Plagiocephaly
What the heck is plagiocephaly?
Plagio – slanting, inclining. Cephaly – head. Plagiocephaly is when a baby has a head that is shaped oddly. Usually it is flattening at the back, but there can be other variations. It can be noticed anywhere from a few weeks to a few months depending on how significant it is.
What causes it?
Nowadays the biggest cause of plagiocephaly is our wanting to keep infants on their backs, especially while asleep. We do this because it reduces the chance of SIDS, so please keep placing your babies on their back to sleep.
Torticollis, a condition where the baby’s head is continually turned one direction, is another somewhat common cause of plagiocephaly. This can be from the baby often being placed with the head turned to one side, the baby starting to prefer one side over another, or another problem that also causes the head to turn (eg, the muscles on one side of the neck not working well).
A third cause of plagiocephaly is craniosynostosis. A baby’s skull is made up of different plates that allow the brain to grow and develop as the baby ages. These plates are initially connected by cartilage (the stuff our outer ears are made of), then slowly grow together as the child ages. Rarely these plates fuse together early, which can stop the brain from growing.
How do I know why my child’s head is oddly shaped?
Most of the time the cause is positioning, but your pediatrician can tell you which one is the cause in your baby. If there’s a question, or if craniosynostosis is suspected, then your pediatrician may order a CT of the head.
How is it treated?
For mild plagiocephaly repositioning is the treatment of choice. If a baby prefers, say, the left side of their head, then lay them so that to see what’s going on in the room, they have to turn to the right. You can place a tightly rolled towel under their shoulder in the car seat or while lying on their back so that there is no pressure on the flat side.
Tummy time is a great way to prevent and treat plagiocephaly. It also helps with development by strengthening the neck and upper body. Just make sure to supervise your baby any time they’re on their belly. You can place the baby on their tummy on the floor, with a little roll under their upper chest if they’re more comfortable that way. Another way is to lay them across both your legs. You can also lay them on your chest. Around 10-15 minutes twice a day is suggested.
If your child has torticollis, or the repositioning alone isn’t helping, then physical therapy is the next step. In PT they will help your baby be more accepting of and able to turn their head to both sides.
The next step, if your baby’s head is still too misshapen by about 6 months old, is helmet therapy. Your pediatrician will send you to a neurosurgeon or plagiocephaly clinic. They will usually start with a CT to make sure your baby’s skull is otherwise okay and not growing together too early. If the CT is okay, then they will set your baby up with a series of helmets as they follow your baby’s head shape.
Rarely, only if your child has craniosynostosis, your child will require surgery to fix the problem.
Bottom line.
Baby heads are very moldable. They often get a little oddly shaped, mostly because of how we position them. Do tummy time, make sure they don’t favor looking one way versus the other, and keep an eye on it.
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