Plagiocephaly: Why Do Flat Heads Matter?
You've probably seen babies wearing helmets ("cranial bands" or "cranial orthotics") to correct their head shape. Your own kiddo may even have a helmet. Or you may be facing the tough decision of whether to invest in a helmet for your baby’s head shape.
No matter what your relationship to baby helmets is, you may have at some point wondered, “Does head shape really matter?”
As a pediatric Occupational Therapist, I'm here to say “YES, babies’ head shapes matter!” But you may be surprised to know why.
Baby’s Head Shape Can Be A Red Flag
Craniosynostosis
A rare but serious cause of infant head shape problems in Cranosynostosis, a condition in which the sutures, or joints, of the skull are fused instead of open at birth. What I'll be addressing in this post and throughout CanDoKiddo.com is something different and far more common - Positional Plagiocephaly. But it’s important to mention that physicians should closely examine head flattening or irregular head shape to rule out Craniosynostosis.
Head Flattening Can Tell Us About Baby’s Movement
Head flattening or irregular head shapes can be present at birth or can develop in infancy. And there are both unpreventable and preventable risk factors for Plagiocephaly.
Two of the most common reasons why a baby’s head would be getting flatter are:
Baby’s Head Movement Is Limited By Internal Forces
Babies grow all squished in a little womb (even more squished in the case of multiples, who are at a higher risk of Plagiocephaly). It is very common for our little ones to be born with minor muscle asymmetries from this womb position - usually so small that a parent wouldn't notice.
Those asymmetries of the neck and torso muscles can contribute to baby finding one head position that they prefer. This preferred position leads to baby resting on one part of the head more. Whatever part of the head they rest on most flattens. Makes sense, right?
Baby’s Head Movement Is Limited By External Forces
With so much baby gear on the market (car seat carriers, bouncy seats, infant loungers, infant swings, etc.), it’s not too surprising that many babies spend a lot of time contained. Not only does the semi-reclined lounge position of infant gear worsen muscle asymmetries that we just talked about, but the devices themselves limit baby’s ability to FULLY turn the head in both directions.
Time to move and play unrestricted by baby gear and the opportunities to experience a variety of positions during awake times (not just the semi-reclined lounge position) are CRUCIAL for the prevention and treatment of head flattening.
Baby’s Head Shape Can Guide Treatment
A trained clinician can evaluate a baby’s head shape and determine what positions will be most effective at slowing, stopping or reversing the flattening - reducing the risk of a helmet being recommended. They can also evaluate baby for any neck or torso muscle asymmetries (including Torticollis) that may be contributing to Plagiocephaly and develop a treatment plan to address them.
Positional Plagiocephaly Isn’t Just A Cosmetic Problem
As a developmental expert, I say, “YES, babies’ head shapes matter!” because MOVEMENT matters.
Decreased movement means decreased sensory experiences.
Decreased movement means decreased opportunities for exploration and early learning.
Decreased movement means less time for strengthening and stretching, kicking, rolling, reaching, grasping and all the other essential components of early motor development.
Uncorrected head turning preferences or Torticollis can impact vision, hand use, posture and movement.
Reflection:
Do I notice my baby preferring to look one direction more than the other?
Do I notice any flattening of my baby’s head? If so, what thoughts and feelings come up when I look at my baby’s head shape?
When I notice a baby wearing a helmet, what thoughts and feelings come up? Are they accurate and/or helpful? If not, what would I rather think and feel?
Want to prevent head flattening?
Want to round out baby’s head without a helmet?
Did someone tell you to “wait and see” if baby’s head would round out but your gut tells you there must be something you can be doing to help it?
I wrote a book just for you, friend:
THE FLAT HEAD SYNDROME FIX
Just listen to how first-time mom Laura felt after implementing the strategies from the book:
"Not only did it give me the tools I needed to round out my son's flat spot (and get rid of his head turning preference), it was a surprisingly engaging and enjoyable book to read and I learned so much from it. My son is now 5 months old and his head is round! What a relief!"