Does my baby have Deformational Plagiocephaly also referred to as Positional Plagiocephaly?

The real question is, does my baby require treatment for this condition?

Some babies develop positional plagiocephaly while still in the uterus. In some cases, this is caused by the baby’s preference for a head positon. In others, multiple births can force the baby’s head to one side, creating positional plagiocephaly. Position, then, is the most common cause of this disorder.

Some babies prefer to look in one direction, or tilt the head to one preferred side, resulting in a limited range of motion due to tight neck muscles. This condition is called torticollis.

In all instances, your baby should be properly evaluated by your pediatrician. If your child is less than 4 months old and seems to be developing a flattening or asymmetry, your doctor may recommend repositioning or physical therapy. If this conservative type of treatment does not correct the condition, you may need to visit a specialist, such as a craniofacial surgeon or neurosurgeon, for evaluation, treatment and a cranial orthosis (cranial band or helmet). The specialist can explain all treatment options and help you make an informed decision.

If you decide to go with a Cranial Remodel Orthosis (CRO) it is important that you ask questions.

Causes of Deformational Plagiocephaly

Torticollis: a relatively common condition in newborns, presents between birth and 3 months. It is caused by the tightening of one or both of the neck’s main muscles, forcing the baby to turn or tilt the head in one position. The result is a flattening of the same side of the head.

You may notice that your baby tilts his head in one direction, looks over your shoulder instead of following you with her eyes, has difficulty breastfeeding on one side, and becomes frustrated when attempting to turn his head to look at you.

Torticollis is often associated with deformational plagiocephaly since the baby has difficulty lying comfortably in all positions. Physical Therapy and a home exercise program offer conservative treatments that can begin immediately upon diagnosis.

Your pediatrician can evaluate your infant for torticollis and, if present, may suggest neck stretching exercises, which you can practice with your baby at home. For example, you’ll be taught how to encourage your child to turn his head in both directions to loosen tight neck muscles, and tighten up loose muscles. Don’t worry! Your baby cannot hurt himself by turning his own head.

One effective exercise, affectionately called “tummy time”, can be safely tried at home as a treatment for a baby with both torticollis and a flat head:

Lay your baby on his or her stomach briefly while awake. Position your baby with his or her head turned away from you. To encourage your baby to turn towards you, talk or sing to him or her. This helps to strengthen baby’s neck and shoulder muscles, as well as allowing your little one to use those muscles needed for early crawling. Practice this exercise several times daily, for a few minutes each time.

If your infant’s condition doesn’t improve with stretching exercises, or symptoms worsen, contact your pediatrician.

In more severe cases, your doctor may recommend physical therapy for additional treatment.

  • Prematurity: the premature infant’s skull bones are softer, so if the baby lies to one side more often than another – for example, your baby is in the NICU on a ventilator – this can cause asymmetry, increasing the risk for deformational plagiocephaly.
  • Multiple births: A tight intrauterine environment may cause pressure on the baby’s skull, resulting in asymmetry.
  • Uterus shape and size: A large baby growing in a small uterus, or a baby adopting an unusual intrauterine position may be born with asymmetry.
  • Sleeping position: the baby’s soft skull bones can become asymmetrical if the baby regularly sleeps in one position against a mattress or firm surface. Frequently change your infant’s sleeping position to prevent this. Practicing “tummy time” when your baby is awake can also be beneficial in strengthening neck muscle. In particular, avoid substituting non-sleeping devices, such as car seats, as primary sleeping areas. These do not allow for the baby’s natural movements, creating risk for the development of deformational plagiocephaly.