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Deformational Plagiocephaly

Deformational plagiocephaly is the name for the flat or misshapen head a baby develops after repeatedly putting pressure on the same side of its skull. Babies have soft skulls at birth, to allow them to squeeze through the birth canal. Unfortunately, these same soft skulls can lead to a flat head over time, if the baby is always laid in the same position, like in a baby that sleeps in the same position every night. Deformational plagiocephaly can also happen to babies with congenital torticollis, a condition in which the muscles on one side of the baby’s neck are too tight, causing their head to twist to the other side. Congenital torticollis gives babies a head-turning preference and can lead to deformational plagiocephaly.

Deformational plagiocephaly is sometimes known by its more common name – Flat-Head Syndrome. This syndrome is different than craniosynostosis, another birth disorder that can lead to a misshapen head. Craniosynostosis is caused by the premature fusion of bones of the skull, while deformational plagiocephaly is caused by lying down on one side of the skull too often. Craniosynostosis usually leads to a skull with a bulgy appearance, while plagiocephaly has a flatter appearance.

Symptoms

The symptoms of deformational plagiocephaly are related to the changes that come with putting pressure on one side of the head:

  • Flattening one side of the head
  • Uneven facial features, like one cheekbone lower than the other
  • Head tilted to one side
  • Forehead bulging on one side
  • Ear pushed forward on one side of the head

Cause

Deformational plagiocephaly is caused by repeatedly putting pressure on the same part of a baby’s head. It leads to a flat spot in that portion of the head. This repeated pressure can happen when a baby is still in the womb, especially in a crowded womb (if there are twins or triplets, the baby may not be able to turn their head and will always lie on the same side). It can also happen after birth if the baby is always lying down in the same position.

Risk Factors

There are several factors that increase the risk of deformational plagiocephaly, including:

  • Congenital torticollis – Babies with congenital torticollis have tighter than normal neck muscles on one side, so they tend to have their heads always tilted in one direction. The tilting causes them to lie down on the same part of their head over and over, and over time this can cause plagiocephaly. 9 out of 10 babies with congenital torticollis develop deformational plagiocephaly.
  • Twins or triplets – Sharing the womb with other babies generally means less space for each baby to move around. Babies who are twins or triplets are more likely to be squished during pregnancy and are at greater risk for always lying on the same part of their head, and thus developing deformational plagiocephaly.
  • Premature birth – Although all babies have softer skulls than adults do, preemies (babies born earlier than normal) have even softer skulls with less developed bones. These babies are at greater risk for forming a flat spot (plagiocephaly) than other babies.

Diagnosis

A paediatrician diagnoses deformational plagiocephaly by doing a physical exam of a child. Usually, the physical exam is enough to diagnose plagiocephaly, but your doctor might want some imaging studies done of your child’s brain to rule out other conditions like craniosynostosis.

Treatment & Management

The treatment for deformational plagiocephaly depends on how severe it is. Many times, plagiocephaly does not need to be treated. If its mild, it can go away on its own when the child begins to sit up. Other times simple changes such as giving a baby more tummy time and less time on his back or changing up your baby’s sleeping position frequently during the night are enough to treat it. Special moulding helmets are used to treat more severe cases of plagiocephaly, that might not correct without interventions.

 
 
 

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