Although experts estimate that approximately one in two infants are affected and one in ten need treatment with a cranial helmet, plagiocephaly is a condition which is unfamiliar to many expectant mothers and parents of newborns. Frequently referred to as “flat head syndrome,” plagiocephaly happens when the side of a baby’s head is flattened, resulting in an abnormal head shape. Although it does not impact an infant’s neurological development, a cranial disorder can become permanent if left untreated.
When a child is born, his skull bones are not fused together, so that the brain can grow freely during his first year. As a result, outside pressures such as a mattress, can hinder growth in one area while the brain continues to grow elsewhere. For this reason, the skull often becomes flattened at the area where pressure is applied.
Cranial asymmetry can happen for a number of reasons. Sometimes it occurs in the womb when there is less space in the uterus due to twin or multiple births. Breech births can cause abnormal head shapes due to the unusual position of the baby in the womb. Premature babies are also at risk since their skulls are softer and more susceptible to misshaping than full term babies.
Factors which contribute to craniofacial disorders after a baby’s birth include poor muscle tone, spine abnormalities and torticollis or neck muscle tightness. Torticollis causes a baby’s head to turn to one side, putting him in a single position for an inordinate amount of time.
One of the most commonly cited causes for plagiocephaly is the launch of the “Back to Sleep Campaign,” launched in 1994 by the National Institute of Child Health and Human Development. At the time, there was a strong push for parents to have infants sleep on their backs to reduce the incidence of Sudden Infant Death Syndrome (SIDS). Although this strategy led to a nearly 50% reduction in SIDS cases, it also coincided with a rise in the number of babies with cranial disorders.
In addition, cranial deformities can also result from babies spending too much time spent on their backs during the day in car seats, swings and other baby carriers.
If you believe your baby has a flat area or abnormal head shape, you should consult your pediatrician. While he should examine your baby’s head during each visit, at three months he should measure your baby’s head and look for cranial symmetry. If an asymmetry of 8mm or more is present, you should consult a professional who deals with plagiocephaly such as a licensed orthotist.
Fortunately, there are noninvasive options which can correct positional plagiocephaly within a matter of months. After examining your baby, an orthotist will recommend a course of treatment. For best results, treatment should take place between four and seven months of age. One of the most common methods is a cranial remolding orthosis such as a STARband cranial helmet. There are a variety of STARband designs which can accommodate different head shapes and circumstances. Once a specific model is chosen, the orthosis is custom-made to the infant.
Basically, a cranial helmet works by keeping contact with the main areas of the head where growth should be restricted and by leaving room for growth in flattened areas. The idea is to force the skull to grow in a more symmetrical fashion. Believe it or not, an infant’s own growth is the key to a successful orthotic treatment program.
Typically, an infant is examined every two to three weeks during a three to four-month course of treatment. Although factors such as the severity of the deformity and individual growth patterns will affect how long a child must wear his helmet, younger infants will generally finish treatment faster than older ones. Luckily, most cranial remolding programs can be accomplished with a single orthosis.
When plagiocephaly happens during childbirth, it will usually resolve itself within a few weeks. Nevertheless, it can also develop as a result of sleeping habits and other practices shortly after a child is born. There are times, however, when the deformity is too severe to resolve on its own. For this reason, it is critical to seek the help of a qualified physician if this condition persists for longer than six weeks. The good news is that, if caught early, there are noninvasive treatments that can resolve the problem quickly and effectively.