Heads - Large, Small and Odd Shapes, Soft spots or Fontanelles /
How to Prevent and Improve Plagiocephaly
01 In Brief
Techniques to prevent or improve plagiocephaly are most effective in the first 3 months when the head is growing rapidly and the bones are still very soft. Alternating head positions, counter positioning, encouraging baby to look to the less preferred side and increasing tummy time are all effective in preventing or improving head shape. Tight neck muscles associated with a head tilt known as torticollis will need physical treatment.
02 What Do I Need To Know?
PLAGIOCEPHALY
- Literally means 'plagio' oblique and 'cephaly' head, and refers to the deformity that occurs when part of the skull of the newborn is flattened as a result of pressure being placed on one area of the skull more than another. It may be present at birth, or it may occur from a preference for the baby to sleep with their head to one side, or from being placed on their back in order to prevent SIDS.
WHAT CAN I DO TO PREVENT PLAGIOCEPHALY OR IMPROVE MY BABY'S HEAD SHAPE?
- The first step is to remember to take the pressure off the flat spot so your baby's head can round out as it grows. This involves moving your baby's head, in order to make sure she does not rest on the flat spot, by consistently repositioning her head to lay on the rounder side. You can also encourage your baby to look to the less preferred side by moving her toys and/or moving her cot (see below under 'Things to do'). You can also alternate the end of the cot you place the baby in, so she constantly changes her head position - just remember to keep her facing the same way.
- Such strategies work best for babies less than 3 months old because the skull is still soft, and your baby is more likely to remain in one position.
- In general, most of the babies show improvement after 2-3 months of repositioning. These methods can still be effective for babies up to 12 months of age.
- Many parents have difficulty getting babies who are 3 months or older to sleep on the rounder side of their head because they have already become accustomed to sleeping on the flattened side. Studies have shown that babies get used to one sleep position within the first 3 months of life and do not readily accept a change after that time. If possible, it's a good idea to get your baby used to different positions by laying them down a different way each time.
THINGS TO DO
CHANGE HEAD POSITIONS WHEN BABY IS LYING FLAT
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ENCOURAGE BABY TO LOOK TO THE LESS PREFERRED SIDE
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MINIMISE TIME SPENT IN FLAT DEVICES
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MORE TUMMY TIME
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TORTICOLLIS: HEAD TILT and TIGHT NECK MUSCLES
If your baby has difficulty achieving full neck rotation to the less preferred side or has positional preference due to the tightness in the neck muscles, then it is important to get physical therapy.
NECK EXERCISES
The American Academy of Pediatrics suggests the following neck exercises when torticollis is present. Try these at each nappy change: 3 times for each exercise.
- Place one hand on the baby's upper chest, the other hand rotates the baby's head gently to one side so the chin reaches the shoulder. This is held for approximately 10 seconds. The head is then rotated to the opposite shoulder and held for the same count.
- The head is gently tilted so that the baby's ear touches her shoulder and is held for 10 seconds. Repeat on the other side.
The combination of neck exercises and the techniques described above will all help improve torticollis and associated plagiocephaly.
The information is not intended to take the place of medical advice.
Please seek advice from a qualified healthcare professional.
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Last updated: 06/03/2012 by Dr Elizabeth Hallam/Claire Galea