Deformational Plagiocephaly is an asymmetry of the skull, most commonly on the back and side of the head. As parents, you may notice asymmetry of their face and skull, this includes a flattening of your baby’s head, forward placement of their ear and some bulging on the front part of their skull. Research tells us that there has been a rapid increase in plagiocephaly since the American Academy of Paediatrics Back to Sleep Campaign in the early 1990’s. It is important to note, that not all children who sleep on their back develop a ‘flat head’. So, what are the other risk factors?
• male gender
• positional preference
• limited head movement
• first-born child
• lower level of activity and lack of tummy time 4,6
The skull/cranial system of babies is soft and heavy, and a lack of head turning or a preference to turn the head to one side, may initiate flattening. In practice, I commonly assess the movement of the cranial or cervical (neck) region and notice that when there are imbalances here, this may create a positional preference particularly while sleeping.
The easiest way to observe if your baby has a flat head, is to lay them on their back and look directly at the top of their head.
A common observation I have seen in practice is parents notice their baby:
• favours one side in the cot whilst asleep or during floor time while playing
• favours one breast when breastfeeding
• is fussy to attach to the breast
• dislikes Tummy Time
There are some great ways you can help encourage strength and range of movement of the neck at home, these include active tummy time and ball rocking. View my previous blog post on Having Fun with Tummy Time for more details.
Research suggests that when Deformational Plagiocephaly is left unaddressed, language and cognitive development is affected, even into toddler and childhood years2,3. The good news is, there is a large window of opportunity where changes can be made to assist babies who have deformational plagiocephaly or ‘flat head’. In my practice, you’ll expect me to ask a detailed history about your pregnancy, your birth, and your baby’s sleep, play, feeding habits plus more. In terms of my assessment, I use a craniometer to measure the degree of plagiocephaly, and I assess for muscle tone, milestone achievement, primitive and postural reflexes. All of which is thorough and specific to you and your baby’s case, as this allows me to provide an appropriate care plan.
Dr Carla Vescio, Chiropractor
BHSc(Chiro), MClinChiro, Webster Certified
If you have any questions, feel free to speak with Dr. Carla about your options. You can make a booking to meet with Dr. Carla here
- Branch., L.G, Kesty., K, Krebs., R, Wright., L, Leger., S, & David., L.R. (2015). Deformational plagiocephaly and craniosynostosis: trends in diagnosis and treatment after the back to sleep campaign. Journal of Craniofacial Surgery. 26(1), 147-140. doi: 10.1097/SCS.0000000000001401.
- Collett, BR., et al. (2011). Development in toddlers with and without deformational plagiocephaly. Archives of Pediatrics and Adolescent Medicine, 165(7), 653-658. doi: 10.1001/archpediatrics.2011.92.
- Collett, BR., et al. (2012). Development at age 36months in children with deformational plagiocephaly. Journal of the American Academy of Pediatrics, 131(1), 109-115. doi: 10.1542/peds.2012-1779.
- De Bock., F, Braun., V, Renz-Polster., H. (2017). Deformational Plagiocephaly in normal infants: a systematic review of causes and hypotheses. Archives of disease in childhood. 102(6), 535-542. doi: 10.1136/archdischild-2016-312018.
- Hutchinson., L, Stewart., A, Mitchell., E. (2007). Infant sleep position, head shape concerns, and sleep positioning devices. Journal of Paediatrics and Child Health, 43(4), 243-248. doi: 10.1111/j.1440-1754.2007.01054.x
- Murgia., M, Venditto., T, Paoloni., M, Hodo., B, Alcuri., R, Bernetti., A, Santilli., V, & Mangone., M. (2016). Assessing the cervical range of motion in infant with potiional plagiocephaly. The Journal of Craniofacial Surgery. 27(4)1060-1064. doi: 10.1097/SCS.0000000000002644.