flattened heads and their parents are distressed that this is going to be a permanent condition and inevitably affect their child’s self-esteem,” she said. Fortunately, there are fairly simple treatment options to resolve this problem.

“The most important first step is to bring your baby to his or her pediatrician when you first notice the problem, to receive a proper diagnosis, and obtain a referral to a specialist, if needed,” Wehby said.

Although the majority of cases of misshapen heads in babies can be attributed to positional plagiocepahly, a small number are born with a far more serious form of plagiocephaly caused by craniosynostosis. In such cases, the deformity is caused by premature closure of the fibrous joints between the bones of the infant skull (called cranial sutures). A thorough examination is necessary to confirm or rule out this diagnosis.

Because of SIDS awareness, many infants now spend nearly 100 percent of the time on their backs. The risk of positional plagiocephaly can be reduced by simply alternating the sleeping position of the infant, adding supervised tummy time during play, and being aware of which direction the infant tends to look.

Follow these tips:

- Place the infant with his or head turned on the opposite side of the head. This can be achieved by placing a towel roll or rolled up blanket beneath the back and hip on the flattened side, positioning the baby to 45 degrees. Place interesting objects on the opposite side of the bed to attract the infant’s attention.

Do NOT put the towel or blanket under the infant’s head, because this can lead to suffocation. Many infants will wiggle off of the roll in a short time; some physicians recommend using Velcro or tape to secure the roll to the infant’s body.

- When holding, feeding or carrying an infant, make sure that there is no undue pressure placed on the flat side of the head. Change infant’s head position from side to side during feeding time.

- Provide an infant with plenty of supervised play time on his or her tummy. This helps build and strengthen neck, shoulder and arm muscles.

- For optimal results, positional therapy should be started before the infant is 4 months old.

If positional therapy does not work, helmet or band therapy may be recommended.

For more information on this topic and other childhood neurological conditions, visit www.NeurosurgeryToday.org and click on Conditions & Treatments.