brachycephaly

In many cases, flat head syndrome will self-correct through repositioning, bringing it within the normal range if carried out correctly. However, where infants have a moderate or a severe flat head, this is unlikely to improve significantly without further intervention.

The question is, what constitutes mild, moderate and severe flat head syndrome?

severe flat head

Measuring Severe Plagiocephaly

Plagiocephaly is a relatively common condition and many parents usually notice that their babies have developed a flattening at around eight weeks of age. In the UK, it’s not uncommon for parents to be reassured by their Health Visitor (HV) and General Practitioners (GP) that their baby’s head will self-correct over time and not to be concerned, regardless of whether the condition is considered mild or severe.

Health Visitors and GP adhere to NHS guidelines and the general advice that all types of plagiocephaly will self-correct to some degree. With little information provided other than this advice, parents are then left to consider whether their baby has severe flat head syndrome and what other treatment options are available.

Head shapes can be categorised as normal, mild, moderate or severe and this depends on how far the head shape differs from the norm before treatment.

To help parents and clinicians, a scale of deformity, developed by Dr Louis Argenta is used to describe the severity of head shape deformities. This is then used as part of the decision making process of whether to go ahead with helmet treatment.

severe-flat-head-syndrome

He has divided the head shapes into two groups. Firstly, plagiocephaly measures the diagonal symmetry from the outside corner of the eye to the high spot on the other side at the back of the head on both sides. The angle from the centre line is usually measured at 30 or 40 degrees from the midline. The difference in measurement can be described as a number by subtracting one from the other, this is known as the Cranial Vault Asymmetry (CVA).

It can also be described as a percentage by dividing the higher number by the lower one and multiplying by 100. The percentage scale, known as the Olbique Diagonal Difference Index (ODDI) is used in continental Europe and the number measurement is used in the UK and USA / North America.

For plagiocephaly there are five classifications:

severe-plagiocephaly

We carry out a visual inspection of all our patients and use diagonal measurements to calculate the Cranial Vault Asymmetry (CVA) in order to determine the severity of plagiocephaly. This takes into account the difference between the diagonal head shape measurements to establish whether the head can be categorised as either mild, moderate or severe plagiocephaly.

Argenta has also classified a wide head shape, known as brachycephaly and it is not uncommon to see a combination of plagiocephaly and brachycephaly appearing at the same time.

Brachycephaly is described using three classification scales.

Assessing the Severity of Head Shape Deformity

In an initial consultation and assessment of a baby’s head shape, three measurements are taken: circumference, width as a percentage of length from front to back, and diagonal difference. We then classify the severity on how much these measurements deviate from what is classed as the population norm.

As the normal standard deviation chart below demonstrates, treatment is recommended for the most severe five percent of infants, who fall within the moderate and severe ranges.

severe-brachycephaly

In a normal head shape (normocephaly), the width of the head is 78 to 83 percent of its length, and the diagonal asymmetry is no more than 6mm. If you were looking down on the head from above, the head appears as an egg or pear shape. This is the green image in the top left hand side of the diagram above.

An asymmetry of over 12mm is considered moderate, whilst a difference of over 18mm is regarded as a severe flat head. We often see asymmetries of over 25mm as well as head shapes than are wider than they are long, at significantly over 100%.

flat-head-severe

The relationship between diagonal asymmetry and width to length ratio varies, with some combinations considered more severe, and therefore more difficult to fully correct, than the milder head shapes.

Monitoring Progress During Plagiocephaly Treatment

To make it easy for parents to monitor the progress of their babies’ flat head syndrome, we have devised an app where you can simply upload a picture and check the head shape against outlines of real babies who have been treated.

If you think your baby may have plagiocephaly, this handy tool helps you understand how severe the deformity is. Simply upload a clear photo of the head shape and we will show you a comparison of head shapes including babies who have undergone treatment with us. You can then see the comparison of the head shapes ‘before and after’ treatment to see the results of TiMband treatment. These results are identified on our severity chart so that you can measure the improvement and see just how much improvement a plagiocephaly helmet can make to your baby’s head shape and way of life.

If you think your baby may fall into the moderate or severe plagiocephaly scale or would like a professional observation and diagnosis, Technology in Motion is here to help. We have clinics throughout the UK and offer free, no-obligation consultations and expert advice. Call us on 0330 100 1800 to book an appointment, or browse our website for more information on plagiocephaly.

brachycephaly

With the incidence of flat head syndrome soaring since the Back to Sleep Campaign, parents are now actively seeking a baby pillow to prevent their child from suffering with a flat head for their child.

Pillows for flat head syndrome are seen as one of the cheapest and most readily available options for prevention, however their use is not medically encouraged and seen as unsafe by many. Please read on to find out the reasons why plagiocephaly pillows can put your child at risk and some alternative methods for safely preventing flat head syndrome.

