About Flat Head Syndrome
Flat head syndrome refers to conditions where a baby’s skull develops an uneven or flattened shape, often due to external pressures or other underlying causes. Two common types of flat head syndrome are plagiocephaly and brachycephaly, each with distinct characteristics and causes:
- Plagiocephaly is an uneven skull shape where one side of the head is flatter than the other. It can be caused by either synostotic plagiocephaly, resulting from early fusion of one or more cranial sutures, or positional plagiocephaly, caused by external pressures in the womb or after birth. In addition to skull flattening, plagiocephaly is often linked to facial asymmetry and uneven ear alignment. Over time, it may lead to issues like dental problems, jaw joint pain (temporomandibular joint syndrome), and delays in cognitive, language, or motor development, according to some studies.
- Brachycephaly is characterized by flattening across the back of the skull, leading to a shorter skull from front to back and a wider shape from side to side. This condition often occurs when a baby’s head stays in one position for too long. In some cases, brachycephaly can also appear uneven, with one side of the back of the head flattened and the other side bulging outward as a result.
Both conditions highlight the importance of early detection and intervention to minimize long-term effects and support healthy development.
Plagiocephaly and brachycephaly (flat head syndrome) are conditions characterized by abnormal head shape in infants. Here are the causes, non-modifiable risk factors, and modifiable risk factors associated with these conditions:
Root causes of plagiocephaly and brachycephaly:
- Plagiocephaly: This is caused by external forces that apply pressure on the infant's skull, leading to asymmetry. This can occur due to factors like positioning in the womb or after birth, limited neck mobility, or spending excessive time in one position.
- Brachycephaly: Brachycephaly refers to a wide and flat head shape. It can result from external forces compressing the back of the skull, leading to a flattened appearance.
Non-modifiable risk factors of Plagiocephaly and Brachycephaly cannot be controlled or changed. They include:
- Premature birth: Preterm infants have a higher risk of developing dolichocephaly (long and narrow head shape).
- Genetic factors: Certain genetic predispositions may increase the likelihood of developing these conditions.
Modifiable risk factors of plagiocephaly and brachycephaly can be influenced by individual habits and lifestyle. They include:
- Positioning: Infants who spend excessive time in one position or lack tummy time when awake have an increased risk.
- Feeding practices: Bottle-only feeding has been associated with an elevated risk of deformational plagiocephaly.
- Delayed motor development: Infants with delayed motor milestones may have a higher chance of developing severe forms of plagiocephaly.
- Obesity: Infant obesity has been identified as a new risk factor for deformational plagiocephaly.
It is important to note that these risk factors may contribute to the development of plagiocephaly and brachycephaly but are not definitive causes. If you have concerns about your child's head shape, it is best to consult with a healthcare professional for an accurate diagnosis and appropriate management.
The most common early symptoms of plagiocephaly and brachycephaly include:
- Misshapen head: The head may appear flattened on one side (Plagiocephaly) or wide and flat at the back (Brachycephaly).
- Asymmetrical facial features: This can include uneven ears, eyes, or facial bones.
As the condition progresses or becomes more severe, other common symptoms may occur:
- Facial asymmetry: The face may become more visibly uneven.
- Altered ear position: The ears may appear misaligned or positioned differently.
- Limited neck movement: The baby may have difficulty turning their head fully in both directions.
- Developmental delays: In some cases, there may be delays in cognitive, language, and motor development.
It is important to note that Plagiocephaly and Brachycephaly do not typically affect brain development. In many cases, these conditions resolve on their own without medical intervention as the baby grows and becomes more mobile. However, if you notice any concerning symptoms or if the condition worsens, it is always best to consult with a healthcare professional for proper evaluation and guidance.
To diagnose Plagiocephaly and Brachycephaly, the following examinations, tests, and procedures are commonly performed:
- Physical Examination: The doctor examines the shape of the baby’s head, checking for flattening, asymmetry, or abnormal contours. They also assess facial symmetry and ear alignment.
- Head Measurements: Measurements of the head’s dimensions help evaluate the degree of flattening or widening. This can help distinguish between plagiocephaly and brachycephaly.
- Imaging Tests: In some cases, X-rays or CT scans are used to rule out craniosynostosis (early fusion of skull bones) or other structural abnormalities.
- Developmental Assessment: Doctors may check for signs of delayed motor, language, or cognitive development, as these can sometimes be associated with plagiocephaly.
It is essential to consult with a doctor who can provide personalized recommendations based on your specific situation.
The goals of treatment for Plagiocephaly and Brachycephaly are to correct the shape of the skull and promote normal growth and development. Here are the recommended treatments and how they work to achieve these goals:
- Counter-position therapy: This involves changing your baby's sleeping position to relieve pressure on the affected area of the skull. For example, if your baby favors sleeping on one side, you can position their head so that they sleep on the opposite side. This helps to encourage symmetrical growth of the skull.
- Exercises: If your baby has muscular torticollis, stretching exercises may be recommended to improve neck mobility and reduce head tilt. These exercises should only be done under the guidance of a healthcare professional.
- Moldiing helmet therapy: In more moderate to severe cases, a custom-molded helmet or band can be worn by the baby to gently reshape the skull. This therapy is typically used for a specific duration and can help achieve a more symmetrical head shape.
- Health behavior changes: Parents can be advised to incorporate tummy time into their baby's daily routine, as it helps strengthen neck muscles and reduce pressure on the back of the head.
It is important to note that medication is not typically used for treating Plagiocephaly and Brachycephaly. The focus is on non-surgical interventions to correct skull shape. These treatments aim to promote normal skull growth and development, allowing for improved cosmetic appearance and long-term function. Remember, always consult with your healthcare professional before starting any treatment or making changes to your baby's routine.