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LOC Welcomes New Plagiocephaly Guidelines

New guidelines from the Congress of Neurological Surgeons (CNS), set out in the November edition of the medical journal Neurosurgery, recommend helmet therapy in the treatment of moderate to severe Positional Plagiocephaly in infants.

A multidisciplinary team of clinical experts developed the new guidelines, following a comprehensive review and analysis of the current research on diagnosis and treatment of the condition. The advice on helmet therapy states that “a helmet, or ‘cranial moulding orthosis’, is recommended for infants with moderate to severe Plagiocephaly that persists after repositioning and/or physical therapy, or for older infants.”

Also known as ‘flat-head syndrome’, Positional Plagiocephaly is caused by constant pressure on a particular part of a baby’s head. The number of infants with the condition has risen dramatically in the past 20 years. There are a number of factors that can cause it, including a baby’s position in the womb or prolonged periods in a car seat or buggy. But, much of this increase is thought to be a result of the ‘Back to Sleep’ campaign (now known as ‘Safe to Sleep’), set up to encourage parents to place babies on their back while sleeping, in order to lower the risk of sudden infant death syndrome (SIDS).

The campaign has cut the number of infant deaths in half and the advice remains that babies should always be placed on their back when sleeping. However, repositioning your baby’s head – so that it doesn’t rest on the same spot – and adopting tummy time techniques can help avoid the development of Plagiocephaly and the new guidelines represent an important step in its treatment.

LOC clinician Sally Hews says: “These guidelines mirror what we have been saying to parents for a decade. As long as the baby is young enough, repositioning is the first option in most cases. Helmet therapy is typically indicated where repositioning has proved unsuccessful or the Plagiocephaly or Brachycephaly is severe.”

Treating Plagiocephaly is one of LOC’s specialisms. We make our bespoke helmets – known as the LOCband – using a scanner to capture the shape of a baby’s head. We then turn the scan into a 3D computer model and use that to build the helmet. It is a pain-free treatment that can be adjusted during growth and gently guides your baby’s head into a more symmetrical shape.

It’s important to start helmet therapy early, in order to have the most positive impact. As babies grow, the plates of the skull become less malleable, meaning that helmet therapy will only be effective if it is pursued well before the age of two. In a baby aged four to seven months treatment usually lasts around three to six months depending on the severity. In the first study of Positional Plagiocephaly conducted on an Australian population – carried out at Sydney Children’s Hospital between 2009 and 2012, and published online in the Journal of Clinical Neurosciencein March 2016 – it was found that the 84 babies (aged between six weeks and one year) who received helmet therapy saw a significantly greater reduction in asymmetry of head shape than the 87 who were not prescribed any therapy at all.

If you are concerned about your baby’s head and would like a fast, free opinion from one of LOC’s experienced clinicians, visit our flat head syndrome diagnosis form to upload photos of your baby’s head and contact details. A LOC clinician will respond within 24 hours.

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