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Q&A with Australian Health Practitioners
What is plagiocephaly?
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Dr Ryan Hislop
Chiropractor
Ryan Hislop is the Clinical Director at the Orange Chiropractic Health and Wellness Centre. As an experienced and evidence-based diagnostician, Ryan works largely by medical … View Profile
There are 2 main types of plagiocephaly.
1. Synostosis (sutural fusion)
2. Non-synostotic (deformational)
The second type of plagiocephaly is the most common and you may notice flattening of one or even both sides of the head.
Plagiocephaly involves the assymetrical flattening of the head, often on one side, which causes the forehead (the frontal bone) to protrude forward, as does the ear of the same site.Report this post
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Dr Aaron Albrecht
Chiropractor
Dr. Aaron Albrecht works at Body Wise Chiropractic in Bibra Lake, Western Australia. The clinic is located within a gym, and Dr. Albrecht is the … View Profile
Many cases of plagiocephaly can be treated by an appropriately trained paediatric chiropractor. Depending on your location, you may have someone near you. If you contact the Chiropractic Association of Australia (CAA) they may have information on practitioners who perform ‘cranial work’ as it is commonly called.
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Dr Beth Thomas
Paediatrician
Beth works at the Angliss Hospital (Ferntree Gully) which has paediatric inpatients and outpatients and a Special Care Nursery. She also works at Monash Medical … View Profile
Plagiocephaly means “flat head” and usually refers to positional plagiocephaly* which is the most common form. This is mostly a problem of appearance, as the head can look asymmetrical, but positional plagiocephaly does not cause brain damage or inhibit brain growth.
Since the SIDS “back to sleep” campaign when infants became systematically placed on their back to sleep plagiocephaly has become much more common. This leads to the other name for this condition which is deformational plagiocephaly, which refers to the fact that it is pressure which causes the flattening of the back or side of the head. Once a particular “flat spot” has developed (or if the child was born with it) the child will tend to want to rest on that flat spot which can perpetuate the problem.
Plagiocephaly prevention: it is important to try to prevent constant pressure on the same part of the skull by counter-positioning. Sleeping on their backs is important for SIDS prevention but as babies tend to want to look at windows or murals in the room, one way of encouraging the child to face the other way is to reverse their position in the cot to encourage them to turn the head. “Tummy time” is another way to relieve pressure on the back of the head. Carrying the baby upright in a sling or baby carrier will also remove constant pressure on the head.
Plagiocephaly treatment: many children will not require treatment at all, as once the child learns to sit the pressure on the back of the head is removed and as the head grows the flat spot will often self-correct. This is particularly when the head is flat at the back and the flat spot is not visible from the front, so there is no cosmetic concern.
The main treatments are counter-positioning, as described above and helmets. A cranial remodelling helmet is a hard outer shell with padding inside which redistributes the pressure over the skull. By removing the pressure over the flat spot the head is encouraged to grow round more quickly. Helmets work best while the skull is still growing quickly, which tends to be between four and eight months of age. The helmet is made by taking a cast of the head, and is adjusted approximately fortnightly as the head grows inside it. The helmet needs to be worn almost all the time, and only removed for hair washing. It is quite a commitment to wear the helmet constantly for several months, but it is not painful and outcomes are good at the end of this time.
(*Plagiocephaly can also be the result of premature fusion of the growth sutures of the skull. This is called craniosynostosis, but is much less common. If you have concerns about this, a skull x-ray can quickly tell the difference by looking at the radiographic appearance of the skull sutures.)
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