If you notice your baby is developing a flattened area on the side or the back of their head, it could be due to a head turning preference and is a sign of positional plagiocephaly.
Plagiocephaly is caused when a baby spends a lot of time lying in the same position. The skull is made up of several plates, which are still soft and pliable before six months. This means that the shape can be altered by external pressures, and so babies skulls are susceptible to being 'moulded' into a flat shape. The ear on the flattened side may be pushed forward and the face may be asymmetric.
The causes are due to one or a combination of the following: tight neck muscles, sleep position, prematurity, lack of tummy time, and prolonged use of car seats. It can also occur while the baby is still developing in the womb.
It is helpful to encourage your baby to use different positions so their head is not always lying in the same position. Ways to encourage this include: placing your baby in the cot to encourage looking towards the less preferred side; positioning them for play so that visual stimuli are from the less preferred side; setting aside time everyday to actively play with your baby on their tummy; trying not to use a car seat apart from when travelling in the car.
For those with difficulty turning the head in one direction, physiotherapy can be very helpful. The sooner the head turns as easily one way as the other, the sooner natural correction of head shape can begin.
Plagiocephaly will stop worsening once they are not favouring just the one position. Head shape will start to improve, with growth, up until about her age of five years. Some flattening is part of normal variation of head shape and will largely be disguised by hair. It should be noted that this is just cosmetic and does not affect how the child’s brain develops or cause any brain abnormalities.
Michelle, our paediatric physiotherapist, will firstly ask a detailed history (including pregnancy, birth and development to date) and then fully assess your baby for head turning preference and plagiocephaly. You will then be taught stretches for your babies neck muscles if necessary, and provided with many practical ideas on how to encourage your child to use different positions to improve their head shape.
Positional talipes, erb’s palsy, abnormalities with walking, symptomatic hypermobility and normal developmental variants.