Does My Baby Have Plagiocephaly?
If your baby has an asymmetry of the head shape – typically one side of the head is flatter than the other then it is likely that he or she will be a ‘Plagio’ baby.
This is a form of ‘flat head syndrome’. At about eight weeks of age, you may have noticed that your baby’s head seemed asymmetric with a flattening on one side, or that an ear is pushed forward on one side, or that the brow is more prominent.
For further information on spotting the symptoms of flat head syndrome, please read our informative blog.
Does Plagiocephaly Matter?
In our experience, children and adults with plagiocephaly can have both practical and psycho-social implications. For example, a child may have to wear an adult’s safety helmet to ride a bike because the child’s size doesn’t fit. Adults may find it difficult to enter certain professions when they can’t wear standard head protection. Socially, it is known that symmetric faces are more appealing and more desirable in society. We had one Mum who was concerned that her little girl could not wear an Alice band as it kept slipping around and falling off.
To read more about what could happen if you don’t treat flat head syndrome, then please read our relevant article.
What Does the Word Brachycephaly Mean?
This is another medical term for a type of flat head syndrome. A ‘Brachy’ baby has a wider than normal head with the flattening across the back of the skull. Many babies will have a combination of both plagiocephaly and brachycephaly, with a wide head shape that is more flattened to one side.
For more details on brachycephaly, please read our article, explaining in depth what brachycephaly is and how it can be treated.
What is Flat Head Syndrome?
Flat head syndrome is the name given to the condition when part of a baby’s head becomes flattened due to continued pressure on one spot. The most common forms of flat head syndrome are:
• Plagiocephaly – This is a flattening on one side of a baby’s head. Its most common form is ‘Positional Plagiocephaly‘. This is where a baby develops a flat area due to continued pressure on one side of their head.
• Brachycephaly – This refers to the condition where a baby’s head is disproportionately wide compared to its depth. It can happen when babies lie for long periods on their backs. This causes the whole of the back of their head to flatten.
For an in depth explanation into what flat head syndrome is, please read the relative information.
What Causes Flat Head Syndrome?
Your baby’s skull is made up of a number plates, which strengthen and knit together as a child develops and gets older. A young baby’s skull is still soft enough to be moulded and can change shape if there’s constant pressure on one area of their head, causing the skull to mould into a different shape as the heads grows. There are several factors that may result in your child developing flat head syndrome.
Plagiocephaly and brachycephaly are often caused by a baby constantly sleeping in one position. The soft bones of their skull can become flattened resulting in a form of flat head syndrome. For further details on the link between baby head shape and sleeping position, please read our previous post. Remember to ALWAYS place your baby on the back to sleep as this helps to minimise the risk of sudden infant death syndrome (SIDS).
Deformities can also occur before your baby is born, this is called intra uterine moulding. The moulding of the skull may occur in the uterus due to restricted space in the womb. This frequently occurs in multiple births (i.e. twins or triplets).
It can be said that premature babies may develop a deformation of the head as their bones haven’t fully developed. All bones including the skull mineralise and strengthen during the last weeks of pregnancy meaning that premature infants may miss these final steps of development.
Some new-borns may have or develop tight muscles in their neck, which prevent them from turning their head, this is known as torticollis which means “twisted neck” in Latin. A true torticollis is the result of a small knot of tangled fibres in one of the side neck muscles, the sterno-cleido mastoid muscle (SCM). Please read our guide on what to do if your baby has torticollis, for further details.
Can You Prevent Flat Head Syndrome?
There are some ways you minimise the risk of your baby developing Flat Head Syndrome. Try alternating your baby’s head position each time they sleep. You should always place a baby on their back to sleep to minimise the risk of sudden infant death syndrome (SIDS), But when you put them down you should take note of which way their head is turned and then next time turn it to face the opposite way. A young baby spends a lot of time asleep and if they are always lying on the same spot their head might develop a head shape deformity.
Use tummy time techniques when your baby is awake. It’s important to minimise the time that your baby spends with pressure on the back of the head when they are awake. This means cuddling them or carrying them in upright positions, using a baby sling and giving them plenty of supervised tummy time. Tummy time will help develop your baby’s neck, shoulder, arm and back muscles. It will also help reduce the chance of your baby developing a flat spot as it gets them off the back of their head. Try to avoid prolonged use of rockers, swings, prams and car seats.
Craniosynostosis is the premature fusion of one or more of the joints (sutures) between the bone plates that make up a baby’s skull. These sutures are normally flexible to allow the natural birth process and they remain open during growth to allow the brain to grow and develop naturally within the skull casing. Over time as brain growth completes, the sutures close naturally to form a protective bone casing around the brain. In the case of a synostosis, one or more of these sutures fuses together prematurely, causing the head to develop a form of flat head syndrome. This type of flat head syndrome can only be corrected by surgery.
