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Have you ever seen a baby wearing a funny looking helmet and wondered what it was for? Or maybe you’ve noticed a substantial flat spot developing on the back of your own baby’s head and you're worried about it. Plagiocephaly, also known as flat head syndrome, is a growing concern among many parents. Read on to learn more about what’s causing it and your prevention and treatment options.

Helmet Therapy

What is Plagiocephaly?

The primary type of plagiocephaly (which we will discuss here) is Positional Plagiocephaly. It occurs when excessive pressure on one area of a baby's head causes a pronounced flat spot or misshaping of their skull. While most babies' flat spots round out by the time they are sitting up and moving around more, for many it is so severe that other options must be considered to round out their head.

SOME CAUSES OF POSITIONAL PLAGIOCEPHALY

  • Too much time spent in one position:
    Infants have extremely pliable skulls with plates that don’t fully fuse together until the toddler years. When an infant spends an extended amount of time on their back (which is common these days with the SIDS "back to sleep" campaign and all of those fancy infant car seats, swings, and bouncers), they can easily develop a flat spot on their head.
  • Pregnancy & delivery:
    If a mother is carrying multiples, oftentimes the tight space can cause one or more of the babies to come out with a severely misshapen head. A traumatic birthing situation, like a breech birth, can also lead to excessive pressure on a baby's skull and plagiocephaly. Preemies are also more likely to develop plagiocephaly because their skull bones are softer and they move around less than full-term newborns.
  • Infant Torticollis:
    Torticollis (aka wryneck) occurs when tight muscles in a baby's neck make them prefer to only turn their head one direction or their head seems like it is always slightly tilted one way. Since babies with torticollis sleep with their head turned the way they favor, they are more likely to develop plagiocephaly.

PREVENTION OF PLAGIOCEPHALY

Here are simple things to keep in mind during those first few months of your baby's life that can drastically reduce their chances of developing plagiocephaly:

  • Limit time in infant car seats, swings, and bouncers:
    With all of the awesome, comfortable infant lounger options these days, it is so easy to put your baby down while you get stuff done around the house. And when they fall asleep in the car seat, why not leave them there? Well, too much time spent on their back during the early months is the leading cause of plagiocephaly. Instead, invest in a top of the line baby carrier (like this one from ERGOBaby) and wear your baby during the day.
  • Lots of tummy time:
    Tummy time is the ultimate way to strengthen baby's neck muscles and keep them off their back. Many infants aren't huge fans of being on their stomach, but if you keep incorporating it in to their daily routine, they will get used to it.
  • Change positions:
    To avoid too much pressure on one side of your infant's skull, encourage them to turn their head both ways. For example, alternate the direction you lay them on the changing table because they will always want to turn their head towards you.  You can do this same thing when you lay them down to sleep because they will most likely want to turn their head out towards the room when they wake up.
  • Watch for signs of torticollis:
    Take note if it seems like your baby doesn't want to turn their head a certain way. A little bit of physical therapy early on can go a long way in correcting torticollis and preventing plagiocephaly.

PLAGIOCEPHALY TREATMENT OPTIONS

If your baby has plagiocephaly and their flat spot seems to be getting worse over time, even after reducing time spent on their back, you may want to pursue additional measures to ensure that their head rounds out. Here are some of the treatment options available, depending on the severity of your child's plagiocephaly. Make sure that you speak to your child's physician about your concerns as soon as possible so that they can work with you to come up with a treatment plan. Your best bet for correcting any head shape irregularity is if you get started within their first year.

Repositioning

This is the first thing you should try when you notice your baby's flat spot. Repositioning basically involves keeping your baby off the flat spot as much as possible. This can include rotating their head periodically while they sleep or even using small rolled up towels to prop them up slightly away from the flat spot. Your baby's pediatrician or even a pediatric physical therapist should be able to give you tips and tricks in regards to this. If over time there is no improvement, you may want to pursue other corrective options.

Helmet Therapy

If repositioning is not improving head shape over time, cranial remolding via helmet therapy is usually the most common option. With helmet therapy, an orthotics specialist will create a special band or helmet for your baby to wear. These work by applying steady pressure to the skull and encouraging the plates to shift into a more rounded position. The length of time your baby wears the helmet depends on the severity of their plagiocephaly and how early treatment gets started. The earlier the better! Your child's pediatrician can refer you to an orthotist that specializes in infant plagiocephaly and they will take measurements of your baby's head and help you decide if this is your best option.

Craniosacral Therapy

Craniosacral Therapy (CST) is an alternative form of medicine in which therapeutic touch is used to manipulate the joints of the cranium and improve whole-body health and wellness. It has been found by many to be a successful treatment for infant plagiocephaly since CST therapists work through gentle touch to remold the plates of the scull to proper alignment. If you are opposed to helmet therapy, this may be a method worth looking in to.

What about the long-term effects of plagiocephaly?

For the most part, plagiocephaly is a cosmetic issue that can lead to asymmetry of the ears and facial features. This can make wearing glasses or hats and sports helmets awkward in later years. In terms of physiological deficits, the research is still out. There are some claims that plagiocephaly is linked to more ear infections and visual impairment in some cases.

In the end, if your child has plagiocephaly it is 100% your decision whether or not to pursue treatment.

From one mom to another:

My son, Landon, wore a helmet for four months to correct his plagiocephaly due to torticollis, rapid growth, and too much time on his back. It was one of the toughest decisions I've had to make as a parent because of the guilt I felt over his misshapen head, the cost, and the fact that plagiocephaly has more to do with appearance than any serious physiological issue. In the end, we made our decision to go with the helmet because we didn't want to live with any guilt or regrets over how he looks when we could have done something relatively painless and easy to correct it. I'm so happy we went for it! My advice to any of you who are worried about your baby's flat head is to research and talk to your child's doctor as soon as possible. Then, follow your gut instinct on what treatment is best for your baby and your family.

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Photo Credit: Dreams To Do


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