POSITIONAL PLAGIOCEPHALY

TYPES

There are two main types of positional plagiocephaly: plagiocephaly and brachycephaly.

1. Plagiocephaly: Plagiocephaly is characterized by a flattening on one side of the baby’s head, resulting in an asymmetrical shape. This can occur when a baby consistently rests their head in the same position, causing increased pressure on one side of the skull. Plagiocephaly can also be accompanied by facial asymmetry, with features appearing slightly uneven.

2. Brachycephaly: Brachycephaly refers to a flattening of the back of the baby’s head, resulting in a wider and shorter appearance. This usually occurs when a baby spends excessive time lying on their back, leading to pressure on the back of the skull. Brachycephaly is commonly associated with the Back to Sleep campaign, where infants are placed on their backs to reduce the risk of Sudden Infant Death Syndrome (SIDS).

SYMPTOMS

The main symptom of positional plagiocephaly is an abnormal head shape. Here are some specific symptoms associated with the condition:

1. Flattening of the head: Positional plagiocephaly can cause flattening or asymmetry in the shape of the baby’s head. This can be seen as a flat spot on one side or the back of the head.

2. Facial asymmetry: In some cases, positional plagiocephaly may lead to facial asymmetry. This can include uneven ears, misalignment of the eyes or jaw, or a tilted forehead.

3. Uneven hair growth: As a result of the head shape abnormalities, babies with positional plagiocephaly may experience uneven hair growth. Hair may appear thicker or sparser on the affected side.

4. Limited range of motion: Infants with positional plagiocephaly may have difficulty turning their head or prefer to look in one direction. This limited range of motion is often due to muscle tightness or discomfort caused by the head shape abnormality.

DIAGNOSIS

The diagnosis of positional plagiocephaly is usually made through a physical examination by a healthcare professional, such as a pediatrician or a craniofacial specialist. During the examination, the healthcare professional will assess the shape of the baby’s head and look for signs of flattening or asymmetry.

In some cases, additional diagnostic tests may be recommended to rule out other potential causes of head shape abnormalities. These tests may include:

1. X-rays: X-rays can help evaluate the position and alignment of the skull bones. They can also help identify any underlying structural issues that may be contributing to the head shape abnormality.

2. CT scan: A CT scan provides detailed images of the skull and can help assess the extent of the head shape abnormality. It may be recommended if there are concerns about the severity of the condition or if other underlying issues are suspected.

TREATMENT

The treatment for positional plagiocephaly depends on the severity of the condition and the age of the child. Here are some common treatment options:

1. Repositioning: In mild cases, repositioning techniques can be effective. This involves changing the baby’s head position during sleep and awake time to reduce pressure on the flattened areas. Alternating the baby’s head position from side to side and encouraging supervised tummy time can help promote more even head shape development.

2. Physical therapy: In some cases, physical therapy may be recommended to address any underlying muscle tightness or imbalances that may be contributing to the head shape abnormality. A physical therapist can provide exercises and stretches to help improve neck muscle strength and range of motion.

3. Helmet therapy: If repositioning and physical therapy do not sufficiently improve the head shape, a custom-fitted helmet may be recommended. The helmet applies gentle, constant pressure to the baby’s skull, encouraging more symmetrical growth and reshaping the head over time. Helmet therapy is typically most effective when started between 4 and 6 months of age.