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Deformational Plagiocephaly

Deformational plagiocephaly occurs when a baby develops a flat spot somewhere on the head. This happens when an infant sleeps in the same position most of the time or has issues using their neck muscles properly that result in a preference turning their head one way or the other.

Deformational plagiocephaly may remind new parents of another disease, craniosynostosis. Craniosynostosis occurs when the bones of the head fuse together before they have a chance to harden. Deformational plagiocephaly does not involve the fusion of any of the bones in the skull. You may also hear deformational plagiocephaly called flat head syndrome or positional plagiocephaly.

Symptoms

The only noticeable symptoms of deformational plagiocephaly is a flat head on the back of the head. In many cases the flat spot develops over the first few months of life and is not immediately noticeable at birth.

Causes & Risk Factors

There are a few different things that can cause a baby to develop deformational plagiocephaly. These include:

  • Muscular torticollis. This is present at birth and involves extreme tightness in one or more of the neck muscles. This causes the head to remain in the same position.
  • Back sleeping. Sleeping on the back or in a car seat for long periods of time without changing positions can lead to a flat spot on the head. However, the back is the safest place for an infant to sleep. Back sleeping reduces the risk of sudden infant death syndrome (SIDS).
  • Premature birth. The bones in a premature baby’s skull are even softer than those in a full-term baby’s skull. Many premature babies also spend time in the same position if they’re put on a respirator when they are first born.

Risk factors for deformational plagiocephaly include being first-born, assigned male at birth, and being born with the help of medical tools like forceps.

Diagnosis & Complications

Your healthcare provider should check for deformational plagiocephaly until your baby’s skull bones completely ossify or harden. Your healthcare provider will do an exam of your baby’s head at birth and at each check up until their bones fully harden, particularly along the suture lines where the skull bones meet, to see if they notice any flat spots. They may also measure to see how severe any flat spots are.

Complications of deformational plagiocephaly are rare. Babies begin to move themselves more frequently as they get older, alleviating any pressure causing the flat spot in the first place. This usually allows deformational plagiocephaly to self-resolve. However, with moderate to severe plagiocephaly, there’s a risk that it may not improve without help. If treatment is not started in these cases soon enough, there is a possibility that the head will always be flat in that certain spot.

Treatment & Prevention

Treatment for deformational plagiocephaly depends on the baby’s age and health. Some potential treatments include changing your baby’s sleep position by turning the head manually, giving your baby as much tummy time as possible when they’re awake, and physical therapy to encourage development of the neck and torso muscles.

If your child’s plagiocephaly is still an issue at six months, your healthcare provider may recommend that they wear a cranial orthotic helmet. These are very effective when fitted properly for your baby.

Deformational plagiocephaly has increased as awareness of the importance of back sleeping for infants has increased. Back sleeping prevents sudden infant death syndrome, or SIDS. While your baby is back sleeping, you can prevent deformational plagiocephaly by giving them as much supervised tummy time as possible during the day, holding your baby, and minimising time in car seats and other infant devices.

 
 
 

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