A Guide to Plagiocephaly: Signs and Symptoms - By: Jamie Simpson

Plagiocephaly is the medical term used to describe an abnormally flattened skull, also known as 'flat head syndrome'. Many babies exhibit some abnormalities in head shape after they're first born: After all, babies are born with soft, malleable skulls in order to facilitate passing through the birth canal. These abnormalities typically correct themselves within the first few weeks.

In some infants, however, flat spots persist and parents often notice the flattening at about eight weeks of age. Plagiocephaly may be considered unsightly but there is no scientific consensus linking it with developmental delay. In many infants, a mild plagiocephaly will resolve on its own; while with others who have a more severe flattening, remoulding technologies such as specially designed cranial remoulding helmet devices may be necessary to correct the deformity.

Causes of Plagiocephaly

Children's skulls remain malleable to some degree until their fontanelles finally close over when they are around two years old. This malleability allows a child's skull to accommodate a rapidly growing brain, but it also leaves the skull susceptible to developing a lopsided shape if the child spends too much time in one position.

'Positional plagiocephaly' is the name given to plagiocephaly that arises from spending too much time in one position. In the home environment, the incidence of positional plagiocephaly seems to have increased since the adoption of Sudden Infant Death Syndrome (SIDS) guidelines that advise infants to remain on their backs when parents put their babies to sleep ('Back to Sleep' campaign). This is excellent advice and should always be followed as Sudden Infant Death has reduced by over 60% since its introduction. Back to Sleep is great advice, but when baby is awake and you are with them they should spend time on their tummies to promote spine and hip strength.

Diagnosis

Frequently, it is the parents who will first notice their baby's asymmetrically shaped head, usually when their baby is around eight weeks old. Many physicians who have not been trained to work with plagiocephaly may dismiss parental concerns.

Plagiocephaly is best observed looking down on a child from above. Parents may notice what appears to be protruding cheekbone or an ear that seems to be pushed forward. This occurs on the side of the head that is flattened.

Treatment

Infants up to Five Months

Placing an infant on his or her back may be the safest position for sleep but it can lead to positional plagiocephaly. For infants under five months, frequent repositioning is the best means of correction. Try to hold your baby whenever he or she is awake. As long as you are nearby to supervise, you can place your baby on his or her tummy to play. Never leave your baby unsupervised in this position however. You can also create incentives for your baby to move his or her own head through the creative use of mobiles and toys or music.

Infants Older than Five Months

If your infant is between five and fourteen months old and exhibiting signs of plagiocephaly, he or she may require a device such as a headband or helmet that can apply a gentle counter-pressure to the flattened area, allowing the head to grow back to a normal shape over time. The device will need to be worn for a ten to 26 weeks depending on age and severity of the plagiocephaly. Adjustments to the device will need to be made at regular intervals to ensure that all is going well and correction is continuing as expected.

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