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Friday, 06 June 2014 03:55

The flat head syndrome

What is flat head syndrome?

According to a news article published recently in the UK1, flat head syndrome, or plagiocephaly--where a baby has a noticeable asymmetry in the shape of their skull--is becoming much more common.  A study performed by Calgary’s Mount Royal University2 showed that nearly half (46%) of the 440 babies studied between 7 to 12 weeks of age had the condition to some extent.  

Plagiocephaly is currently said to be a cosmetic issue only, but many cranial specialists believe that is can cause spinal asymmetries, which can lead to pain and discomfort in later life. Plagiocephaly can be worrying to parents, and if severe may lead to psychological problems for the child due to facial unevenness later in life.

How does it happen?

Newborn baby skulls are extremely impressionable.  Before birth, skull bones are not fused together, which allows the bones to shift and slide underneath each other as the infant moves through the birth canal. After birth, the skull bones remain unfused to allow for brain growth.

In the very early stages of a baby’s life any prolonged or repetitive pressure on one part of the skull in comparison to the rest will cause asymmetries.

Why is it now more common?

It is thought that flat head syndrome is more common in today’s society because of a number of factors.

Back to Sleep Campaign

It is likely that the Back to Sleep SIDS campaign (a UK based campaign which encouraged parents to lay infants on their backs to sleep to minimize cot death risk) has had a large role in increased reports of plagiocephaly.  Infants are likely to favor turning their head one way (probably to face wherever Mom isor away from a wall) so whichever side is in contact with the bed surface will become flatter over time. 

Use of Travel Systems

Busy modern family lifestyles, which encourage increased use of car seats and travel systems, may play a role in increased cases of flat head syndrome.  Although essential for car travel, in recent times infant seats have often become the main mode of transport for babies so parents can run errands and manage family life.  The prevailing “travel systems” encourage overuse of car seats, as they click out of the car and onto the stroller. Being strapped into a restraint hinders the free movement of the baby’s head, so any developing flat areas of skull will undoubtedly become flatter with increased use.

Decreased Baby Wearing

A third factor in higher numbers of flat head syndrome may be the decreased use of baby slings and carriers in our modernized world.  In many developing countries babies are predominantly carried for the first few years of their life.  It has often been noted that there are far fewer cases of plagiocephaly in these cultures. 

How can this be helped?

Re-positioning your baby is a full time job, but in my opinion is extremely important. This advice can be applied to all new moms, but especially if you notice the slightest asymmetry in your baby’s head.  If you notice any irregularities you must begin re-positioning at once.  It is not as simple as turning your baby’s head whilst they lie in their cot! 

 Buy a baby carrier

There are plenty of options when it comes to “babywearing,” and a simple online search will provide lots of information.  Wear your baby as often as possible!  This will take all pressure off of your baby’s skull and allow it to develop naturally.  This will make an enormous difference and is one of the most important changes to make.  Not only can it reduce the possibility of plagiocephaly developing, but studies have also shown that babywearing may reduce colic and reflux in babies as well.3

Adjust bed so that baby must lie on the other side

Placing a rolled-up baby blanket underneath baby’s ‘flat’ side (underneath his head, shoulders and back) is a great way to encourageyour baby to sleep facing the opposite way.  Of course, you must continually assess your baby’s skull to decide when you should stop using the blanket or perhaps use it on the opposite side if needed.

Tummy Tummy Tummy Time

Tummy time is very important, but especially so if you are not frequently carrying/wearing your newborn. Tummy time not only reduces pressure on baby’s skull so it can grow and expand symmetrically, it also ensures your baby is adequately developing the posterior neck muscles (the muscles at the back of the neck), enabling them to safely hold up their head once they are old enough. In my clinic I have witnessed babies unable to hold their head up even though they can sit up, resulting in them leaning and falling over repeatedly to the same side!

Get Creative

Essentially everything you do with your baby can be altered so that = baby is not resting on the flat bit of her head.  This could include putting toys only on one side of the baby when lying on the floor or in the cot, changing the side the car seat is on if baby looks out of the window, or putting a toy or mirror on the seat to encourage head movement. 

A word about Helmet treatment

A study published in the May 2014 edition of the British Medical Journal has strongly discouraged the use of helmets for the treatment of moderate to severe flat head syndrome.  They concluded that the “high prevalence of side effects, and high costs associated with helmet therapy” far outweighed any potential benefit, and they also stated that letting the deformity follow its natural course was equally as effective4. 

What else should I know?

