Ever since the 1994 Back to Sleep recommendations came out, the incidence of SIDS has dropped 80%, but the incidence of positional plagiocephaly has increased 600% to approximately 13% of children. Because it’s now so common, Lemondrop asked me to talk about this based on a post by Miranlee.

Positional plagiocephaly is a generally benign and reversible condition resulting in flattened head shape.  Still, there are some other conditions that your pediatrician will need to rule out in making the diagnosis.  One, torticollis, was mentioned by emama in the thread linked above.  This is a condition where the muscles in your baby’s neck don’t stretch normally.  The condition can be treated with the help of a pediatric physical therapist, who will show you stretching exercises that you can do with your baby.  Another, craniosynostosis, occurs when the skull sutures prematurely fuse.  If your baby has been found to have this condition, you will be referred to a specialist for definitive management.

Prevention:

1.  Each night alternate which side of the head your baby is laying on.  They may move, but this should help keep some symmetry.

2.  Avoid long term use of car seats or swings as places that your baby naps or spends a lot of time.

3.  Do at least 30-60 minutes of tummy time daily.  This should NOT occur during naps or nighttime sleep, but rather when your baby is awake and you are supervising.

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4. Position your baby at different places in the room so that he or she doesn’t always look in the same direction.  We do this by placing interesting pictures on the wall next to Jack Jack’s crib, and then flipping which way we position her so that one day she’s looking to her left and one day she’s looking to her right.

If your baby already has flattening:

The baby’s head is most malleable between 2-4 weeks of age, with peak flattening observed at 4-6 months of age.  As the brain develops, you should see regression of the flattening.

1.  Continue to do the preventive techniques discussed above.

2.  You can lengthen your supervised tummy time.

3.  Check for torticollis and craniosynostosis with your pediatrician and obtain neck stretching exercises for torticollis.

4.  If the degree of flattening is severe and your pediatrician is concerned, you can get a referral to a craniofacial specialist.  They can provide a hard plastic helmet specially molded for your baby that the child will wear 23 hours a day.  There is no great evidence to suggest that this is significantly better than positioning in younger age groups (6 months and under).  Helmets are best used in children 6-12 months of age or older who have failed the measures described above.

Rest assured that most of the issues with head flattening are cosmetic and that using positioning techniques and allowing time for head growth will usually resolve the issue!

Reference: Prevention and Management of Positional Skull Deformities in Infants

*The information on this site is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment, and is for education purposes only.  Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.

Hellobee Series: Mrs. Jacks part 4 of 12

1. Attachment Parenting: One strategy by Mrs. Jacks
2. School is now in session! by Mrs. Jacks
3. Babywearing 101: Inward or outward facing? by Mrs. Jacks
4. My baby's head is flat! What's the deal with plagiocephaly? by Mrs. Jacks
5. Responsible media viewing by Mrs. Jacks
6. What to do when your baby goes on bottle strike by Mrs. Jacks
7. Birth plans: the other side of the story by Mrs. Jacks
8. Beyond colic: milk/soy protein intolerance by Mrs. Jacks
9. Cracking the code on toddler tantrums by Mrs. Jacks
10. Talking with children about race by Mrs. Jacks
11. Toddler eating habits cause parental grey hair by Mrs. Jacks
12. A warm winter treat by Mrs. Jacks