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Plagiocephaly is a disorder that affects a baby’s skull making the back or side appear flattened.

What is it?

Positional Plagiocephaly is a disorder that affects a baby’s skull making the back or side appear flattened. A baby’s skull is made up of several plates of bone which are not tightly joined together. Baby’s’ bones are softer than adult bones and this means that their shape can be altered by pressure. It is usually the back of a baby’s head that develops a flattened look (moulding).

What causes it?

Positional plagiocepahly is produced by pressure from the outside on part of the skull. It can occur whilst inside the womb but frequently occurs after a baby is born. The main cause is baby’s sleeping position. Babies spend much of their early lives lying on their backs. If your baby lies flat on their back any positional moulding is likely to spread across the back of the head. Some babies have a tendency to turn their heads in one direction and develop positional plagiocephaly on the side they usually lie on.

In severe cases moulding of one side of the back of the head can produce unevenness at the front although this is usually mild.

Is it common?

Positional plagiocephaly is very common.. Some reports estimate that it affects around half of all babies under a year old to varying degrees. It tends to affect premature babies more often than babies born at term.

Is it harmful?

Positional plagiocephaly is entirely cosmetic. The underlying shape of the head is entirely normal and as soon as the moulding process ceases the head starts to grow back towards its natural shape. In mild cases it may have corrected itself by the time the child is a year old. Even in more severe cases improvement is shown with time however growth of hair tends to cover the remaining flattening.

Positional Plagiocephaly does not affect how the baby’s brain develops or cause any brain abnormalities.

What can you do?

In mild cases babies do not need any treatment.

  • Early recognition – The younger the baby is when positional plagiocephaly is recognised the more likely the progression can be stopped and the natural correction process can be encouraged.
  • Tummy Time – Babies must always sleep on their back but the more time babies spend on their tummies, the better the chance of stopping the plagiocephaly getting worse and allowing natural correction to begin.
  • Head Position – Adjust the baby’s sleeping position or position in the room so that they are encouraged to turn their heads in differing directions when they sleep or when they are trying to look at exciting things in the room.
  • Sleeping position – A rolled up towel under the mattress may help your baby sleep with less pressure on the flattest part of the head. Always check that sleeping position is safe and check how they are lying in car seats and buggies too.
  • Physiotherapy – For those children with difficulty turning the head in one direction physiotherapy may help. Refer to community paediatric physiotherapy.
What if that doesn’t work?
  • Helmets and bandsThe use of these is controversial. There is no evidence that the use of these devices are effective, and they have to be worn for 23 hours every day if they are to show any benefit. If they are to be used they need to be commenced whilst the head is still plastic enough to have the correction process encouraged usually before 6 months of age. They are not routinely available on the NHS and are very expensive (over £1000).
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