Mothers and fathers sometimes encounter an asymmetry in the head of their newborn children. It seems to be “flat” or a little crooked, tilted. This feature can be treated and is known as plagiocephaly, or flattened head syndrome . There are mild and other more serious cases, which may need an orthopedic helmet to correct the formation.
Up to the first six months of life, any deformation or change in the growth of the baby’s head can be considered a case of cranial deformation , with plagiocephaly being one of them. For a diagnosis, the doctor must first differentiate plagiocephaly from brachycephaly and scaphocephaly, which are very similar, but plagiocephaly only deforms one side of the head.
Sometimes tests such as X-rays, Computed Tomography or Magnetic Resonance Imaging are prescribed, but it is usually not enough to need them to recognize plagiocephaly, and visual inspection and measurement by a craniometer are sufficient.
Plagiocephaly can be classified into three levels , depending on the difference in the measurement of the angles of the two longest diagonals of the baby’s head. In cases where there is no asymmetry, these diagonals form angles of the same measure. When there is a difference, it can be calculated as follows:
|Mild plagiocephaly||Up to 9 mm|
|Moderate plagiocephaly||10 a 19 mm|
|Severe plagiocephaly||But of 20 mm|
Causes of Plagiocephaly
Positional plagiocephaly (PP), unlike other anomalies of the cranial shape, is caused by factors external to the baby’s body : such as, for example, its position in the uterus during pregnancy. When the child in formation stays for a long time on the same side, or in the same position inside the mother’s belly, this can result in congenital torticollis and positional plagiocephaly.
Also after birth, if the baby does not move around a lot and spend a lot of time lying down, he may also develop postural plagiocephaly . This is because the baby’s skull bones are not yet fully formed, having movable plates, called sutures.
Therefore, the pressure of the mattress or pillow on your head can cause these plates to flatten, especially behind ( anterior plagiocephaly ) or on one of the sides. As there is also not enough strength in the neck to support the head, the entire weight of it goes straight to the point of contact with the mattress, causing the deformation. From these causes of plagiocephaly, it can regress spontaneously if pressure on the affected area does not continue.
It is also proven that the majority of cases occur in male babies . Some other associated diseases, such as craniostenosis , premature births and other risk factors, may be associated with the cause of plagiocephaly. Check the table with the main Risk Factors:
|Pre and perinatal||Postnatal|
An interesting fact is that, after the American Academy of Pediatrics recommended that parents put their children to sleep on their backs (supine position) to avoid Sudden Infant Death Syndrome , there was an increase, on the other hand, of plagiocephaly in American babies, which reaches 13% of newborns .
In the case of Brazil, studies are still being done. However, as plagiocephaly is not as serious as the risk of sudden death, it is even more recommended that the baby sleep on his back, and that other measures be taken for treatment.
Recommendations to Prevent and Treat Plagiocephaly
The concern with plagiocephaly is important, because it causes deformations, and, especially if there is an early detection of the problem (in the first month, or even in the maternity ward), there is a way to reverse it in a simple way. Doctors recommend starting physical therapy measures until the child’s six months of age, when there is a chance of a better treatment result.
However, until the age of 18 months or, at the most, two years, the skull may still be being formed (this time varies) and it is possible that interventions and changes in habits have some effect.
The solution can be simple: measures to change the baby’s position while he is awake can help, such as encouraging him to lie on his stomach for 15 to 20 minutes, four times a day. Moving the baby’s cradle weekly is also recommended in plagiocephaly, as the baby’s preferred positions and the direction of his gaze may have to do with the arrangement of the objects in the room, or the mother’s own, in relation to the cradle.
IMPORTANT: It is necessary that the baby has supervision during the prone position, and that he never sleeps in this position, as there is a risk of suffocation and sudden death.
A tested and recognized pillow by pediatricians , pediatric neurosurgeons and pediatric physiotherapists is now available for sale to help support the baby’s skull in situations of long lying down, such as when traveling.
In the most severe cases of plagiocephaly, it may be necessary to use a “cranial orthosis” , which is a kind of orthopedic helmet, as shown in the figure below.
The helmet can be put on from the age of 5 months and the baby. Currently, there are many colors and designs on the market. In Brazil, the artist Paula Strawn develops a painting work on these helmets. They must be used for 22 or 23 hours a day, to be effective.
Parents report that the results are so good that they may be worth the effort. The problem is that it is not a cheap type of treatment. Preventing as soon as possible ends up being the simplest and least costly way to resolve plagiocephaly in your baby.
My name is Dr. Alexis Hart I am 38 years old, I am the mother of 3 beautiful children! Different ages, different phases 16 years, 12 years and 7 years. In love with motherhood since always, I found it difficult to make my dreams come true, and also some more after I was already a mother.
Since I imagined myself as a mother, in my thoughts everything seemed to be much easier and simpler than it really was, I expected to get pregnant as soon as I wished, but it wasn’t that simple. The first pregnancy was smooth, but my daughter’s birth was very troubled. Joana was born in 2002 with a weight of 2930kg and 45cm, from a very peaceful cesarean delivery but she had already been born with congenital pneumonia due to a broken bag not treated with antibiotics even before delivery.