Plagiocephaly

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What is plagiocephaly?

This condition is also referred to as “flat head syndrome,” that is, the flattening of the cranium following prolonged pressure on the baby’s head. (CHU Ste-Justine, 2018)

What are the causes?

  • Poor intrauterine positioning
  • Back sleeping
  • Torticollis
  • Lack of autonomous movement
  • Prolonged periods in a car seat or other type of seat 

How to prevent plagiocephaly

(CHU Ste-Justine, 2018)

During sleep: a safe environment and always on the back

  • Vary the orientation of your baby’s head (alternating between pointing to the head of the bed and pointing to the foot of the bed)
  • Vary the position of your baby’s head in the bed (alternating between facing the right and facing the left)
  • Place a mobile in the centre of the bed above your baby’s bellybutton, not their head. Beware of new positioning tools. They’re not always useful and can be unsafe for your baby.

During awake time

  • Place your baby on their stomach several times a day for short periods, based on tolerance.
  • When your baby is on their back, encourage rotation of the head from side to side.
  • Position your baby on their side, with a small roll against their back for support.

About torticollis

“Often associated with plagiocephaly, torticollis is a head posture that appears when the baby constantly keeps their head tilted to one side with their chin pointing in the opposite direction.” (CHU Ste-Justine, 2018)
“Torticollis is caused by stiffness in one of the neck muscles, the sternocleidomastoid, on the side the head is tilting toward.” (CHU Ste-Justine, June 2018)

The consequences of plagiocephaly

(Aarnivala et al., 2015)

Aesthetic consequences:

  • Flattening of the cranium on one side
  • Forehead that’s more prominent on the affected side 
  • Displacement of the ear or the cheek on the affected side 

Plagiocephaly does not hinder brain development. (Thibault, 2019) 

Other actions you can take on a daily basis

  • Alternate sides when bottle feeding or carrying the baby.
  • Limit the time spent in a car seat or other type of seat.
  • Keep the head well aligned when the baby is in a swing (place a small roll on either side of the head) and limit swing time.
  • Prioritize use of the activity mat.
  • Toys that place the baby in a standing position are not recommended (lead to poor alignment of the body and head). (CHU Ste‐Justine, 2018)

Who to refer to, if needed

Your baby has a flattened head, more difficulty turning their head to one side than to the other, or has a tendency to always turn their head to the same side?

Talk to their doctor and/or see a physiotherapist, who will conduct an assessment and refer you to the appropriate treatment.
(Thibault, 2019)

Information brochure

Consult the information brochure on positional plagiocephaly, developed by the CISSS du Bas-Saint-Laurent, at this link.

References

Aarnivala, H., Vuollo, V., Harila, V., Heikkinen, T., Pirttiniemi, P., & Valkama, A. (2015). Preventing deformational plagiocephaly through parent guidance: a
randomized, controlled trial. European Journal of Pediatrics, 174 (9), 1197-120.

Cavalier, A., & Picaud, J. C. (2008). Prévention de la plagiocéphalie posturale. Archives de pédiatrie, 15(1), S20-S23.

CHU Ste-Justine. ( 2018). Torticolis et plagiocéphalie. Repéré à https://www.chusj.org/soinsservices/T/Torticolis-et-plagiocephalie

SickKids. ( 2011). Plagiocéphalie positionnelle (Syndrome de la tête plate). Repéré à https://www.aboutkidshealth.ca/fr/Article?contentid=24&lan
guage=French

Thibault, A. (2019). Plagiocéphalie : pourquoi mon bébé a‐t‐il la tête plate? Ordre professionnel de la physiothérapie du Québec. Repéré à https://oppq.qc.ca/blogue/plagiocephalie/

Unwin, S., & Dika, C. (2017). Deformational Plagiocephaly‐‐A Focus on Prevention. Journal for Nurse Practitioners, 13(2), 162‐169.