Plagiocephaly and Brachycephaly (Flat Head Syndrome)

Plagiocephaly and brachycephaly, collectively known as flat head syndrome, are conditions characterized by the flattening of one or both sides of a baby's head. This occurs when a baby spends too much time in the same position, causing pressure on the soft bones of the skull.

Causes

• Prolonged periods of lying on their back or side, which can cause the skull to flatten
• Torticollis (a condition where the neck muscle is tight), which can lead to preferential positioning and subsequent flattening of one side of the head
• Preterm birth, as preterm babies are more likely to develop flat head syndrome due to their softer skull bones
• Multiple births (twins, triplets, etc.), where space constraints in the womb may contribute to the development of flat head syndrome
• Genetic predisposition, although this is less common

Symptoms

• A noticeable flattening of one or both sides of the baby's head
• An asymmetrical appearance to the face and ears
• Prominent forehead or facial bones on the affected side
• Difficulty turning their head to one side, if torticollis is present

Types of Flat Head Syndrome

• Plagiocephaly: a condition where one side of the head is flattened, often accompanied by facial asymmetry and ear misalignment
• Brachycephaly: a condition where both sides of the back of the head are flattened, resulting in a wider-than-usual head shape

Treatment Options

• Repositioning techniques: regularly changing the baby's position to reduce pressure on the affected area and encourage even growth
• Physical therapy: exercises to help improve neck mobility and strength, particularly if torticollis is present
• Helmets or head molds: custom-made devices that gently reshape the baby's skull over time, typically used for more severe cases or when repositioning techniques are not effective

Prevention

• Provide tummy time: regular periods of supervised playtime on their stomach to reduce pressure on the back of the head and promote even growth
• Vary sleep positions: alternate the direction of the baby's head while sleeping to avoid prolonged pressure on one area
• Avoid overuse of car seats, swings, and other devices that can contribute to flat head syndrome

Prognosis

Most cases of plagiocephaly and brachycephaly can be treated effectively with repositioning techniques and physical therapy. In more severe cases, helmets or head molds may be necessary. With proper treatment, the majority of babies will have significant improvement in their head shape by 12-18 months of age.