First of all, you are not alone!!! Today, nearly 1 in every 2 infants (47%) is affected by some degree of plagiocephaly. Plagiocephaly is a fancy term for a misshapen skull or flat head syndrome.
1 in 4 (~25%) have moderate to severe plagiocephaly.
Fortunately, the condition is treatable - there is something you can do!
The best way to monitor a headshape is with pictures. Our recommendation is to take pictures once a week (birds eye view) so flattening can be identified quickly. Watch the back of the head, as this is where you’ll see the flattening first.
Because a newborn’s skull is very soft at birth, it is susceptible to forces placed upon it. Since all infants should sleep on their back, there is prolonged increased pressure on the back of the skull while sleeping. This can cause misshaping of the skull. The good news is with more awareness it can be prevented and then easily corrected with early intervention.
Skull asymmetries can be caused by positioning in the womb, so sometimes you will notice it at birth. Most parents, however, recognize headshape differences by 2 months of age. Our goal is to have parents of newborns watching the head shape from day 1 so they can seek treatment or modify their day-to-day activities immediately.
Other possible reasons for flattening include:
If you notice a flat spot, try the suggestions above for a week or two, but if you are not seeing noticeable improvement, a therapy referral is probably your best bet.
THERE IS A VERY SMALL WINDOW OF OPPORTUNITY FOR RESHAPING.
SO THE "WAIT AND SEE" APPROACH IS NOT RECOMMENDED. THE IDEAL AGE TO SEEK HELP IS BETWEEN 4-8 WEEKS OF AGE!!
You will sometimes hear "It will get better on its own" or "It will get better once they start rolling/moving/sitting". Unfortunately, these are WRONG.
External forces are the only way to help reshape a skull and when your baby starts to move on their own, the window of opportunity is almost completely closed to change head shape.
This external force typically comes from strategic repositioning when the baby is sleeping on their back (which is between birth and 4 months of age). Positioning should always be your first line of defense if appropriate for your baby's age.
The BEST time to start physiotherapy is between the ages of 4-6 weeks.
Earlier is better!!
The physiotherapist will assess your baby and provide you with positioning suggestions, stretches and other activities to help with their head shape, neck and body movement and overall development.
There are many things you can start to do right away if you notice that your baby is developing a flat spot. The main goal is to get pressure OFF the flat spot and onto the FULLER part of the skull.
If treatment is not initiated before the baby starts to move/roll (often around 4 months of age) then there is very little success in modifying head shape. In these cases, if you are looking to reshape your baby's skull, then a helmet may be an option.
Although physiotherapy alone may be not be as effective in reshaping the skull after your baby starts to move, physiotherapy can still be extremely valuable. The goal with movement for infants is SYMMETRY.
Often when a baby has plagiocephaly, there is also asymmetry through their neck (torticollis) and/or trunk and core (tortisoma).
You may see this asymmetry in movements such as preferring to roll to one side more than the other or lying or sitting in a curved position.
Physiotherapy can help!
Head is flat on one side. Head appears skewed to one side from above. One ear is often more forward than the other
Head is wider than normal. Back of head is flat rather than curved. Head may be widest above the ears.
Head is longer, taller and narrower than normal
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