Brachycephaly in Infants
Brachycephaly is a form of flat head syndrome and is characterised by a flattening at the back of the head, with the width of the head being wider than usual. Unlike plagiocephaly, there is no asymmetry with brachycephaly in infants, unless it is present alongside plagiocephaly.
A baby’s skull and the sutures that join the cranial bones are soft and flexible at the start of life, to accommodate brain growth. Because of the flexibility of the skull, when the back of a baby’s head is flattened, the head shape can look very wide and tall at the back.
The temporal bones (pictured) that sit just above the ear can also become flexed and prominent.
The word ‘brachycephaly’ comes from the Greek word for ‘short head’. Brachycephaly in infants presents as the shape of the skull being shorter, front-to-back, than average babies’ skulls. Babies with brachycephaly may have:
- Skulls that are flat at the back
- Crowns that are high at the rear
- Wide faces
- Protruding ears
It might be that your baby has plagiocephaly, which is an asymmetrical head shape that usually involves one side of the head being flatter than the usual. In most cases, babies have a combination of brachycephaly and plagiocephaly. You can learn more about the key differences between plagiocephaly and brachycephaly here.
What Causes Brachycephaly in Infants?
Positional brachycephaly is caused by positioning after birth, and the risk factors for acquiring brachycephaly outside of the womb tend to match the risk factors for plagiocephaly. One of these key risk factors is that a baby can be lying in one position for too long during the day and night. Our advice is that you must always place your baby to sleep on their backs; this has saved the lives of many babies. During the day ,when your baby is awake and you are with them, we recommend plenty of tummy time to reduce the pressure applied to the back of the baby’s head.
We explore the causes of brachycephaly in more depth in the section below, and you can also learn more about the causes of brachycephaly in our blog post, titled What is Brachycephaly and What Causes it?
Types of Brachycephaly
Linked to the cause of brachycephaly, there are two types of the condition, including varying degrees of severity from mild brachycephaly to severe brachycephaly:
- Asymmetrical Deformational Brachycephaly (ADB) – Also known as plagiocephaly with brachycephaly or vice versa, ADB is a combination of plagiocephaly and brachycephaly, resulting in flattening in the back of the head. This leads to an unusually wide head and an asymmetrical appearance.
- Symmetrical Deformational Brachycephaly (SDB) – SDB refers to brachycephaly that is not accompanied by plagiocephaly, and therefore doesn’t display asymmetry, as the widening is bilateral.
If you’re not sure what type of brachycephaly your infant has, our team of clinicians are here to help assess your baby’s head shape.
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Brachycephaly in babies becomes obvious due to visual indicators at around eight weeks of age. Particularly when looking at a baby from the side and from above, parents can often see that their baby has a flattening to the back of the head, as well as a wider-than-usual appearance from the front.
Signs to Look Out For in Brachycephaly in Babies
- Flattening across the back of the head at the position of the occipital bone. The occipital bone is the lower bone at the back of the head, below the back (posterior) fontanelle.
- A head that looks very wide in comparison with its front to back length. A normal head shape is like an egg, a bit wider at the back but longer than it is wide.
- A head that is very high at the back in comparison to the front.
- Bulging at the temple area at the front of the head.
- Bulging over the ears.
- Some asymmetry at the back of the head indicating plagiocephaly.
We break down four key indications of brachycephaly in babies in our previous blog post.
Diagnosis and Brachycephaly Treatment
If you are concerned about your baby having brachycephaly, we would recommend a free pre-assessment with one of our skilled clinicians who can take some brachycephaly images and assess the severity of your baby’s condition.
The best form of brachycephaly treatment varies between individuals, depending on the age and severity of the condition.
The best treatment option for brachycephaly depends on the severity of a baby’s condition, as well as their age. As with plagiocephaly, we recommend initially starting with repositioning techniques to try correcting brachycephaly by positioning, before considering an orthotic helmet. However, for severe cases, a custom-made brachycephaly helmet can make significant improvements. For more information on the symptoms of brachycephaly and more ways to treat it, please read our informative blog post.
Correcting Brachycephaly by Positioning
Following a professional diagnosis and consultation with one of our clinicians, the brachycephaly treatment we offer will depend on the age of your baby and the severity of the condition. For babies whose, brachycephalic head shape is in the ‘mild’ range, and for babies who are still very young, we recommend trying repositioning techniques before anything else.
Repositioning techniques can often help to treat brachycephaly, and tummy time gives your baby time during the day to play on their front, encouraging them to try new positions during playtime.
Read our top tips on how to make tummy time and repositioning easier for your baby in our repositioning guide.
Moving Toys and Mobiles
Using toys and mobiles in your baby’s cot doubles up as a source of entertainment and sleeping aid. However, they can also be utilised to encourage babies to sleep on different areas of their head whilst in their cot. Changing the position of your little one’s toys and mobiles can influence your baby to turn their head and relieve pressure to areas of their head.
Alternate Carrying and Holding Positions
When you feed or carry your baby, try to alternate the side you do so, and, where convenient, introduce a sling instead of a car seat or pram to help keep your baby as mobile as possible.
However, if these techniques have failed and/or a baby’s head shape is severe, we might recommend our TiMBandAir helmet treatment to treat brachycephaly in infants. The helmet works with your baby’s natural skull growth to bring about a permanent correction. This treatment is most effective when started between 4 and 7 months of age, but we can start our brachycephaly treatment up to 14 months of age.
During treatment, parents see a significant improvement in head shape, even just a few weeks into treatment. For an infant with brachycephaly, the TiMBandAir™ allows the head to grown and develop in a guided way, improving the overall head shape. It’s worth noting that during the correction process, the flexed temporal bones may become more noticeable. However, this is normal, and over time, as the head continues to grow and develop throughout childhood, this will become less noticeable as the head is corrected to a normal shape.
Brachycephaly treatment options, including the TiMBandAir™, are just as effective as treatment for plagiocephaly. If treatment is started early enough and the helmet is worn as prescribed, the brachycephaly helmet can make an impactful and permanent improvement to your baby’s quality of life.
Contacting a Clinician
If you wish to know any more information on the different types of brachycephaly treatment there are, please read our blog post, what is brachycephaly? Alternatively, if you feel that your child may have brachycephaly and would like to book a no-obligation initial consultation, please book an appointment.
If your child is currently undergoing TiMbandAir treatment and you are concerned by any lumps, ridges or abnormalities that do not seem to be smoothing out, please make sure to show and ask the advice of the clinician at your next progress check-up. If your concern is growing, please feel free to contact us so we can set up an earlier appointment with you and your child.
If you have any questions regarding brachycephaly in infants, we would love to hear from you. Simply call us on 0330 100 1800.