Flathead syndrome

How often have you come across a baby whose head-shape makes you stop and stare just a little longer? Often, the back or one side of their head appears really flat, and you wonder to yourself, just how did that happen?

The condition is called Positional Plagiocephaly (PP) – or flathead syndrome – and it is entirely avoidable. But unfortunately not all new parents understand the importance of, or even realise that they have to alternate baby’s head position every time they sleep.

Why is it so common?

PP used to only occur in 1 out of every 300 babies, but studies confirm that since 1992 it has increased to affect around 1 in every 60 babies. The alarming increase can be attributed to the hugely successful ‘back to sleep’ campaign. This campaign was launched in response to research that indicated that babies who slept on their tummies were almost 12% more likely to die from Sudden Infant Death Syndrome (SIDS).

So the campaign saved precious lives by radically reducing the incidence of SIDS, but at the same time it failed to educate new parents about the dangers of letting their babies sleep on the same side all the time, and so the incidence of PP sky-rocketed.

What exactly is positional plagiocephaly?

Plagiocephaly is translated to mean ‘skewed head’ and it occurs because of the softness of a young baby’s head. When a baby is put to sleep on the same side every time, a flat spot develops on their head. Within a matter of weeks this spot acts like a magnet and the baby’s head will continually come to rest on the spot over and over again, creating a bigger and bigger problem.    

In the vast majority of cases this condition is purely a serious cosmetic problem and will not affect a baby’s life or their brain function. And precisely because of this, it is a condition that is not taken very seriously, resulting in many parents being told by their doctors that they should simply grow their child’s hair or get them to wear a cap and forget about it.

What treatment is available?

It is very important to remember that PP is most effectively treated early, while a baby is still younger than 12 months. This is because a baby’s head grows very rapidly in the first 12 months and then slows down dramatically after that, and treatment is most effective during this rapid-growth phase.

Various treatments can be used, and the choice will depend on the severity of the PP. Firstly, there is counter-positioning which is pretty simply putting your baby to sleep on the other side of their head. The biggest problem with this treatment is the fact that the flat spot acts like a magnet, and it is often almost impossible to force a baby’s head to not come to rest on that spot.

Physiotherapy can be beneficial in stretching muscles in the neck and shoulders and also promotes positional techniques during sleep and play, and is often successfully used in conjunction with other treatments.

The final treatment is helmet therapy. It is based on the notion of applying a gentle pressure to the protruding area of the head while leaving the flat area of the head without any pressure. With this assistance the baby’s head then very gradually grows back into a more natural shape. This therapy does work best when done early on, while rapid head-growth is still expected.

Prevention is better than cure

The great news is that PP is a completely avoidable condition that should not develop if new parents ensure that they alternate their baby’s sleep position each time, that they give their baby ample tummy-time while awake, and avoid allowing their baby to spend excessive amounts of time in car seats or other seats such as bouncy chairs.

If your baby does develop PP do not believe a doctor who says that you simply need to grow your baby’s hair - it is treatable and the earlier you search for help the better.

For local support and advice contact Gerard Kohler on 072 187 1779 or email bestforbaby@mweb.co.za

Read his family’s story.

Has your baby suffered from plagiocephaly?

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