The most important piece of information to take away from this article is to please get your baby checked by someone who specializes in cranial therapy if you notice any flat areas on your baby’s head past age 6-8 weeks.  If the flattening is mild, then making the changes listed above may be all that is required; however, more pronounced deformities may need professional help.  You can always discuss any concerns with your Health Visitor or GP.

 

Sources:

1 "'Flat head syndrome' now affects 47 percent of babies and guidelines to prevent sudden infant death syndrome could be to blame". Daily Mail UK. July 2013. Web.

<http://www.dailymail.co.uk/news/article-2358511/Flat-head-syndrome-affects-47-percent-babies-guidelines-prevent-sudden-infant-death-syndrome-blame.html>

2 "The Incidence of Positional Plagiocephaly: A Cohort Study". Aliyah Mawji, RN, PhD, Ardene Robinson Vollman, RN, PhD, Jennifer Hatfield, PhD, Deborah A. McNeil, RN, PhD, and Reginald Sauve, MD, MPH, FRCPC.Pediatrics. Vol. 132 No. 2. pp. 298-304. Official Journal of the American Academy of Pediatrics. 1 August 2013. Web <http://pediatrics.aappublications.org/content/132/2/298.full>

3 "The Benefits of Baby Wearing." New Beginnings. Vol 21, No. 6. pp. 204-208. November-December 2004. Web. <http://www.lalecheleague.org/nb/nbnovdec04p204.html>

4 "Helmet therapy in infants with positional skull deformation: randomised controlled trial." van Wijk, RM, van Vlimmeren, LA, Groothuis-Oudshoorn, CG, Van der Ploeg, CP, Ijzerman, MJ, Boere-Boonekamp, MM. BMJ.  1 May 2014. National Center for Biotechnology Information.PubMed.gov. Web. <http://www.ncbi.nlm.nih.gov/pubmed/24784879>

Published in Newborn Care
Monday, 11 February 2013 11:22

Infant Chiropractic Care for Plagiocephaly

You may have noticed that some young babies have heads that aren’t exactly round; you may even have noticed it in your own baby. This common condition called plagiocephaly (plagio=oblique, cephal=head) and it occurs when the cranial system in a baby isn’t working properly. It can appear as a flat spot in some babies, or sometimes as a distortion through a baby’s whole head. A baby’s body is made mostly of membranes and cartilage, and is very pliable. The skull of a baby is basically a membrane, covered with bones that are not yet thick enough to protect the brain the way that an adult skull does. This makes it very easy for a baby’s head to become mis-shapen, especially if there has been trauma, or if there is a torticollis present (twisted neck).

While the cause of plagiocephaly remains largely unknown, there are a few things that may contribute such as birth trauma or not enough tummy time. All parents should be aware that a plagiocephaly isn’t just about having a baby with a funny shaped head. Plagiocephaly has been found to cause developmental delay in children according to several sources. (1, 2, 3)

There are many different kinds of plagiocephaly, and they are classified by the shape of the head with the deformity. Plagiocephaly needs to be assessed by someone who knows exactly what to do. Chiropractors with special pediatric training are a good place to start. Chiropractic has been shown to help babies with plagiocephaly (4), and if there is a problem that needs to be dealt with by a medical doctor (for example, if the sutures actually fuse, rather that get jammed, even though it’s very rare, it is a medical emergency that needs to be dealt with immediately), a chiropractor with postgraduate training in pediatrics will know what to do.

To find a chiropractor who is trained to deal with plagiocephaly please go to http://www.icapediatrics.com/members-referral.phpand type in your location. There are chiropractors trained in pediatrics near you.

References

  1. Hutchison BL, Stewart AW, Mitchell EA. Deformationalplagiocephaly: a follow-up of head shape, parental concern and neurodevelopment at ages 3 and 4 years. Archives of Disease in Childhood. 2011;96:1 85-90Published Online First: 29/09/2010
  2. Van Neil, C. Infants with Plagiocephaly Are at Risk for Developmental Delays as Toddlers. Journal watch Pediatrics & Adolescent Medicine. 2011 [1538-3571] Van Niel, Cornelius
  3. Hutchison BL, Stewart AW, de Chalain T,  Mitchell EA. Serial developmental assessments in infants with deformational plagiocephaly. Journal of Paediatrics and Child Health 2012; 2012: 48(3);274–278
  4. Leighton JM. Non-synostotic deformational plagiocephaly: An evidence-based case report. Clinical Chiropractic, Dec 2008; 11(4):211–218

 

Published in Newborn Health

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