The Stages of Plagiocephaly Intervention: Repositioning and Cranial Remoulding

The Stages of Plagiocephaly Intervention: Repositioning and Cranial Remoulding

Close collaboration between parents, treatment specialists is essential to ensure that intervention is started at the right time to provide effective treatment for babies with plagiocephaly. Timing takes into account a number of contributing factors to the condition including, the age of the infant, the severity of the deformity and the presence or absence of other related issues such as facial deformity, torticollis and craniosynotosis.

There are three vital stages of plagiocephaly intervention that should be considered for effective plagiocephaly treatment in infants.

Stage 1: Repositioning Techniques

Parents should always adopt repositioning techniques from the moment their baby is born to help develop vital motor skills and protect against flat head syndrome. These techniques involve placing the infant in a prone position (tummy down) position during playtime when the baby is awake and parents are with them. This along with adopting the best ways to carry a baby to minimise pressure on the back of the head whilst feeding, dressing and bathing will help to prevent a flattening from developing.

Babies should always be placed on their backs to sleep in accordance with the Safe to Sleep Campaign (formerly known as the back to sleep campaign). Introduced in 1994, the National Institute of Child Health and Human Development (NICHD), developed the campaign to educate and inform parents and guardians about a safe sleeping environment, addressing the issue of sudden infant death syndrome and its causative link to sleeping position.

The development of the Safe to Sleep Campaign is backed by thorough research and evidence and their advice should be followed by all parents and guardians. However, there seems to be a link to an increase in flat head syndrome symptoms as a side effect of babies spending prolonged periods of time on their backs. During the night and naptime, babies should always sleep supine (on the back), though there are a number of techniques which can be undertaken to subtly manipulate the head position whilst the infant is still sleeping on their back. For example, turning the baby head end to toe end once every week to encourage the infant to face alternate directions during sleep.

Our repositioning guide offers more detail on the most effective repositioning techniques and a more thorough understanding of ‘tummy time’. It’s important to remember that repositioning can only work in the earliest stages of a baby’s life and significant results can only be achieved until the infant is able to roll over independently.

Repositioning techniques do strengthen muscles in a baby’s neck and spine whilst reducing the tendency for a flattening to develop. This is the first stage of plagiocephaly intervention and if these techniques are introduced early enough, they can provide effective in preventing plagiocephaly. However, if there is no significant improvement by the time the child reaches four to five months, it is time to consider the next stage of plagiocephaly intervention.

 

Stage 2: Referral

The presence of torticollis can interfere with repositioning techniques and can also be a causative factor in the development of flat head syndrome. If you suspect torticollis, the baby should be treated with a course of therapy and should be referred to a paediatric Physiotherapist, Osteopath or Chiropractor.

Our recent blog post on physiotherapy for plagiocephaly and torticollis and how it can help details the most appropriate treatment for torticollis.

If the deformity remains moderate to severe at around five months of age, the paediatrician or therapist may refer the baby to a craniofacial unit to rule out craniosynostosis. At this stage, the only effective intervention for plagiocephaly is a cranial remoulding orthosis otherwise known as helmet therapy.

 

Stage 3: Helmet Therapy

Helmet therapy is an effective form of flat head treatment using advanced cranial remoulding technology to treat moderate to severe cases of flat head syndrome. Technology in Motion have developed the TiMband which is made to exact specifications of a baby’s head shape. Using advanced computer aided design techniques, a model is made which gives room for growth in the flattened areas of the skull and a helmet is made over this model. The TiMband allows the head shape to gently correct, giving time for the flattened areas to catch up with the rest of the developing head during growth. .

The TiMband is made by highly experienced clinicians who make all the necessary modifications and oversee the technical staff in the initial manufacturing process.

The device is worn for 23 hours a day, usually over a period of 3 – 6 months, and adjusted at regular intervals to ensure optimal fit and correction.

A revolutionary study published last year has provided crucial evidence that helmet therapy has proven effective for babies with flat heads. A significant study of 4,000 patients was undertaken to monitor rates of correction throughout treatment. While repositioning alone achieved acceptable correction in 77.1% of cases even then, 15.8% of patients required helmet therapy and were moved into helmet treatment group.

94.4% of the infants who started in the helmet-treated group achieved full correction, as did 96.1% of those who were transferred from the repositioning group into the helmet-treated group.

Technology in Motion offer a no-obligation assessment of a baby with suspected flat head syndrome, offering support and guidance for parents on the best form of treatment for their baby.

If you would like to know more about the treatment options for plagiocephaly, call Technology in Motion on 0113 218 8030 and speak to one of our clinical team and we will answer any questions you might have.

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