Do torticollis or plagiocephaly affect development? It’s a question that comes up every so often. While there may be evidence of a correlation between plagiocephaly and motor delay, it’s currently unclear whether or not this is a cause and effect relationship. However, a recent study investigating the potential ties between plagiocephaly, torticollis and motor development may shed a little more light on the nature of this link. (more…)
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?
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.
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:
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.
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.
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%.
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.
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.
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.
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?
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.
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.
Plagiocephaly and craniosynostosis are both conditions affecting the shape of the skull and without knowledge, the symptoms can be confused with one another. While plagiocephaly is relatively benign, with severe cases affecting approximately one in 25 infants, craniosynostosis is rarer, affecting one in 3,300.
The word synostosis means that a joint has fused into a single bone, which naturally occurs over time in all the long bones at the growth plates. The sutures or seams between the plates in the skull are open to begin with and remain flexible to allow growth throughout childhood, adolescence and into early adulthood, until later in life, when fusion occurs.
Occasionally, one or more joints in the skull can fuse too early, usually during development in the womb. This is called craniosynostosis, and if not managed properly, it will cause deformity and can affect the growth of the brain. The condition can also be associated with developmental deficiencies, some of which are serious, so it’s important to understand the difference between plagiocephaly and craniosynostosis.
Please note that the information provided here is no substitute for diagnosis by a qualified healthcare professional. If you are in any doubt whatsoever as to the nature of your child’s head shape deformity, consult your baby’s GP.
Plagiocephaly is a common head shape deformity caused by external pressures on the skull and manifesting in a flat head shape. Craniosynostosis is rarer, affecting about one in 100 infants who develop a severe head shape deformity.
Plagiocephaly can appear for a number of reasons, such as crowding in the womb, breech birth and a lot of time spent lying in the supine position (i.e. on the back) during the early years of life. If caught early on, mild plagiocephaly can be managed successfully towards a full correction, either through repositioning or, in moderate and severe cases, by means of a custom made helmet. Without management , it can result in a lifelong deformity. There are no reported serious effects on development but parents are concerned about the psycho-social issues of such a deformity.
Contrasting to this, Craniosynostosis involves the premature fusion of one or more of the sutures between the bony plates that make up a baby’s skull. This prevents the skull from being able to develop normally within its casing and can inhibit the growth of the brain. The only way it can be managed is through surgery, by reopening the suture that has closed too early. If there is a residual deformity once this has been done, this can be corrected using a cranial remoulding helmet.
There are some units in Europe and the USA that take a gentle approach, using minimally invasive surgery followed up by treatment with a remoulding helmet. The surgeons who do this work find that the infant has a reduced anaesthetic time, reduced blood loss and a shorter time in hospital. The overall treatment time is longer as the head needs to gently grow back into shape, but the results are equivalent or better than with traditional surgery.
The difference between plagiocephaly and craniosynostosis can be very difficult to tell apart visually, and you should by no means treat the information provided here as a diagnostic tool. However, the key signs to look out for, as indicated by the NHS, include:
Intercranial pressure (ICP) is another common symptom, which may not become noticeable until an infant reaches 4 – 8 years of age. This is the pressure that builds up in the brain as a result of the irregular shape of the skull, and can manifest in persistent headaches, visual problems and an unexplained decline in the child’s academic abilities.
Left untreated, ICP can cause vomiting, irritability, unresponsiveness, swollen eyes and difficulties breathing and hearing, so it’s important to take your child for a check-up if you notice that something is amiss.
If you see us for an assessment and the head shape is typical of a synostosis, we will not treat but refer you to your own doctor to seek investigation and if necessary, appropriate treatment. Rest assured, the vast majority of the infants that we see do not have a synostosis and achieve an excellent result from our treatment.
Our overriding concern is to ensure that all infants that we treat are treated appropriately and with the utmost care. If you are at all uncertain about the cause of your child’s head shape deformity, contact us for a free check-up and our expert Orthotists will be able to help you.
Call 0330 100 1800 or fill in our form to book an appointment at your nearest clinic, or browse our website for more information on Technology in Motion and the service that we offer.
A baby can catch an illness at almost any age and any time of year and a baby’s first cold can often feel a little scary for parents. However, it is important to remember that colds and illnesses at an early age often build up a baby’s immunity and will help them fight infection much quicker in future.
Nevertheless, being able to diagnose cold symptoms in young babies quickly is important to help ease discomfort and prevent illnesses developing into more serious conditions.
This blog post explores the initial signs and symptoms of a cold to look out for, simple steps to treat a baby’s cold and how this may affect plagiocephaly treatment.
How do I Know if my Baby has a Cold?
Symptoms of a cold are often easy to spot and are not too dissimilar to the symptoms we experience as adults. A stuffy, runny or congested nose is often the first tell-tale sign your baby may be suffering with a cold but there are a few other symptoms to be aware of. They include:
If your baby is currently undergoing plagiocephaly treatment and is wearing a plagiocephaly helmet for long periods of time throughout the day, you may be concerned as to how this may affect your baby if they are showing symptoms of a cold.
Please read our advice from our clinicians on how illness can affect wearing a plagiocephaly helmet which covers if and when your baby should be wearing a plagiocephaly helmet if they have a rash, high temperature or other illnesses such as chicken pox. The post also explores if less helmet wear during illnesses affects overall progress and results.
4 Simple Steps on Treating a Baby’s Cold
Once you have established that your baby has caught a common cold and doesn’t appear to be developing any other serious symptoms, you will naturally want to try and make your little one feel comfortable and help them to recover as soon as possible.
When to See a Doctor
If your baby is under three months old and is showing signs of a cold, they should be seen by your local GP as a precautionary measure. Seeking medical advice will help to prevent your baby developing anything more serious and will also put your mind at ease.
A fever is another common cold symptom and is the body’s natural way of fighting off infection. However, if your baby has a fever of 39 degrees or higher or the fever is persistent for 5 days or more, you should also book an appointment with your local GP. Other symptoms to be aware of also include difficulty in breathing, severe loss of appetite and signs of dehydration. If your baby displays any of these symptoms it’s important to visit your doctor as soon as possible.
No one knows their baby better than a parent and if you are worried or concerned about any symptoms of illness your baby is showing, it is best to contact your GP for some advice. If your baby is currently undergoing plagiocephaly treatment and you are concerned if and when your baby should wear their plagiocephaly helmet during illness, contact one of our friendly and experienced clinicians who can advise you and provide you with that all important peace of mind.
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?
Trying to decide whether to give your baby plagiocephaly treatment with or without a helmet is by no means an easy task. Conflicting attitudes and opinions from GPs, HVs, the press, private clinics and other parents can often serve to heighten the anxiety – no matter how honourable the intentions behind their advice might be. (more…)