Signs and Symptoms of Plagiocephaly (AKA Flat Head Syndrome) and Torticollis
When your baby was only a few weeks old, you may have noticed how he seemed to cock his head whenever he looked at you. Seeing him in other situations, you might have then realised that this was his customary posture. When you tried to move his head away from his shoulder, he may have cried as though you were causing him pain.
Looking through photos, you notice that his head is always in the same position and he doesn’t seem to turn to the other side. These are all common symptoms of plagiocephaly and/or torticollis.
Symptoms of Torticollis
Muscular torticollis or wry neck is a condition caused by spasms in the sternocleidomastoid muscle of the neck, which cause the muscle on one side to contract. An infant with this condition appears to be tilting her head to one side whilst rotating the chin in the opposite direction.
Around one in 200 infants are believed to suffer from some degree of torticollis [souce: Child and Youth Health]. If you have witnessed any of these symptoms or suspect that your child may be affected by torticollis, it is advisable that you seek medical help to confirm the diagnosis.
Sternocleidomastoid contracture is often the result of intrauterine positioning or traumatic birth. When a baby is crowded so tightly in the uterus that he can’t move, contractures may develop and range of motion can be affected. Babies who are delivered with forceps, breach babies and multiples are all at higher risk of developing this condition.
Torticollis is also rarely associated with infections and cervical abnormalities, which your paediatrician will need to rule out before treatment can begin.
Untreated, torticollis can give rise to a host of problems in later life including facial and muscular asymmetry, visual disturbances, a delay in acquiring gross motor skills, and plagiocephaly or flat head syndrome, a persistent flat spot on your baby’s head.
Plagiocephaly and Torticollis
While not every infant who shows signs and symptoms of plagiocephaly has problems with the neck muscles, most infants with problematic neck muscles do go on to develop plagiocephaly resulting from the inability to move their heads. If your baby has flat head syndrome, you may notice that either the back or one side of her skull has sparser hair than the rest of the head, and that the underlying area appears to be flattened.
Plagiocephaly, AKA flat head syndrome, usually occurs when an infant spends too much time in a certain position. Infants’ skulls are soft in order to accommodate the remarkable brain growth that takes place during the first two years of life. When an infant consistently lies with one side of the head resting against a flat surface, this can eventually leave an indentation in the malleable bones of the skull.
Other common causes of flat head syndrome include in-utero constraint, torticollis and prematurity.
Treating Plagiocephaly and Torticollis
The treatment for torticollis often involves physiotherapy, where the therapist works through a series of exercises to gently stretch the sternocleidomastoid muscle and improve the range of motion. Parents are then given a program of exercises that they can run through with their babies at home.
Plagiocephaly can often be corrected by repositioning the baby’s head so that he or she is not always lying on the flat spot. Whilst the baby must always sleep in the supine position (on the back), there are various techniques that can be employed to subtly manipulate the position of the head. When the baby is awake, plenty of tummy time should be encouraged and time spent in carriers and car seats limited to relieve pressure on the affected area(s).
Where such interventions fail, typically in moderate and severe cases of flat head syndrome, a custom-moulded helmet can be used to gently correct the formation of the bones in the skull, resulting in a more symmetrical and acceptable shape. Provided you choose a reputable provider, begin treatment before 14 months of age (ideally at around four to seven months) and follow the clinician’s guidelines, a helmet will provide a safe, pain-free and highly effective correction.
If your baby has persistent and/or severe flat head syndrome, we can help. Call 0330 100 1800 to book a free check-up at your nearest clinic and we’ll take a scan and advise you on the best possible course of action.