Flat Head Syndrome in Babies – Causes and Treatment
We are seeing more and more babies in helmets these days. You may notice, stare for a slight moment and then not give it another thought. But what you don’t know, is that this is occurring in 16% of babies (and 56% of twins) today. This statistic is staggering, and has grown five-fold in the last 15 years. What is going on, and why are our children’s heads suffering? Flat Head Syndrome is known as plagiocephaly in the medical community, and it is a cranial malformation. Like I said, it is becoming more and more common with little to no attention for parents to understand why. A new study in Canada, published in the journal Pediatrics, found that more than 46% of 2-3 month-old babies may have some form of the condition, although most cases are mild. (16% of children being severe enough for immediate intervention.) Historically, a dolichocephalic (elongated) head shape was always the norm. Currently the norm has changed to a more brachycephalic (shorter and broader) shape. Source Infants who require NICU care, and particularly premature infants, are more prone to positional plagiocephaly and dolichocephaly. This is because they spend days, weeks, or longer being laid on their backs. Both can be prevented or minimized by proper positioning! So do not fear if your little one needs to stay awhile. Source
What is causing this?
Research has (and continues) to show that an infant being laid in the supine sleeping position (on their backs) and spending extended time in this position is the cause to this growing pandemic. You know that you have been told, more like it’s been drilled into your head, to lay your baby on his back to sleep? There is even a “Back to Sleep” Campaign that began in 1993, as belly sleeping was thought to be causing SIDS. And while the number of SIDS deaths has dropped drastically since this campaign, the increase in plagiocephaly has increased and is still rising. Obviously, the reduction in SIDS is wonderful, and I am not advocating a return to the prone (belly) sleeping position. But within two years of the recommendation, there was a six-fold increase in the cases of plagiocephaly. This is research that needs to be noted, and there are changes that need to be made. Newer campaigns are focusing on a broader range of safe sleeping practices for infants, like using a firm mattress and avoiding soft bedding in a baby's crib. Overall, SIDs is rare, affecting just over 2,200 babies per year in the United States, according to the Centers for Disease Control and Prevention. Flat areas on the backs or sides of babies' heads are typically caused by pressure on the bones of the skull and can develop in the first few months of infants' lives. In some cases, the change in head shape is so subtle it is difficult to spot, in others it is quite clear and cannot be missed. Risk factors for flat head syndrome include: Source- assisted forcep vaginal delivery
- prolonged labor
- unusual birth position
- multiparity (twins, etc)
- male gender
How you can prevent flat head syndrome
Interesting, when babies spend time in the prone (belly) position, infant scoliosis and cranial malformations (flat head syndrome) are significantly reduced. While this contradicts SIDS information, it does explain why, when babies are not asleep, they need to be held, worn, experience tummy time, or other options that do not include being on their backs. Source
It is important for parents to be informed about the importance of supervised prone (belly) playtime to enhance the development of early motor skills. Parents also need to be aware of their infant's head position preference and remember to alternate head positions when putting the infant to sleep. This is even more important when cranial flattening is noticed immediately following the birth of an infant. Preventative measures include: Source
- Daily tummy time
- Limit the time in supine position in car seat, infant swing, and infant carriers.
- Encouraging increased head and neck movement.
- Babywearing
- Hold your baby more often: Reduce the amount of time your child spends lying on her back or often being in a position where the head is resting against a flat surface (such as in car seats, strollers, swings, bouncy seats, and play yards).
How you can treat flat head syndrome
If plagiocephaly is left untreated, the infant can have prolonged developmental delays. It can also cause abnormal occlusion, temporomandibular joint difficulties, and strabismus. Any altered physical appearance, without treatment, may be permanent as well. Source
In most cases of plagiocephaly, the condition is self-resolving. A study found plagiocephaly to be present in 20% of 8 month-old infants, but that by the age of two years, this number had decreased to 3%.
- 73% of infants suffering from plagiocephaly have the problem resolved with frequent head turning.
- 23% of infants are cured by the use of helmet molding therapy
- 4% require surgery
A helmet called a thermoplastic orthotic device involves the use of thermoplastic materials that can be molded directly onto the infant's head. The device is lined throughout, using a soft material to protect the skin of the infant. It is light, comfortable, and tolerated well by the infant This method of treatment is most effective if used between 4 and 12 months of age and involves the infant wearing the helmet for several months with weekly adjustments made by a technician. Source
Affording the helmet can be an issue within itself, as most insurances see this as a preventable problem and may not cover the costs involved. But it is worth fighting for. Alongside of chiropractic care, the above-mentioned treatment plans, and the helmet, your little one should fully recover quickly, and this will be nothing but a memory. But please do not hesitate to start treatment, as your little one could suffer lifelong motor skill delays. 
