July 13, 2019
Plagiocephaly in Babies Lloyd Hannis|Brachycephaly in babies, Helen Binge, Paedriatic Physiotherapist Lima Peru, Plagiocephaly in babies
Flat Head Syndrome is the lay term for a disorder that affects the skull of babies. The correct medical term is Plagiocephaly, and sometimes Positional Plagiocephaly or Deformational Plagiocephaly.
This condition occurs when the back (or the side) of a baby’s head appears flattened and misshaped.
Helen Binge is a specialist pediatric physiotherapist in Lima with studies in Europe and other parts of the world. Helen has shared the following advice and information with us about this condition.
I see so many babies who have this condition and who unfortunately are not been advised well by their Paediatricians early enough. However, the good news is that it is rarely serious and something can be done.
Some reports estimate that this affects at least half of babies under one year old.
The not so good news is that parents often wait until the baby’s skull has become harder and this, in turn, is then more difficult to treat.
There are two types of flat head syndrome; Plagiocephaly and Brachycephaly.
Plagiocephaly is the most common. The head is flattened to one side, causing it to look asymmetrical and distorted. When viewed from above, the head may look like a parallelogram.
Brachycephaly is when the back of the head becomes flattened causing the head to widen.
What are the causes of Plagiocephaly?
Positional plagiocephaly (the clue is in the name!) is produced by pressure from the outside on the baby skull. It can occur whilst the baby is in the womb, but much more commonly it occurs in the first 3 months of life.
The baby’s skull is very soft in the first few months of life. It is soft and “plastic” enough to be molded and therefore affected easily by outside pressure. So, when a baby is placed for long periods on their back, such as when they are sleeping, this constant pressure affects the shape of the baby’s head.
So, without a doubt, the baby’s sleeping position is the main cause of this syndrome, although there may be other factors at work.
Most countries in the world have campaigned to put babies asleep on their backs. Doctors have recommended this position to reduce the risk of Sudden Infant Death Syndrome, (SIDS), or ‘cot death’. Nowadays, new babies spend a large proportion of their life on their backs.
The usual scenario is as follows:
Should the baby’s back or one side of their head be squashed against a firm mattress, the soft bones of the skull become flattened. Once their head is flattened, it will automatically stay on the flattened side or roll towards it. This will then become the preferred side for sleeping and for resting their head during the day
So, what’s the solution?
Sound and up to date advice are that babies should sleep on their backs at night. The risk of SIDS outweighs the chance of developing plagiocephaly… so the answer is to be vigilant WHEN the baby is AWAKE.
Here are my top tips for avoiding and helping this common problem
- Early intervention and early recognition is the key! The younger the baby is when it is recognized and dealt with greatly improves the chances of correcting the head shape.
- A Physiotherapy assessment with a specialist Pediatric Physiotherapist, who can show you what to do to position your baby and stimulate your child, is advised. Sometimes the muscles of the neck are tighter on one side than the other, and this needs to be dealt with, too.
- “Tummy Time” is used to give a baby time on their tummy for short periods each day. I prefer the “little and often” approach.
- When your baby is awake, you should change their position often. Hold them vertically over your shoulder, lie them on their right and left sides, switch baby from a sloping chair to a car seat into a buggy. Later carry in a sling/baby carrier.
- Change the position of toys and mobiles in their cot to stimulate and encourage them to turn their head to the non-flattened side.
- Invest in a special pillow, such as the Love Nest by Baby Moov, (made in France) or the Mimos Pillow. Your Physio will advise you on this and how and when to use it.
Getting Your Baby Checked
I cannot stress how VERY IMPORTANT early intervention is, and how the outcome is so much more effective if these measures are followed.
Your Paediatrician may or may not notice this condition, but it will be checked for in any good development assessment. The good news is that in nearly all cases, brain growth or your child’s development is not affected. In other words, the result is merely a cosmetic one.
There are other conditions where skull and brain growth are affected, such as Craniosynostosis, (a condition where the skull plates fuse too early). This normally requires surgery but is very different to plagiocephaly. Head circumference measurements are also important at Developmental assessments to ascertain the proper growth of the skull.
In rare and severe cases, the use of Helmets or headbands may be used, but this is extremely unusual and not normally called for.
Helen’s Final Words of Advice
If you follow all the suggestions given above, the head shape will usually correct itself by the time the baby is one year old. It is SO important to understand that early treatment is vital for the best outcome.
If you think your baby has a tendency to look to one side or you notice any flattening, get your child seen by an experienced Pediatric Physiotherapist. They will show you all the correct positioning. Plus, give you tips and advice on how and when to follow through. They will also check for torticollis, measure the head circumference and its growth, and above all, reassure you.
Have fun and keep that baby moving!
Questions or Concerns About Your Baby?
For more information or to make an appointment with Helen, please drop us a line using our Contact Form.