Plagiocephaly is the technical term for wonky heads. The infant skull is made up of a group of pliable bones which are designed to mould, both within the bone (bending) and between bones (overlapping). This allows the head to pass more easily through the birth canal. Normally the baby’s head will return to normal within a few days of birth. If not, there are a range of possible causes of plagiocephaly:
During the birth process the baby’s head may be subject to prolonged squeezing, or to distortion through the use of instruments such as forceps or ventouse. If your baby was engaged in the pelvis before birth, or was squashed by a twin or fibroid, then this may also cause retained moulding.
If your baby’s head changes shape after birth, this is usually positional – due to lying in one position for a long time. Since the ‘back to sleep’ advice came in, there has been a huge increase in positional plagiocephaly. Remember to allow your baby some ‘front to play’ time every day so that he is not always on his back.
Sometimes there is a torticollis or ‘wry neck’ preventing the infant from turning his head, forcing him to lie in one position. Another possible cause is craniosynostosis. This is where the infant skull bones fuse – usually along one join, but sometimes involving more bones. It is important to check if this is the cause of your baby’s wonky head as it may need surgical treatment – but it is very rare.
If you are concerned about the shape of your baby’s head, do ask your GP or Health Visitor for advice. An Osteopath can also assess your baby and advise you on an appropriate course of action. When your baby starts sitting the head shape will often start to resolve naturally, but it does take some time.
You might also consider using a baby pillow to support your baby’s head. A bit of history: – Health Visitors used to advise that babies be placed on their back with a pillow. Then research showed that there was a risk of them choking on their own vomit so the advice changed to lying babies face down, without a pillow. Then the SIDS research suggested a link with lying face down and the advice changed again to lying babies on their back – but they left out the pillow! Plus there was some concern that if there was a pillow and the baby turned its head, it might suffocate. However, in Sweden, the current advice for all newborns is to lie on their back – but with a pillow under head and shoulders to prevent plagiocephaly. These baby pillows are cheaply available in the UK and are endorsed by several paediatricians and osteopaths. Another option is a specially designed mattress which supports the baby’s head without a pillow.
The big question is about helmets. These have been introduced quite recently as a treatment for severe plagiocephaly. There is no long term research on their effects yet, and they are expensive. They provide a protective shell for the skull so that the pressure is taken off the bones, allowing the head to return to a more symmetrical shape. Babies seem to tolerate them quite well. Clinics vary as to the latest age that a baby can be fitted with a helmet – somewhere between 9 and 12 months is usual. Please inform yourself about this option – see links below – and discuss it with your GP, Health Visitor or osteopath before you decide.
www.londonorthotics.co.uk Clinics in London and Ross on Wye
Ossur Clinics in various centres around Britain
Parents have a forum for discussing plagiocephaly at www.plagiocephalycare.org and this website also has good advice for preventing positional plagiocephaly using conservative, home based measures.