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Plagiocephaly Helmet: What Can You Do About 'Flat-Head Syndrome'?

Plagiocephaly Helmet

Plagiocephaly (pley-jee-uh-SEF-uh-lee) is a condition characterised by a flattening on one side of the back of a baby's head. While this might sound alarming, in most cases it can be considered harmless. Understanding this condition and seeking the right treatment will help your baby get back to its healthy self.

Plagiocephaly Helmet: How Do You Know If Your Baby Has 'Flat-Head Syndrome'?

Plagiocephaly may also involve bulging of the forehead, fullness of the cheek and ear misalignment on the same side as the flattening. Under the broad term 'Flat-head syndrome' there are two other head shapes: Brachycephaly and Dolichocephaly.

In the former the head is wide in relation to its length and appears flat at the back; the head may have a high a 'peaked' appearance, and sometimes both sides of the forehead can be bulged. In the latter, the head is narrow in relation to the length of the baby's head.

1. What Causes the Condition?

Newborn babies often have some asymmetry of the head due to the inherent stresses and strains of the birth process. This normally settles in the first few weeks after birth. However, because a baby's skull is still malleable and can, therefore, be shaped by external forces any existing flattening may not necessarily disappear of its own accord.

It seems that the increased prevalence of the condition in recent years is an unfortunate by-product of the successful 'Back to Sleep' campaign. As this campaign has reduced the incidence of Sudden Infant Death Syndrome there is no suggestion that parents should stop their babies sleeping on their backs.

2. What are the Treatment Options?

The first option is to try to reposition the baby's head as much as possible with the aim of encouraging your baby to rest its head on the non-flattened area. The second option is for the baby to wear a Cranial Remoulding Orthosis but this should not be considered until the baby is at least 3 to 4 months old.

You could even consider physical therapy to help strengthen your baby’s muscles. If your baby has asymmetric neck muscles, physical therapy will help improve the range of motion. Your doctor and physician can even show you some exercises to do at home.

If you are concerned about the effects of plagiocephaly, it’s best to consult your doctor. Despite the fact that the shape of your baby’s skull won’t affect the growth of its brain, your doctor will be able to determine the best treatment.

3. How Can You Tell if Your Baby has Plagiocephaly?

Typically, a baby’s skull is perfectly round in the back and symetrical on the sides. One of the main indicators of plagiocephaly is asymmetric abnormalities or flat spots on your baby’s skull.

You may also note that your baby’s head has less hair on one side or area. It’s perfectly normal for paediatricians to check for plagiocephaly during your routine checkups. If you notice that your baby’s skull might look a bit asymmetric, you should consult your doctor as soon as possible.

4. How Do You Prevent Plagiocephaly?

Despite most cases of plagiocephaly being perfectly harmless and easy to counteract, most parents will want to try and prevent the condition where possible. Luckily, this is quite an easy task to accomplish.

Constant movement is key to prevent the “flat-head syndrome”. Ensuring that your baby doesn’t lie flat in one spot for too long will take the pressure off of its head. Keep in mind that your baby’s head is still soft and malleable so the longer that they’re on a flat surface, the more likely that their head will start to take shape as such.

5. Repositioning Treatment Suggestions

The objective is to reduce the amount of time a baby spends resting its head in the same position. Following these suggestions may well be enough to encourage natural correction of a baby's head shape.

Most of these treatments are easy to do and can be done in the comfort of your home:

  • Reposition night time sleeping: At night time considers alternating the end of the cot where your baby lays its head. Turn your baby's head so that it is not lying on the flattened side.
  • Encourage tummy time: During the day encourage your baby to spend as much time on its stomach (tummy time must be supervised) as possible. Make tummy time fun by spending time lying down with your baby on top of or in front of you. Use toys to entertain them. Most babies dislike this initially as they do not have the strength to hold their head up. However, persevere and gradually build up the length of time they spend on their tummy. This will also help them to build strength in their neck and trunk muscles.
  • Hold your baby where you can: Try and reduce the amount of time your baby spends lying flat by picking them up where you can. Your baby spends a lot of time lying against flat surfaces like its car seat or mattress. If they fall asleep in their car seat, instead of keeping them in it, pick them up and take the pressure off of their head.

6. Cranial Remoulding Orthosis Treatment

If repositioning techniques do not work, the next step is to consider Cranial Remoulding Therapy. These baby helmets are often reserved for extreme cases where babies have severe plagiocephaly. This is due to the fact that once the baby starts sitting, the shape of its head often returns back to normal.

The Cranial Remoulding Orthosis or Band looks very much like a bike helmet. It is non-invasive and works by applying constant pressure over the areas of the baby's skull which are most prominent while allowing unrestricted growth over the flattened areas.

It is a pain-free treatment. The Band consists of a soft foam layer inside a thermoplastic shell. This allows for frequent adjustments during growth as the Band gently moulds the baby's skull into a more symmetrical shape.

Treatment is most effective in babies between 4-7 months old and takes between 3-6 months to complete. Babies up to the age of 14 months can be treated but the treatment is likely to take longer.

There are no hard and fast rules for treating plagiocephaly. The condition can be avoided, if possible, but for parents who are going through it can take comfort in knowing that there are suitable treatments available. Speaking to your medical practitioner will help you decide on what’s best for your baby and how you can improve its health.

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Article By

Dr Beverley (MBChB, MRCGP) is a qualified GP. She works in a GP practice in Manchester and also helps in the out of hours GP service. She has experience in both obstetrics & gynaecology and paediatrics and has three children of her own.

to read more articles by Dr Beverley Sanders

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