More and more parents consult their pediatrician or their physiotherapist about the flat head syndrome, also called plagiocephaly. It is true that for a few years now, the number of plagiocephalies increased considerably, in particular owed by the late recommendations of the W.H.O. and the A.A.P. regarding the sudden infant death syndrome (S.I.D.S.). Newborns are now spending more time laying on their back, having more risks to be subject to a distortion of the skull. There are a few simple actions to do in order to prevent plagiocephaly or to reduce it if there is already a flat spot on the skull.
What is plagiocephaly?
Plagiocephaly, or flat head syndrome, is a flattening of the skull, typically at the back of the head, on the right or the left side, or in a symmetrical way. We also speak of brachycephaly when the head of the baby is wide and shallow. This kind of distortion can emerge either in-utero because of the position of the baby whose head is always placed in the same direction or in the first months of life and it is called positional plagiocephaly. Putting babies on their backs to sleep is indeed one of the causes, but it is not the only one. A baby who does not move a lot, who does not request his neck muscles a lot, who needs to be stimulated to move is a subprime baby. As a matter of fact, the flattening occurs mostly when the head of the newborn is always turned on one side. Indeed, babies'skulls are soft in order to get through their mom's pelvis, so they get easily distorted when they are subject to a lot of pressure.
Usually, the skull of a healthy baby is perfectly round in the back and symmetrical on the left and right sides. To check if your infant has plagiocephaly, look at his skull on the above to see if you can spot an asymmetry or flat spots. If the plagiocephaly is important, you can also notice an eye smaller than the other one, ears not symmetrical, even a face distorted.
How to prevent plagiocephaly
The goal here is to make sure that your child does not spend more time with his head turned on one side rather than the other. When you put him to bed, think to turn his head once to the left, once to the right. When you play with him, stimulate both sides in a same way. When you carry him in your arms, or when you give him the bottle, remember to change sides. Take time to observe him when he is awake, in order to see if he prefers one side over the other.
What to do in case of a proved plagiocephaly?
Most of doctors recommend to put infants on their belly and to practice some tummy time a few minutes every day when they are awake in order to limit moments where their head is leaning on a hard surface. This also allows babies to learn how to maintain their head straight while strengthening their neck muscles. If this suggestion may apply for 4 or 5 months old babies, it does not seem helpful for newborns. Indeed, when lying on his belly, a newborn will have a tendency to pull back with his head to straighten it and will then be in hyperextension. It will request to much efforts and strength to lift his head and to keep his balance witch could lead to useless tensions.
So how to act?
First, you can try to organise your space in a way that will request to your child to turn his head on the opposite side of the distortion. For instance, if your child has a left plagiocephaly, reverse his position in his bed so that the window is one his right, place a mirror, attractives images or a few toys on his right to encourage him to look on the right.
Put your child down on the floor: restrict the time your baby spend in swings or bouncers and even more the time spent in car seats. This kind of seatings limits baby's motor abilities: he can not move easily because he is confined. Let him play on a mat, he will be free to move as he wishes and better feel his weight and the contacts between his body and the floor, he will be able to move his legs and pelvis easier which will eventually lead him to turn on his belly, he will be able to turn his head to the right or to the left to look at his big brother, listen to some bells, watch a ball rolling away...
Carry your baby. Whether in your arms or with a sling, baby-carrying is really advantageous. Firstly because you share a moment of contact and intimacy with your little one and secondly because it allows you to turn his head on the side he explores less. He also strengthens his back and neck muscles. If you can, carry your infant with a sling when he naps, it will reduce the time he spend lying on the back.
Do some repositionning: do not leave your child in the same position all the time. Turn his head on the opposite side of the plagiocephaly when he sleeps or plays. Some plagiocephaly pillows exist but I will not use them (unless they are recommended by your pediatrician or PT) because they restrain motor abilities and lock your infant in a position that he can not leave when he needs to.
Consult your pediatrician and go to a physical therapist who is trained about this subject. They could act on the muscles and joints which are bothering your baby.