Understanding Plagiocephaly (Flat Head Syndrome)
What is plagiocephaly?
Plagiocephaly… sounds like a pretty scary word, but honestly, it is just the medical term for an asymmetrical head shape. The roots “plagio” and “cephal” mean “oblique, slanted” and “relating to the head” respectively.
Asymmetrical head shapes are fairly common these days with some reports that 45% of infants have plagiocephaly in some form. Incidences of plagiocephaly have significantly increased since the “Back to Sleep” campaign of the 80’s where parents were encouraged to keep their babies off of their bellies during sleep. The reasoning behind this is the strong link between SIDS (sudden infant death syndrome) and being positioned belly-down for sleep prior to 6 months of age. This, of course, means that babies started spending a lot more time on their backs. It also means that a lot of parents have more anxiety about positioning their babies on their bellies. But that’s another topic.
What are the three types of plagiocephaly?
Plagiocephaly, Scaphocephaly, and Brachycephaly.
Plagiocephaly is the most common type of atypical head shape. The head takes on a “parallelogram-like” shape due to lying down with pressure more on one side of the head than the other. Babies with general plagiocephaly usually have flattening of the rear of their skulls on one side, not centered. More involved plagiocephaly can include flattening and asymmetry of the baby’s face as well.
Brachycephaly describes a head shape that is wide and flat at the rear. This head shape is common for babies who have had medical issues that have required them to lie flat for extended periods of time, or babies that spend a good amount of their day in car seats, bouncers, and swings.
Lastly, Scaphocephaly describes a narrow, elongated head shape. This shape is more common in babies born prematurely. This shape poses a unique challenge because babies with scaphocephaly have difficulty keeping their head centered, usually keeping their head turned to either side.
Why does my child have plagiocephaly?
There are many reasons for why your child may have developed plagiocephaly:
In-utero positioning
postural preferences (possibly caused by torticollis)
first born babies due to less uterine capacity
increased time lying on their backs with head against firm surface in car seats, bouncers, swings
The sutures of infants’ skulls are soft and malleable. This is particularly important when exiting the birth canal. In fact, infants’ skulls collapse slightly when they enter the world through their mother’s vaginal canal. This helpful malleability also means that head shape can change significantly based on the forces that are applied to it.
If your child is in the same position in-utero for many months, then you can see how a soft malleable skull would come out in an asymmetrical shape. Often times babies enter the world with round heads, but quickly develop plagiocephaly due to postural preferences, such as always keeping their head turned to one side. If your baby prefers to look to the right, and spends a lot of time on their back (as most newborns do), gravity will begin to shape their soft head into more of a parallelogram shape than a circle. The good news is we can use this same malleability to correct their head shape with strategic positioning exercises.
What should I do if my baby has a flat spot?
Infant physical therapists are uniquely qualified to treat plagiocephaly. If your child is seen before 4 months of age, there is an extremely good prognosis. Significant change in head shape can happen with a commitment to repositioning at this young age. Often, a helmet can be completely avoided. If you wait until after 6 months, prognosis goes down significantly. When it comes to plagiocephaly. Early action is more important than ever. As your baby ages, the malleability of their skull decreases as sutures start to fuse together and form a more solid skull. In order to take advantage of the skull’s ability to reshape, it is important to start treatment prior to four months of age.
Making sure that your baby’s neck can move well in all directions is an important part of treating plagiocephaly.
Need help?
I started my career treating infants with torticollis and plagiocephaly, and have continued to do so throughout my 15+ years working in pediatrics! I have advanced training on how to treat plagiocephaly without a helmet, including strategic positioning and stretching techniques. Do you have a baby with a not-so-round head shape? Reach out today for an evaluation… Don’t wait! I offer free consultations where we can get all of your questions answered prior to beginning treatment. I look forward to hearing from you and answering any additional questions you might have.
