From a medical encylopedia

[Guest guest]

Encyclopedia Index H head, flat (plagiocephaly) | Search

head, flat (plagiocephaly)

The head of a young infant that appears flattened in one area can

have one of several causes:

Flattening of the head behind the ear due to habitual right-side

sleeping or sleeping on the back (supine) with the head always toward

the same end of the crib (plagiocephaly - pla-gee-o-SEF-a-lee). This

is cured by alternating the baby from night to night - head to the

right, head to the left, head to the right, etc.

Flattening purely on the back of the head is also usually positional -

the child who lies in the crib or playpen all day

Other elongations or deformation of the head shape could be

synostosis (sin-os-toe-sis) which is abnormal, premature growing

together of the normally separate plates of the skull in an infant.

This should be checked by your doctor and possibly a specialist.

Plagiocephaly or flat head can also be a sign of torticollis,

especially if the signs include include not only a flattened back of

the head but a more prominent forehead, a flattened ear on the

affected side, asymmetry of the jaw with an upward slant on the same

side as the torticollis, and facial asymmetry, with one cheek

appearing fuller than the other.

The use of helmets to correct or prevent simple positional

plagiocephaly in babies caused by back sleeping is not supported by

controlled medical studies, to my knowledge. I personally have not

seen any permanent problem cases arise in the years since adoption of

the " Back to Sleep " program in my practice, which is a busy one. The

babies seem to grow out of the mild head asymmetry without any help

from medical science. Severe cases (usually due to other conditions

such as torticollis) can be effectively treated with helmet

remodelling devices - one has recently been approved by the FDA for

use in infants.

Again, attention to sleep positioning - let the baby sleep half the

nights with the head one way, half the nights the other way - until

the child is mobile in the crib and rolling around, is sufficient to

prevent any significant or lasting skull asymmetry. I certainly would

not recommend any sort of parent-prescribed treatment without the

evaluation of a pediatric neurosurgeon, and recommend that parents

not be swayed by Internet sales pitches for such devices just because

there is minor flattening of the head in an infant. This is something

that your pediatrician and pediatric neurosurgeon should decide

Lorraine