Introduction
Plagiocephaly is a flattening of the skull due to a baby having a preference for turning or lying to one side. This can occur due to the baby being packaged tightly in their mother’s womb during pregnancy or throughout the birthing process. A baby with plagiocephaly may demo
nstrate tight muscles on one side of the neck which encourage the baby to look and turn in a particular direction, this is known as a torticollis. Some babies may have also have a palpable lump in these tight neck muscles which can be alarming when first noticed by parents in the weeks following birth. These lumps are often benign in nature and resolve with time and appropriate physiotherapy intervention.
What are the risk factors for Plagiocephaly?
- Male
- First born
- Multiple pregnancy
- Prematurity
- Oligohydramnios (Not enough amniotic fluid during pregnancy) ;
- Forceps delivery
What will happen if you don’t get treatment?
Not all babies with plagiocephaly require treatment. Babies heads are programmed to grow in a spherical shape. If pressure is removed from the flattened area and the baby is encouraged to turn its head in both directions than the head will return to normal shape as the baby grows. However , if continued pressure is placed on one side of the head it can result in facial asymmetry and delayed acquisition of developmental milestones. The following strategies are therefore recommended for all babies:
- Try to alternate your baby’s head position between left and right rotation each time they sleep. NOTE: A baby must ALWAYS be placed on their back to sleep to reduce the risk of Sudden Infant Death Syn
drome(SIDS) or Cot death. - Encourage your baby to actively turn their head in different directions by changing the position of the cot in the room or alternating which end of the cot your baby sleeps at.
- Encourage your baby to play on their tummy or side when they are awake to strengthen their neck muscles and encourage motor development
- Vary the positions that you hold and carry your baby to encourage movement of the neck in multiple directions
Physiotherapy treatment
Physiotherapy intervention is particularly important in babies who have been diagnosed with a torticollis or lump in their neck. Studies have shown that the earlier the child commences treatment for their plagiocephaly the better the outcome.
The goal of physiotherapy treatment is:
- To restore full neck range of motion
- Decrease muscle tightness
- Improve facial and cranial symmetry
- Encourage age appropriate development of gross motor milestones
What does physiotherapy treatment involve?
- Parental education
- Stretches
- Positioning ideas to encourage movement to the neglected side and lengthen tight neck muscles
- Ideas for active ideas to strengthen weak neck muscles
Conclusion
Plagiocephaly is an easily treatable condition, particularly is diagnosed early. If you are concerned that your baby is demonstrating a turning preference or some flattening on one side of their skull than a review by a health professional is advised. If you would like a physiotherapy review contact us or book an appointment online.
References
Hutchinson, L., Stewart, A., de Chalain, T., & Mitchell, E. (2010). A randomised controlled trial of positioning treatments in infants with positional head shape deformities. Acta Paediatrica, 99(10), 1556- 1560.
Royal Children’s Hospital Melbourne. (2004). Plagiocephaly: Misshapen head. Retrieved from http://www.rch.org.au/kidsinfo/fact_sheets/Plagiocephaly_misshapen_head/.
Serong, A. (2015). Deformational plagiocephaly. Paediatric Physiotherapy Theory, the University of Melbourne.
Skinner, K. (2012). Guide for parents: Torticollis and plagiocephaly. NSW Health, Western NSW Local Health District.
Vlimmeren, L., Helders, P., van Adrichem, L., & Engelbert, R. (2006). Torticollis and plagiocephaly in infancy: Therapeutic strategies. Pediatric Rehabilitation, 9(1), 40-46.
