The ‘Flat Head Syndrome’ in Babies

Plagiocephaly or the so called Flat Head syndrome: How to manage it, how to avoid it, how to improve it.

‘What is it?’

Plagiocephaly is a deformity of the baby’s skull, usually from positioning or moulding in the womb.
According to some research, about half of babies nowadays have a flattening of the head with varying degrees. However due to the large scope of different prognosis, it is hard to have more specific numbers.

At birth and in young babies the skull is composed of 44 separate bony elements, meaning that some of the bones are not even fused within themselves. There are separated by areas of dense connective tissues (6 fontanelles, cf picture). The cranial bones themselves are very soft and membranous, and are separated by unfused sutures, allowing the room for general musculoskeletal growth and the growth of the brain.

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In summary, babies have very soft heads, in order to allow appropriate growth and brain development. Unfortunately, this means their heads are prone to deformities, rated light to severe.

These deformities are commonly called plagiocephaly (flattening on one side of the head, ‘parallelogram’ head), but also brachycephaly (flattening of the back of the head, square head).

Plagiocephalies are commonly associated with torticollis, but your baby can have positional plagiocephaly without suffering from a torticollis.

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‘What causes my baby’s head to misshaping?’

  1. Muscle spasm in the neck (torticollis) causing the baby to look only on one side and affecting the position of the head, gradually causing moulding/flattening on one side.
  2. Birth strain, if the baby was compressed in the whomb or ‘stuck’ during labour; or if there was use of ventouse, forceps etc
  3. Spending too much time on their back; on too hard surface; not enough ‘tummy time’

However, more serious reasons can cause head deformities, and it is important that you check with your GP, health visitor, midwife or osteopath if the misshape of your baby’s head is only benign and not caused by:

  • Craniosynostosis: when there is a premature fusion of certain sutures in the head, possibly impairing healthy development and with a risk of raised intracranial pressure.
  • Muscular anomaly: hypotonicity caused by syndrome (eg Downs); muscular dystrophy or other neuromotor conditions.

‘How can it affect my baby?’

Plagiocephaly and brachycephaly are measured and classified from light to severe.
Correction is important in the mild to severe cases as if sustained on the long term the whole body of your baby is going to grow with this asymmetry and around it; predisposing to compensatory scoliosis; movement asymmetries and possibly impairing normal healthy development.
For the ‘lighter’ correction is mainly for comfort and cosmetic reason.
Plagiocephaly can indirectly be associated with feeding difficulties, aerophagia and colic. If the feeding mechanics are impaired by head movement, the jaw will be affected, causing discomfort to both baby and mum, and the increased chance of air swallowing.

‘What can I do?

Simple little things parents can do in order to promote natural correction of flattening of the head such as:

  • Promoting tummy time (8 to 10 times a day, from seconds to minutes)
  • Interacting with your baby more to the side opposite the flattening, changing toys position and cot set up
  • Regularly change position of your baby to decrease the pressure on the flattened area
  • Consulting an pediatric osteopath in order to have a check-up and promote more symmetry in your baby’s head, neck movement and general body. You will be provided with more personalised advice according to your baby’s need.

‘How about helmet therapy?’

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This is an optional therapy for the severe cases of head flatenning.
From 5-6 months of age, usually last between 3 to 6 months. It consists of wearing a personalized helmet for 23hrs per day with check up and reviews every 6 weeks.

Usually recommended to try manual therapy first. And alongside if deciding to do it, in order to help the baby coping with the changes.

 

What can Osteopathy do?

If your baby has a ‘funny shaped’ head, most likely, they will grow out of it, and with hair it will be less noticeable (although, less evident for boys). However, in more obvious cases, it is worth seeking the advice of your pediatric osteopath in order to ensure your baby as full range of motion in the neck and that flattening do not affect their development and/or is not due to more serious causes. The osteopath would promote better spinal movement and more balanced muscular tone, looking to promote a healthy body alignement, working gently using mainly cranial techniques. Treatments over time, combined with natural growth and parents’ following advices; will promote a more symmetric head shape.

 

For more information do not hesitate email or contact via phone.

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