Why are Pillows for Flat Head Syndrome Unsafe?

Plagiocephaly pillows contravene the safety advice issued by the NHS and the Safe to Sleep guidelines from the American Department of Health. Both recommend that babies always sleep on the back on a flat, firm surface, without duvets, quilts, blankets, wedges, bedding rolls or pillows.

The main reason for this is that if a baby’s face ends up pressed up against any such object, they will not be able to lift themselves up, increasing the risk of  Sudden Infant Death Syndrome (SIDS).

Safety concerns aside, there is no scientific evidence to prove whether or not a flat head syndrome pillow will stop flat head syndrome. The fact remains, however, that placing your baby to sleep on a flat surface can leave an indentation on the skull. So, what is the solution?

How Do I Fix My Baby’s Flat Head?

The American Academy of Pediatrics recommends that whilst babies must always sleep on their backs, they should be given time on their tummies whilst supervised. Repositioning your baby in this way will relieve pressure on the back of the head, helping to prevent flat head syndrome and reducing the risk of SIDS.

If you have a doughnut-shaped baby pillow, we recommend that this is only used to support the back of their head when they are awake and you are with them.

The usual time to begin repositioning is as soon as you notice a flattening, although it can be started any time from birth – and the sooner the better. Between the ages of four and five months, it will start to become less effective as your baby will be moving and rolling more independently.

If a flattening has already started to develop, you should begin repositioning immediately. Small changes, such as feeding your baby from alternating sides and moving objects of interest from one side of the cot to the other, can make all the difference, as can carrying your baby in your arms where possible rather than using a buggy or carry cot.

Not only does supervised tummy time help with flat head syndrome; it can also help you teach your baby to prop themselves up, and it’s excellent for strengthening the back, hips and neck muscles. More tips and techniques can be found in our repositioning guide.

Alternative Methods

We appreciate that it’s easy to be overwhelmed by the conflicting advice on the various products for flat head syndrome. As a parent your top priority will, of course, be the safety of your child, and until we know more, the safety concerns relating to plagiocephaly pillows far outweigh their potential benefits.

In many cases, repositioning your baby whilst awake can provide adequate correction for mild flat head syndrome. However, if this has failed to make the difference that you had hoped for by the time your baby reaches four to six months of age, helmet therapy is a safe, effective and scientifically proven way to treat flat head syndrome.

If you have any concerns about the shape of your baby’s head and wish to enquire about helmet therapy, Technology in Motion can help. Call 0330 100 1800 to arrange a free, no-obligation assessment at your nearest clinic or browse our website for more information on flat head syndrome and the treatment options that we provide.

brachycephaly

What is Brachycephaly?

Brachycephaly is a condition characterised by a flattened area at the back of the skull. Most parents notice their baby’s brachycephalic head shape when their baby is around eight weeks of age, with their baby’s head appearing wider than expected and their ears sometimes being pushed outwards. A brachycephalic head shape can also involve a slight bulging on the forehead and a wide brow.

For babies with brachycephaly, the head is also often higher at the back and the whole back of the head can appear completely flat with the absence of any rounding towards the neck. Brachycephaly is a form of flat head syndrome and can be found either in isolation or in combination with plagiocephaly.

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brachycephaly

Flat Head Syndrome and the Nature vs. Nurture Debate – Is Flat Head Genetic?

Flat head syndrome is usually attributed to external pressures on the skull. Consistently resting the head in the same position while sleeping, sitting and playing can eventually cause a flat spot to emerge in babies. Flattening can also begin to occur before or during birth, often as a result of breech position or crowding in the womb, or when forceps are used during an assisted birth. But, is flat head syndrome genetic to some degree, or is it caused exclusively by these external pressures on the skull?
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brachycephaly

Mini Directory of Plagiocephaly Advice and Support Websites

Having a baby with flat head syndrome can feel rather overwhelming at times. While the condition is not proven to have a negative effect on development, it can still be distressing for parents who, naturally, want what is best for their little ones. But you are not alone. In the UK, plagiocephaly affects around half of all babies under the age of one to some degree.

No matter what stage of the plagiocephaly journey you and your family are at, there are several fantastic resources out there which you can turn to for plagiocephaly support. Whether you wish to share your experiences with other parents or seek advice on plagiocephaly from the experts, this mini directory will help you find the right places to go in times of need.
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brachycephaly

If you suspect that your baby might have positional plagiocephaly, naturally you’ll be wondering how severe the deformity is relative to other infants, and whether or not you should seek treatment. But how is plagiocephaly measured, and what system is used as a severity assessment for Plagiocephaly? (more…)

brachycephaly

Parents are always concerned about the potential risk factors associated with helmets for flat head syndrome. Understandably, many have come to us asking “what are the risks associated with using baby helmets?” and “are they dangerous / uncomfortable / harmful to my baby’s development?” (more…)