Plagiocephaly & Treatment Options

What is plagiocephaly?

A condition which is characterized by the development of a flat spot on the back or side of an infant’s head.

• Affects nearly one in two infants
• One in ten infants should be evaluated for treatment 

What causes plagiocephaly? 

There are many different causes of flat spots in the developing head of an infant.

• Position in the womb due to limited space.
• Breech orientation.
•  Multiple births where space is limited for movement and repositioning.
• Premature birth due to particular softness of the infant’s skull and/or extended period of time following birth in a neonatal intensive care unit with the head in a fixed position due to presence of a respirator.
• Lack of normal head movement due to developmental delays.
• Congenital muscular torticollis which results in extreme tightness of the neck muscles causing difficulty with normal movement and repositioning of the head.
• Extended exposure to rigid surfaces such as car seats,bouncy seats and swings. Normal use is not a concern.
• Back sleeping (There is a strong correlation between back-sleeping and plagiocephaly, and while the American Academy of Pediatrics recommends back-sleeing to prevent Sudden Infant Death Syndrome, it also recommends frequent repositioning of the infant’s head and supervised tummy time to help prevent plagiocephaly). 

How will plagiocephaly affect my baby? 

• Plagiocephaly will not likely affect a baby’s neurological development.
• If left untreated, however, the head will remain misshapen as the baby grows into adulthood.
• May result in facial asymmetry.
• May cause eyeglasses to fit poorly due to the misshapen head.
• Presents with visible flat areas of the head, particularly with short hairstyles.
• Difficulty in fitting safety equipment such as helmets for sports, bicycling, skiing, etc. 

Types of of plagiocephaly

These shapes can occur with varying degrees of severity and can often occur in combination with one another. 

• Plagiocephaly-head is flat on one side
• Brachycephaly-head is wider than normal
• Scaphocephaly-head is longer, more narrow and wider than normal

Less Common Occurrence of Plagiocephaly

A less common reason for plagiocephaly occurs in the presence of craniosynostosis in an infant. Craniosynsotosis is a condition characterized by a misshapen skull due to abnormal fusion of the bones in the skull. Because your child’s pediatriciain routinely monitor’s the size, shape and growth of the head, this condition is usually diagnosed early and by your child’s pediatriciain. When the pediatrician is concerned that your child may have craniosynostosis, you will be referred to a pediatric neurosurgeon for further evaluation. If you have concerns about the shape of your child’s head, please contact your child’s pediatrician. 

Management of Plagiocephaly 

• Evaluation by a primary care physician and potentially by a pediatric neurosurgeon.
• Repositioning techniques, including supervised tummy time.
• Cranial helmet therapy, also known as cranial orthosis. 

For more information or to schedule an appointment, call 843-876-0111.