Preventing plagiocephaly (misshapen head) in newborns
Plagiocephaly is a common condition seen in newborns and young infants where the head is ‘misshapen’ or asymmetrical. Sometimes babies are born with an irregular head shape, and other times it develops in the weeks or months following birth. The bones in a young babies’ head are soft and the joins between the individual bones that make up the skull have not yet fused, making the head very susceptible to change in shape. If a baby spends a lot of time with their head turned to one side, a flat spot can develop. Plagiocephaly is more common in premature babies, and often occurs secondary to torticollis.
To prevent your baby from developing an irregular shape, we recommend the following:
Keep an eye on which way your baby’s head is turned while they sleep. Babies must be placed on their back to sleep to reduce the risk of SIDS, but they should ideally spend some time with their head turned to the right and some to the left. If you notice your baby always has his/her head turned to one side, they should be further assessed for torticollis.
Vary the position of your baby within the bassinet, or change the position of the bassinet/cot in the room. Babies are drawn to noise and fixed objects, for example, a window or mobile. By varying positions, you will be varying the direction your baby is prompted to look.
Keep up regular tummy time. Tummy time helps to develop strength in the neck and trunk muscles and is essential for the progression of gross motor skills. The position allows the baby to have some time without any pressure on the back of their head. Encouraging your baby to build their gross motor skills by spending time on their tummy will give them the strength to sustain other positions (e.g., sitting) later on.
Vary the way you hold and carry your baby. This will help to encourage your baby to look in different directions and use different muscles.
An irregular head shape is thought to be simply a cosmetic problem rather than affecting brain development. The earlier Plagiocephaly is identified, the more responsive it is treatment to regain a round head shape. From around 9 months, it is more difficult to regain a round head shape because the joins between the bones in the skull begin to close. At Little Movers Physiotherapy, we treat Plagiocephaly by showing you ways to position and hold your baby to develop neck strength, full mobility and promote the development of a symmetrical head shape. Exercises are gentle, play-based and able to be carried out in the home environment.
The Royal Childrens Hospital (2010) Kids Health Info: Plagiocephaly, retrieved 11.1.18 from https://www.rch.org.au/kidsinfo/fact_sheets/Plagiocephaly_misshapen_head/
Bialocerkowski, A. (2008). Physiotherapy reduces the risk of deformational plagiocephaly in infants who have a preferred head position when lying supine, Australian Journal of Physiotherapy, vol. 54, no. 4, pp 283-283.
Mawji, A., Vollman, A.R., Hatfield, J., McNeil, D., & Sauve, R. (2013). The incidence of positional plagiocephaly: a cohort study. Pediatrics, vol. 132, no. 2, pp 298-304.
Robinson, S & Proctor, M. (2009). Diagnosis and management of deformational plagiocephaly, Journal of Neurosurgery, vol. 3, no. 4, pp 284-295.
Meara, J.G, Padwa, B. (2011). Plagiocephaly in children. Retrieved from Boston Children’s Hospital http://www.childrenshospital.org/conditions-and-treatments/conditions/plagiocephaly
Sids and Kids National Scientific Advisory Group. (2013). Safe Sleeping: Pillow Use. Retreived from http://www.sidsandkids.org/wp-content/uploads/SIDS_SafeSleeping_A4_IS_Section2_PillowUseweb2.pdf.