Plagio written by Mel mum of Morgan
lack of amniotic fluid in the womb
difficult birth
prolonged time in the birth canal
external force to the head (forceps delivery)
position of the baby in utero (breech)
Most babies who suffer from Plagiocephaly however are not born with the condition. Babies who develop Positional Plagiocephaly usually develop it at around 4-8 weeks of age, due to a number of factors:-
They may suffer from Torticollis (tightening of the neck muscles). Babies who suffer from torticollis find it almost impossible to move their heads in both directions, therefore will almost always lie facing to the left or right (depending on which side of the neck is affected).
Prolonged pressure from hard surfaces (eg: car seats, hard floor, cot mattress etc). This can mould a babies head into an abnormal shape.
There is a group of babies who have a higher 'risk' of developing Plagiocephaly:-
Boys - Plagiocephaly is 3 times more common in boys
Premature babies (their bones are softer and may have spent prolonged time on their backs in special care unit)
Low birth weight
Multiple births (less room in the womb for movement)
The main signs of Plagiocephaly are :-
Flattening to the side or straight across the back of baby's head
Misalignment of ears - one ear may be further forward than the other
bulging forehead at the same side as the flattening
One eye may appear larger than the other or slightly higher than the other (this is best viewed by holding your baby up infront of a mirror)
Future problems your child may have should the Plagiocephaly remain untreated are problems with getting glasses as ears are out of alignment. Problems with getting bicycle/ski helmet to fit unusual headshape. Potential of bullying in school due to abnormal headshape
While there is no medical evidence of Plagiocephaly causing any specific side effects in later life, specialist Dr Blecher has observed that severe cases can affect the alignment of the jaw and teeth.
Craniosyntosis which is another type of Plagiocephaly which cannot be treated in any other way than by surgery. Craniosyntosis is caused by the bones in a baby's head fusing too quickly. This is a condition which must be treated urgently to ensure that there is enough room for the brain to grow. You should ALWAYS have your baby checked for Craniosyntosis by a Doctor before beginning any treatment plan.
If your baby is young (prior to 5 months) then the best option for treating Plagiocephaly is Repositioning
Tummy time, tummy time, tummy time!
Not only is Tummy Time important to prevent Plagiocephaly, but the experience of being on their tummy helps babies learn to push up, roll over, sit up, crawl, and pull to a stand. But if your little one fusses and cries when you put him on his belly, what can you do?
Always remember to put your baby to sleep on his back. Sleeping on his back reduces your child's risk of sudden infant death syndrome (SIDS). However, alternate which side his head faces, to the left one night, face up the next and to the right the following night. Or, alternate which end of the cot you place his feet. This will cause him to naturally turn his head towards light or objects in different positions.
From the first day home, play with baby on his tummy two or three times a day, gradually increasing the length of time spent on his tummy. The best time to do this would be after a nappy change or when he wakes up from a nap.
Here are some tips on how to make him feel at home on his tummy.
Keep your baby company
The simplest strategy is to distract your baby from the unfamiliar feeling of being face-down until he gets used to it. The best thing you can do, is join your baby on the floor. Encourage him, talk with him, shake his rattle, make funny faces, play peekaboo. Another option is to lay your baby tummy-down on your tummy, either on the floor, in a recliner, or even in the bath.
Once your baby has sufficient head control — around age 4 months — you can play airplane: Lie on the floor and bend your legs. Put your baby's tummy against your legs, his head at your knees. Then bend your legs while holding on to him firmly. He'll probably love the new view. You might also put him on the bed, near the edge, and sit on the floor with your face next to his. He might appreciate the softer surface, and you can easily interact with him in this position.
Provide entertainment
Prop a board book open in front of your baby, or place a favourite toy within reach. Invest in a tummy-time toy or mat, designed especially for babies to play with while on their belly. Take your baby's socks off so he can get good traction on the mat. Involve sibling’s, have them lie on their tummies just like baby, it may keep him distracted, and will make them feel involved
Prop your baby up
If your child has some neck strength and head control (by age 3 or 4 months) but can't get up on his forearms, simply place a towel or pillow under his chest and armpits, with his arms in front of it. (If he tends to roll forward, keep your hand on his bottom.) When he can get up on his forearms independently, remove the pillow and let him work on his motor skills without it. Some babies enjoy rolling on a big exercise ball. Hold him on it tummy-down while you gently rock the ball back and forth.
Time it right
Make sure your baby isn't hungry or tired when you set him tummy-down. On the other hand, don't place him on a full belly, which might be uncomfortable. When your sure he’s had enough, pick him up and try again later. His tolerance for tummy time will increase gradually with a little bit of coaxing. Most babies are more content with tummy-time once they can roll over and it becomes a matter of choice.
Tune in to your baby
Try to figure out if there's anything in particular about tummy time that your baby finds distressing. Maybe he prefers to be bare bottomed, or needs his blankie. See if your baby likes to be massaged while he's on his tummy. If he does, it could help him feel more comfortable in that position, and is great bonding too.
Never leave your baby unsupervised during tummy time.
Remember, Back to Sleep, Tummy to Play.
Repositioning advice.
Repositioning is a very effective method of treating Plagiocephaly. It is estimated to take longer than using a helmet, but if started early enough, in the first weeks of life, may only take a few weeks. Certainly repositioning techniques should be practised as standard by parents to AVOID Plagiocephaly in the first place.
The aims of repositioning are to encourage the baby to rest his head on the non-flattened areas. It is most effective when started at a young age, and because of a baby’s increased mobility, may become much more difficult over the age of about six months.
A baby may also have tight neck muscles on one side. This is called torticollis and a physiotherapist can show how to stretch the tightened muscle to allow normal left and right head movements. You may also find that a course of cranial osteopathy helps to ease your baby’s torticollis.
Employing the following repositioning tips will help to encourage a baby’s head to grow more symmetrically.
Sleeping
Try changing the baby’s position by alternating the end of the cot that his head is placed each night.
Change the position of the light in the room so that it is on the side that the baby tends to favour less. Even young babies will turn towards the light source.
If the baby sucks a thumb, try covering the one that he prefers, to encourage turning to the other side.
Reposition the baby’s head away from the flattened side after he has gone to sleep. It is best to do this when the baby is in a deep sleep as he will be less likely to move it back again.
Sleepcurve mattresses have been recommended by many parents.
Babies should always be placed on their backs to sleep.
Feeding
Most breastfed babies are used to switching sides while feeding, so if your baby is bottle fed, switch which side you feed him on at every feed. It takes a little getting used to, but it soon becomes comfortable.
Travel
Reduce the amount of time that the baby spends with the back of his head on a firm flat surface, for example: when in car seats, baby walkers, buggies, etc.
Use slings and front carriers or hold the baby in your arms.
When in a car seat, use a rolled towel or soft foam pad to move the baby’s head away from the flattened side. Many hight street stores now stock 'neck rolls' for this purpose.
Other tips
There are many new products appearing on the market designed to take the pressure of the babies head. Boppy do a wonderful range of pillows and supports to ease pressure on babies head.
Many people have recommended Bumbo seats which are suitable from as young as 3 months of age.
Goi Goi baby pillows have been recommended for use when the baby is awake and supervised, for example, at nappy changes.
Under no circumstances should baby be left unsupervised.
Should repositioning not be successful then there is the option of cranial remoulding "HELMET" treatment. At the moment this is not often available on the NHS.There are however, 3 private helmet suppliers in the U.K.
Written by Mel mum to Morgan