Plagiocephaly, commonly known as flat head syndrome, refers to an asymmetrical distortion or flattening of a baby’s skull. It is estimated to impact approximately 20-30% of infants to varying degrees. This condition can arise from multiple factors, including sustained pressure on one area of the head, restricted neck movement, and the malleable nature of a newborn’s skull bones.

Causes and Contributing Factors

The causes of plagiocephaly are nuanced but generally stem from fixed or restricted positioning of the head during sleep and waking hours. For example, consistently resting an infant on their back can cause flattening of the rear skull. Prolonged time spent in car seats, strollers, swings, and other stationary containers may also contribute to plagiocephaly if pressure is placed on the same part of the head repeatedly.

Muscle tone and strength also play a significant role, especially in the neck. Infants with low muscle tone or minimal strength to lift and turn their heads are more susceptible to developing plagiocephaly. Prematurity, torticollis, and multiple births are other potential risk factors.

Impacts of Plagiocephaly

If left untreated, plagiocephaly can lead to both cosmetic and developmental issues. Visible skull and facial asymmetry may be present. In severe cases, plagiocephaly can cause compensatory cranial distortions, such as the forehead protruding on the flattened side.

Some studies also indicate that persistent plagiocephaly may impact early cognitive and motor development, although more research is needed in this area. Early treatment is crucial for preventing cosmetic issues and ensuring infants meet physical and mental developmental milestones.

Treatment Options

To resolve plagiocephaly, healthcare providers typically suggest repositioning techniques to encourage full head movement throughout the day and supervised “tummy time” while awake to build neck strength. Alternating the baby’s direction in the crib at night is also recommended. In many cases, diligent repositioning and tummy time resolve mild to moderate skull flattening.

In persistent plagiocephaly cases, a molded helmet can be prescribed to gently reshape the skull over time. Helmet therapy is most effective in infants under 6 months old while the skull is still malleable. The helmet is worn 23 hours a day for several months and works by applying mild, constant pressure to protruding areas while leaving room for flattened regions to expand symmetrically.

Preventative Measures

Preventing plagiocephaly from developing is a proactive process starting right after birth. Parents and caregivers should aim to alternate their baby’s orientation frequently throughout the day – during naps, feedings, playtime, and other activities. Limiting prolonged time spent in car seats, carriers, swings, and other stationary containers is recommended whenever possible.

Additionally, supervised tummy time should be incorporated into each day, starting with just a few minutes at a time in newborns and building up as infants gain strength and motor control. Tummy time promotes muscular development and gives babies experience moving their heads in all directions, reducing positional flattening.

By proactively working to provide infants with opportunities for multi-directional head positioning and movement, parents and healthcare providers can greatly reduce the risks of plagiocephaly and support symmetrical skull growth.

The Role of Healthcare Providers

Healthcare professionals are crucial in preventing, identifying, and treating plagiocephaly. Properly explaining infant positioning and tummy time guidelines empowers parents to reduce plagiocephaly risks proactively. Regular screening for skull asymmetry and other markers allows for early detection and intervention.

In cases where plagiocephaly is identified, providers guide families through appropriate treatment plans, which may include physical therapy, repositioning education, and referrals for helmet therapy evaluations. By staying up-to-date on plagiocephaly research and therapy options, healthcare teams can best serve patients and nurture optimal infant development.

Cranial Specialist Stuart Weiner, CPO, LPO, and director of the Cranial Center of New Jersey, says, “Your baby’s head shape can be scanned, captured, and tracked over several months to see if the baby is improving, staying the same, or getting worse.”

Plagiocephaly requires attentive care from parents, caregivers, and healthcare teams. Infants can achieve full symmetrical head shape and healthy physical and cognitive development through a comprehensive understanding of causes, vigilant monitoring, and proactive steps for prevention and early treatment. With proper education and management, the effects of plagiocephaly can be minimized or avoided.  There are different types and combinations of Plagiocephaly and headshapes.

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