plagiocephaly information for parents, carers and healthcare professionals

PlagiocephalyInformation for Parents, Carers and

Healthcare Professionals

Plagiocephaly

1. What is plagiocephaly?2. Causes3. Signs and symptoms4. Prevention5. Treatment6. Advice

1. What is Plagiocephaly?

• A form of Flat Head Syndrome• Believed to affect almost half of infants• Characterised by an asymmetrical,

parallelogram-shaped head• One side of the head is usually flatter than the

other

What is Plagiocephaly?

What is Plagiocephaly?Examples

What is Plagiocephaly?

Comparison of flattened and regular head shapes

2. Causes of Plagiocephaly

• A flattening occurs when the infant spends a lot of time lying with the head resting in the same position.

• Because the bones in the skull are still fairly soft, the pressure on the head eventually leaves an indentation.

3. Signs and Symptoms of Plagiocephaly

• An asymmetrical, parallelogram-shaped head.• A tendency to face in one direction.• The neck muscles may be tighter on this side.

This is called torticollis and may require therapy to help correct it.

4. Preventing Plagiocephaly

• In the vast majority of cases, plagiocephaly can be prevented or treated in the early stages through ‘repositioning’.

• Repositioning involves removing pressure from the back of the head while your baby is awake, and varying the position of the head when he or she is asleep.

Preventing Plagiocephaly: Repositioning

• Please note: your baby should always be placed on the back to sleep.

• This minimises the risk of Sudden Infant Death Syndrome (SIDS).

• However, there are a few ways in which you can subtly manipulate the head position while your baby is asleep.

• Start repositioning as soon as you notice a flattening (usually around eight weeks).

Encourage your baby to face in different directionswhen asleep by:• Gently turning the head with your hands• Moving toys and other objects of interest from one

side of the cot to the other• Turning the cot through 180 degrees• Covering the thumb that your baby usually sucks

Preventing Plagiocephaly: Repositioning

Reduce pressure on the back of the head when yourbaby is awake by:• Placing your baby on the front to play

(‘tummy time’)• Using a carry sling or papoose• Taking your baby out of the car seat / buggy when not

travellingAim to reduce pressure on the back of the head for at leasthalf the time your baby is awake.

Preventing Plagiocephaly: Repositioning

Holding your baby

Preventing Plagiocephaly: Repositioning

5. Treating Plagiocephaly

• In 95% of cases, active repositioning is adequate for reducing the signs of plagiocephaly.

• A cranial helmet is the preferred treatment for the most severe 5% of infants.

• If repositioning has failed to make the difference you had hoped for by the time your baby is 4 – 5 months old, a helmet is the best way to ensure a more normal head shape.

Treating Plagiocephaly:Cranial Helmets

“[Helmet therapy] should be the treatment of choice for moderate to severe cases [of plagiocephaly]. Only mild cases (modified CVAI ≤ 6.5%) can be adequately treated by conservative, i.e. non-helmet, management.”

Sybill Naidoo and An-Lin Cheng (2014)Long-Term Satisfaction and Parental Decision Making

About Treatment of Deformational Plagiocephaly

Treating Plagiocephaly:Cranial Helmets

• A custom-moulded helmet is worn 23 hours a day, usually for 3 – 6 months

• This gradually corrects the shape of the head as the skull grows

• Cranial helmets are a safe and effective treatment for moderate to severe cases of plagiocephaly

• Unfortunately, they are not currently available on the NHS and cost around £2,000 from a private clinic

• However, there are a number of charities that can help you raise the funds if required (try Tree of Hope and Headstart4Babies)

• Provided you begin treatment before your baby reaches 12 – 14 months and follow treatment protocols, a cranial helmet will make a significant improvement to your baby’s head shape.

• After this time period, the deformity can only be corrected by surgery.

Treating Plagiocephaly:Cranial Helmets

6. Advice for Parents & Carers

• If you notice a flat spot on your baby’s head, begin repositioning straight away.

• If this has not made a difference by the age of 4 – 5 months, contact your local plagiocephaly clinic and book an appointment to see if your baby could benefit from helmet treatment.

Thank you for taking the time to read this presentation.

Brought to you by Technology in Motion, UK orthoticclinic and plagiocephaly specialist.

To find out about our TiMband treatment, please visitwww.technologyinmotion.com or callus on 0330 100 1800

References• Mawji, A., Robinson, A., Hatfield, J., McNeil, D., Sauvé, R. (2013). The

Incidence of Positional Plagiocephaly: A Cohort Study. Pediatrics, 132(2), 1-9. doi: 10.1542/peds.2012-3438

• Hutchinson, B. L., Stewart, A. W., Mitchell, E. A. (2010). Deformational Plagiocephaly: a Follow-Up of Head Shape, Parental Concern and Neurodevelopment at Ages 3 and 4 Years. Archives of Disease in Childhood, 96(1), 85-90. doi:10.1136/adc.2010.190934

• Naidoo, S., Cheng, A. (2014). Long-Term Satisfaction and Parental Decision Making About Treatment of Deformational Plagiocephaly. Journal of Craniofacial Surgery, 25(1), 160-165. doi: 10.1097/SCS.0000000000000383