To learn the difference between plagiocephaly and craniosynostosis, please read our previous blog post.
Are Some Babies More at Risk than Others?
Research shows that head shape deformity is most common in babies who:
• Are born prematurely or are a twin or a triplet.
• Have had an assisted birth (forceps or ventouse).
• Have limited ability to turn their head due to a torticollis.
How is Plagiocephaly Normally Diagnosed?
Plagiocephaly diagnosis is currently based upon visual inspection and measurement of the infant’s skull. If the skull shape is not typical of a deformational plagiocephaly, further investigation such as X-ray or CT scans will confirm whether there is a synostosis (abnormal fusion) of the sutures between the cranial bones , for which surgery is required.
Signs and Symptoms of Plagiocephaly
Parents typically notice an asymmetry or flattening of their infants’ skulls at 2 to 3 months of age and diagnosis is typically made at this time.
Typically, there is a parallelogram shaped skull, with flattening towards the back of either the left or right hand side. There may also be some facial and brow asymmetry on the same side as the flattening. In severe cases there can also be some bulging on the opposite side at the back and the back of the head can look as if it’s been pushed to one side.
For more detail on how to recognise the symptoms of plagiocepahly, please read this informative post.
Will the Skull Correct Itself Naturally?
Up to age four to five months repositioning will help, as will osteopathy or physiotherapy. After this age your baby will be sitting and rolling so up until your baby is four or five months old, there is a chance the head will improve naturally.
After this, if you’re not seeing further improvement, it is doubtful that the shape will improve greatly without help. We can give advice on repositioning techniques that will take the pressure off the flatter side of the head for young babies. For example, when your baby is awake and you’re with them, putting your baby on the tummy to play is a good technique. Approximately 20% of the babies that we see don’t need corrective orthotics, as the head is not very severe and these will become unnoticeable in time.
Will My Baby’s Head Shape Self Correct?
Our experience is that head shape will improve to some extent with time however, we regularly receive enquiries from parents of older children asking if we can help but sadly we’re not able to as there is insufficient head growth to bring about any correction once the child is older. If you are not seeing significant signs of improvement after four or five months of age, it’s doubtful if the head shape will improve naturally to any great extent.
For an in depth look into whether flat head syndrome will correct itself or not, please take a look at the relevant article.
What is TiMband treatment? Is it safe?
This treatment for plagiocephaly involves wearing a lightweight helmet that allows the head to grow back to a more normal shape. Each TiMband is made especially for your baby using a photographic scan, which accurately takes all necessary information quickly and safely.
As the head grows, the TiMband helmet gently allows the head to grow back into a normal shape, ensuring a safe, gentle and permanent correction.
Are all helmets the same?
No. Some brands produce helmets with very thick liners, some thinner liners, and some have no liner at all. The reasoning for a thicker liner has been proposed as allowing for more growth room and ‘lasting longer’. However, a thick liner doesn’t allow for as much control with correction and can actually result in treatment taking longer. Helmets with no liner, on the other hand, have more control and achieve quicker results. Here at Technology in Motion, we have created a happy medium that ensures results and comfort in one.
The most important thing to think about is the internal corrections that are being made to the head shape. If a helmet is too big, it will rotate and cause unwanted pressure problems If it’s too small, it will result in excess pressure and cause skin breakdown.
As with all things, there’s a happy medium and we know that we’ve achieved this with the TiMband, which has a well-defined overall symmetry and width/length modifications, plus a lightweight liner which adds comfort, controls rotation, and allows for faster improvement in head shape.
I’ve heard that some babies need to wear a second helmet. Why is this? Can correction not be achieved with one helmet?
Some of the infants that we see have extremely severe head shape deformities that aren’t possible to correct using a single helmet. Because such significant improvements are needed, these can’t be accommodated for in one helmet. In cases like this and when there is still the possibility for further correction, some parents decide to go on to use a second helmet to gain further improvement. However, only a single helmet is needed in the majority of cases.
Why is TiMband different?
The TiMband was developed over five years ago and has been used to successfully treat thousands of infants in the UK and Europe. Initially using an American helmet, we introduced cranial remoulding treatment into the UK in 2003 and for contractual reasons had to move to develop our own helmet. With our experience we developed the TiMband and work with an extremely experienced and high level manufacturing company. We believe that our scanning technology, modifications, easy to wear lightweight helmet and clinical protocols place us at the forefront in management of head shape deformities.