The Treatment for Flat Head Syndrome or Plagiocephaly
Plagiocephaly, commonly known as flat head syndrome, is the medical term for a condition that affects as many as two out of every ten babies. Flat head syndrome develops when a baby repeatedly lies in the same position. This can occur when parents aren’t aware that they need to change an infant’s position during the day or because of problems with neck muscles. An infant’s skull is so soft that flat surfaces can actually mould the shape of an infant’s head. Since 1992 when the American Paediatric Society began recommending that infants sleep on their backs to prevent SIDS (Sudden Infant Death Syndrome), paediatricians have seen a six-fold increase in flat head syndrome. This experience is reflected in the UK since this advice was adopted. Babies must always be placed on their backs to sleep and this has saved thousands of lives. During the day when they’re awake and Mum is with them, babies should be placed on their tummies and pressure relieved from the back of the head.
Plagiocephaly may be associated with brachycephaly, a type of flat head syndrome where the head shape is very wide and the flattening appears across the back of the head. With brachycephaly, the back of an infant’s head flattens uniformly, causing the crown to be wider and taller while the distance between temples and chin may be longer. Brachycephaly is also classified as flat head syndrome, and responds to many of the same interventions.
Parents are usually the first to be aware of flat head syndrome. They may notice a flat spot on the back or side of their infant’s head where hair growth is noticeably sparser. Their baby’s ears may not be symmetrically aligned or some other facial asymmetry may be present. When torticollis, a tight neck muscle is a factor, a baby’s head may appear to be tilted to one side the much of the time.
In the vast majority of cases, plagiocephaly caused by a restrictive sleeping position responds to simple therapies. Yet the diagnosis itself can be so intimidating that some parents may be frightened of interacting with their babies in a normal way that includes tummy time and playing to relieve pressure on the flat spot. A baby with a flat head is no more fragile than any other baby.
Repositioning techniques are the best intervention for simple flat head syndrome. You’ll want to position your baby in his or her crib so that the affected side is not lying flat. When your baby is lying down, encourage active turning of the head by hanging a mobile or some other bright object where the baby will want to look at it. Limit the time your child spends in car seats, carriers and pushchairs with flat backboards that press up against his or her head. When holding, feeding, or carrying your baby make sure to reposition so that the flat spot is not pressing against you. Slings and other baby carriers which position your baby’s face towards your body benefit a baby with a flat head by decreasing the amount of time spent with pressure to the back of the head.
Some parents misinterpret the Foundation for Sudden Infant Death (FSID) guidelines to mean a baby should never be placed on the tummy. This is simply not the case. Supervised tummy time is good for your baby. Tummy time helps babies develop control of their head and neck muscles and overall hip and spine development, it also encourages bonding, particularly if you are comfortable enough to get down and interact. Try putting your baby’s rattle and toys just out of reach so he or she is encouraged to reach for them.
More severe cases of flat head syndrome may require physiotherapy and/or a corrective helmet. If your interventions don’t seem to be working, research the alternatives which will be able to help.