Plagiocephaly

Plagiocephaly, also known as "flat head syndrome," refers to the flattening of a baby's head either on one side or the entire back of the head. This occurs when the soft skull of an infant becomes flattened in a specific area, which can worsen if the baby sleeps in the same position most of the time or experiences mobility challenges with the neck muscles that lead to a head-turning preference.

It is important to note that Plagiocephaly is not the same as Craniosynostosis, which is the fusion of a baby's skull bones before they are supposed to.

Plagiocephaly is caused by repeated pressure on one part of the baby's skull, which can begin developing when they are in the womb, particularly if they are in an abnormal position or are a twin/multiple. Premature babies also have a higher risk of developing Plagiocephaly due to spending significant time in the neonatal intensive care units (NICU) and laying in a fixed position for too long.

Muscular torticollis, a condition where a child's head is continually bent to one side due to neuromuscular tension and restricted movement, can also cause or contribute to plagiocephaly in a big way, and many children struggle with both conditions simultaneously.

The use of birth intervention, such as forceps or vacuum during delivery, has been linked to an increased occurrence of head shape abnormalities, including plagiocephaly, in infants. Multiple studies have investigated the association between birth intervention and plagiocephaly, with one systematic review and meta-analysis published in the Journal of Pediatric Rehabilitation Medicine in 2018 finding a significant increase in the risk of plagiocephaly associated with the use of forceps or vacuum during delivery. Another study published in the

Journal of Craniofacial Surgery in 2020 found a higher incidence of plagiocephaly in infants born via vacuum-assisted delivery, particularly those who experienced longer periods of vacuum application, compared to those born via spontaneous vaginal delivery or c-section.

It is important to recognize that birth intervention can cause physical strain and tension on a baby's head and neck, which can be considered as birth trauma. While forceps and vacuum extraction deliveries are mentioned in the studies above, a challenging c-section delivery can also result in complications with plagiocephaly and torticollis for the child.

Plagiocephaly is closely associated with another condition called subluxation, which occurs when there is misalignment and abnormal motion within the neurospinal system, leading to an imbalance and dysfunction of the nervous system, known as dysautonomia. A balanced and equal movement in the neurospinal system allows the skull to shape into a round shape naturally, and when subluxation and stress on the nervous system interfere with this, it can lead to the development of plagiocephaly.

As Pediatric Chiropractors, our goal is to address the underlying cause of a child's presenting condition, which is often limited range of motion and subluxation, rather than solely addressing the visible flattening of the head and facial asymmetry.

What Are the Signs of Plagiocephaly?

Plagiocephaly can be easily identified by the following signs:

• A flattened area on one side or at the back of the baby's head. Less hair growth on the flattened side of the head.
• The ear on the flattened side may appear to be pushed forward when viewed from above.
• Asymmetry in the facial features, including the eyes and ears.
• In severe cases, bulging of the forehead on the opposite side of the flattened area.

Although plagiocephaly is not painful for babies, it can hinder their development of gross motor skills, subluxation, and torticollis. A study has shown that these delays may continue into toddler years.

Furthermore, untreated plagiocephaly can increase the risk of ear infections and respiratory infections as subluxations and motion restrictions can impede the drainage of fluids and mucus through the respiratory and lymphatic systems.

Treatment for Plagiocephaly

Fortunately, parents can explore alternative treatment options to traditional medical recommendations such as helmet therapy or physical therapy. It is essential to find the root cause of plagiocephaly.

Most cases of plagiocephaly do not require medication or surgical intervention, as craniosynostosis is not involved. However, if your child underwent any birth interventions discussed above, subluxation may contribute to their plagiocephaly and other challenges. Contact a pediatric chiropractor who can locate the exact location and severity of the subluxation within your child's nervous system using non-invasive technology called INSiGHT scans. Consistent chiropractic adjustments are necessary to resolve plagiocephaly and any underlying issues.

Failing to address these issues can lead to the development of more complex challenges such as gross motor delays, fine motor difficulties, sensory integration disorder, or even ADHD. At home care can also support your baby's recovery, such as providing plenty of tummy time, alternating the side when feeding and carrying, and limiting the time spent in bouncers, swings, and car seats.