Plagiocephaly is a general term one that refers to a persons head which is shaped abnormally due to various causes.
Defining Positional Plagiocephaly
The term, 'Positional Plagiocephaly,' is used to describe a misshapen or flattened head that can be the result of crowding within the womb, or from an infant who has been placed in the same position, such as on their back, for extended periods of time. Workers in the medical field might also use the term, 'brachycephaly,' in order to describe a flattening of the back of an infants skull. Plagiocephaly and brachycephaly many times happen together.
"Plagiocephaly," is a general term, one that refers to a person's head which is shaped abnormally due to various causes. Positional plagiocephaly is one of different types of plagiocephaly. Other types of plagiocephaly can result from a twisted neck that is present at birth, referred to as, 'congenital muscular torticolis,' skull sutures that have closed too soon called, 'craniosynostosis,' as well as fluid around the infants brain - called, 'hyrdocephaly.' Sometimes, plagiocephaly can be severe and might even require surgical treatments.
Causes of Positional Plagiocephaly
Positional plagiocephaly is usually caused by placing an infant in the same position, such as on their back, for extended periods of time. A baby's skull is soft, and is made up of several skull plates. The plates are movable and have space between them, referred to as, 'sutures,' which allow their head to be flexible, so their brain can grow. If their head is left in the same position for extended periods of time, the plates move in a way that leaves a flat spot. Common causes of positional plagiocephaly can include a lack of sufficient time spent upright, lack of enough time spent on their stomach when the child is awake and supervised, as well as too much time spent in carriers, car seats, and bouncy seats. Babies who are pre-term are more likely to get flat spots on their heads; their heads are softer than babies who are full-term.
Prevention of Positional Plagiocephaly
The majority of cases of positional plagiocephaly can be prevented, and sometimes even corrected, through repositioning. Repositioning relieves the pressure that can be applied to the back of an infants head. There are some different techniques for repositioning.
'Tummy Time: Providing your baby with, 'tummy time, when the child is awake and someone is watching. Tummy time not only assists in the prevention of flat spots, it also helps the baby's shoulder, neck, and head muscles to gain strength as a part of their development. Both parents and caregivers can try tummy time two or three times daily for short periods of time until the baby becomes accustomed to being on their tummy. Once the child starts to enjoy tummy time, parents and caregivers can try longer periods of time, or increase the frequency of tummy time.
Changing Lying Positions: Changing the direction a baby lies in the crib from one week to another can help in preventing positional plagiocephaly. Position the baby's feet pointing towards one end of the crib for a few days, and then change their position so their feet point towards the other end of the crib. The change in position encourages the baby to turn their head in different directions, as well as to avoid resting in the same position all the time.
Additional techniques for repositioning include:
Avoiding too much time in car seats, carriers, and bouncers while the infant is awake.
*Getting "cuddle time" with the baby by holding them upright over one shoulder often during the day.
Changing the location of the baby's crib in the room so that they have to look in different directions to see the door or the window.
Babies who are healthy should be placed on their backs to sleep for naps, as well as at night, in order to reduce the risk of Sudden Infant Death Syndrome (SIDS). While placing a baby on their back for sleep might risk flat spots on their head, flat spots present a much less serious risk than SIDS. Flat spots can many times be prevented and treated. Parents should therefore not discontinue the practice of placing babies on their backs to sleep. Instead, parents should be sure to offer their baby tummy time while they are awake, and make use of repositioning techniques.
Treatment of Positional Plagiocephaly
The majority of babies who experience flat spots on their heads find that they go away on their own once the baby starts sitting up and crawling. Repositioning may also successfully correct positional plagiocephaly. If the issue is detected early, more severe forms of positional plagiocephaly can usually be successfully treated with the assistance of a health care provider. There are a couple of treatment options related to positional plagiocephaly, to include:
A Custom Helmet: A custom helmet can prevent a baby's head from always falling to one side when they are lying down. More importantly, such a helmet permits a baby's skull to expand into a more rounded shape as their brain and skull grows.
Custom Bands: Custom bands may also be used to help reshape a baby's head. The band place a small amount of pressure on the baby's skull in areas that need re-shaping. The baby's health care provider will adjust the band on a regular basis as the baby's head grows.
Using these forms of treatments, the flat spots a baby has commonly go away over a period of approximately two to four months. If the shape of the baby's head is the result of another form of disorder, one that is not related to position, a health care provider might also recommend helmets or the use of bands. If the baby's head is severely misshapen, or is misshapen as the result of carniosynostosis, surgery might be required in order to correct the issue.