Plagiocephaly – what can I do?
Plagiocephaly is a term used to describe the flattening or asymmetry of baby’s head shape – usually by extrinsic forces such as a firm surface a baby’s head lies on. In most cases, plagiocephaly is not harmful to children and is merely cosmetic. It is not uncommon in newborn babies to notice slight flattening of the head as the bones are soft and malleable at this age.
Most of the time, plagiocephaly is caused by the position that a baby’s head remains in for long periods of time. If you notice your baby is preferentially turning their head one way, they may be more likely to develop a positional head preference when lying which may lead to some flattening of the head on one side. Other causes of plagiocephaly include congenital muscular torticollis which describes the tightening of specific neck muscles which can limit a baby’s ability to turn their head both ways, which can also contribute to flattening of the head.
Whilst in most cases a flat head is the result of plagiocephaly, there can be other conditions that cause flattening of the head (such as craniosynostosis) that requires medical intervention. For this reason, we strongly advocate for children to be assessed by a paediatric physiotherapist.
At home strategies that can sometimes work include:
Changing the direction of the crib you place your baby to sleep. This is because babies often look towards the light. If baby turns their neck in a different direction it will also change which area of the skull is being slept on.
Increase tummy time during the day. The less time during the day that baby is resting on the back of the head – the better. In addition to this, whilst baby is supervised, placing them on an incline may reduce the pressure on the back of the head.
Use a carrier – this will help to reduce the amount of time that an infant is putting pressure on the back of the head
Gently stretch the neck from side to side. If neck tightness is contributing to the plagiocephaly stretching the neck from left to right can be helpful. If babies head can’t turn equally to each side – strongly consider a physiotherapy assessment.
Eye follow exercises. When babies are born the balance systems responsible for coordinating their eye follow is still developing. This can cause reduced visual coordination to one side and may contribute an infant only looking in one direction. Helping baby to practice looking to the opposite side can be helpful.
The best time to intervene for children with plagiocephaly is as early as possible. Physiotherapy can be very effective from 2 weeks to 5 months. When children get closer to 5-6 months, there is reasonable evidence to suggest that helmet therapy should be considered to treat moderate and severe plagiocephaly. This said, every child is different and an accurate assessment is required to make an informed decision around the best treatment pathway.
Reach out if you need assistance!
