Plagiochephaly

Positional plagiocephaly is flattening or molding of an infant’s skull due to prolonged contact with external surfaces. It often becomes apparent when an infant is two or three months old.

There are two major types of plagiocephaly:

1. Infants with occipital plagiocephaly have a head shape that looks like a parallelogram. The ear will be forward on the same side as the flattened part of the head.

2. Infants with flattening across the entire back of the head have a kind of plagiocephaly called brachycephaly.

Causes

• Head turning preference to one side-this maybe baby’s preferred sleep position.

• Tight neck muscles which limit them turning their head fully- your baby may need stretches to their neck muscles which will be taught by your physiotherapist.

• Position in utero or after a difficult labour.

• Lack of tummy time- although it is recommended that all babies sleep on their backs, it is essential that they experience tummy time regularly throughout the day.

• Prematurity-babies born too soon have softer skulls, which are more prone to moulding

Intervention

Sleeping

• Always place your baby on their back to sleep. Alternate which end of the cot you place your baby to sleep each night, this will encourage them to face both directions.

• Rearrange nursery furniture. Babies are attracted to look at light sources and may try to turn their head towards a window.

• After your baby has fallen asleep, gently move their head to the non preferred side, to take the weight off the flattened area.

Playtime

• Tummy time is very important. It is a good position for your baby to practise lifting their head, develop strength in their back and neck muscles and take weight through their arms. A small roll under their chest may help them maintain this position. Try a little and often approach.

• Reduce the amount of time your baby spends in one position where there is uneven pressure on their head, e.g. baby bouncer chair, car seat. Place your baby in a variety of positions to play.

• Encourage active head turning away from their preferred side using bright and interesting toys, sounds or people’s faces When awake and lying on their back position their head in the middle using a towel, pillow or blanket (only when awake and supervised).

Feeding

• If bottle feeding alternate the arm in which you hold your baby and encourage them to look away from their preferred side.

Holding and Carrying

• Hold your baby facing away from you with their ear resting in the crook of your elbow and your other arm between their legs for support, you can do this to either side.

• Hold your baby close to your chest with their head turned to their non- preferred side.

Travel

• Try to minimise the use of car seats to when your baby is in the car. Using a sling is a good alternative to a buggy when you are out and about.

• Check how your baby is lying in their car seat. Consider using a small towel to position your baby’s head in the middle and make sure this does not interfere with the straps. Always follow the manufacturers advice to ensure this does not interfere with the function of the car seat or compromise your baby’s safety

• If possible position the car seat so that turning to look out of the window is turning away from their preferred side.

Helmets

• The benefit of specialist helmets remains controversial and is not supported or recommended by the Association of Paediatric Chartered Physiotherapy

If you are looking for a children’s physiotherapist in Gloucester, head to our contact page and get in touch.