Plagiocephaly can start to appear before or during birth but often takes a few weeks to become apparent. A parent or health professional may notice that the head has an altered shape with a flattening to the side or at the back. If this is severe, the face and forehead may also be asymmetrical, with one ear further forward than the other. There are many different factors that can cause Plagiocephaly in babies, and they all relate to the fact that infants are born with soft, malleable skulls.
Causes of Plagiocephaly and Other Forms of Flat Head Syndrome
Babies are born with an extremely malleable skull to enable them to pass safely through the birth canal. This also accommodates the rapid brain growth that occurs during the first few months of life.
At first, the bone plates in the skull are held together with elastic tissues known as cranial sutures. Because the bones don’t fuse until the baby is a toddler, the shape of the baby’s skull can be affected by a number of factors, the position of the baby in the womb being one of them.
Flat head syndrome is common in multiple births as there is less room for infants to move around, placing added pressure on the soft bones of the skull. Depending on the positioning of the babies, one baby may be at risk more than the other. Studies have indicated that babies at the bottom of the womb are more likely to develop plagiocephaly. Because of this, multiple birth babies are more likely to develop plagiocephaly than babies born singly.
Premature babies are also particularly susceptible as they don’t benefit from the mineralisation that occurs during the final few weeks of pregnancy. Additionally, premature babies can sometimes prefer to rest their head on one side as they are not yet able to move their head themselves, and because their skulls are even softer than full-term babies, this can lead to Plagiocephaly.
Pressure on the head after birth is one of the most common Plagiocephaly causes, particularly where a lot of time is spent resting the head against flat surfaces. This problem is made worse by conditions like torticollis, a tightening of the neck muscle on one side, which can be treated through physiotherapy.
How can Plagiocephaly be Treated?
While Back to Sleep advice has radically reduced cases of cot death, the incidence of flat head syndrome has spiralled as an unexpected side effect. It is, of course, vital that you continue to follow this advice, but there are a number of special repositioning techniques that you can use to help relieve pressure on the back of your baby’s head. In mild cases, regular implementation of these techniques can often be enough to return the head to a more symmetrical shape without the need for clinical intervention.
Whilst your baby should always be placed in the supine position (on the back) to sleep, mobiles and toys can be relocated or the cot can be rotated 180 degrees to encourage him/her to face in alternating directions.
When your baby is awake during the day, supervised tummy time should be implemented to relieve pressure on the affected area whilst promoting healthy muscle development in the hips and spinal extensors.
Cranial Helmet Treatment
If you don’t see an improvement in your baby’s head shape by four to six weeks of age, it is best to seek advice from a medical professional. At this age, there is a limit to what can be achieved through repositioning. It’s at this point that a bespoke helmet may be required to return the head to a normal shape.
These helmets work with the infant’s natural growth to gently reshape the skull. They are custom-made to ensure that they fit each child perfectly and are lined with soft foam for added comfort. Regular reviews ensure that the infant is responding well to treatment.
It is important to realise that helmet therapy becomes obsolete once the bones in the skull begin to fuse at around 12-14 months of age, so parents must seek advice as soon as they notice a flattening. And the sooner the better, as treatment efficacy declines toward the end of this window.