Plagiocephaly

A plagiocephaly head shape is one where one side of the head does not match up with the other side – it is asymmetrical.

A baby’s skull is made up of several ‘plates’ of bones which at birth are not tightly joined together. They are soft enough to be moulded by outside forces; this means their shape can be altered by pressure, just lying or sitting in the same position against a firm surface can cause flattening usually at the back of a baby’s head

If you are concerned that your baby might have a plagiocephaly head shape these are the physical symptoms to watch out for:

  • Posterior flattening on one side
  • Anterior forehead flattening on the opposite side to posterior flattening
  • Anterior ear, forehead and eye orbit shift on the same side of posterior flattening
  • Posterior bulge
  • Often associated with facial asymmetry

If you are concerned about the shape of your baby’s head, help and advice is at hand. You can get immediate and free advice from one of our experienced clinicians here.

 

 

Causes

Positional plagiocephaly can be caused by a number of factors involving positioning, such as extended time spent in a neonatal unit, the birth process, position in the womb and often the infant's preferred sleeping position. It can also be caused by a condition called torticollis.

 

What is Torticollis?

Torticollis is a condition in which a tight or shortened muscle in one side of the neck causes the head to tilt or turn to one side, resulting in the infant resting its head in the same position. In 2013, we analysed the data from all first appointments in our Kingston clinic and found that 20% of the babies examined had some kind of neck condition that was causing head immobility.

How common is Positional Plagiocephaly?

Frankly, there does not seem to be much consensus on the incidence of positional plagiocephaly. The situation is not helped by the fact that the NHS does not measure head shapes either at birth or subsequently. Where head shapes are measured in other countries it is difficult to make comparisons because one is never certain that the same methodology is being used. Great Ormond Street Hospital for Children says: “Some reports estimate that positional plagiocephaly affects around half of all babies under a year old but to varying degrees.” GOSH’s summary is supported by a Canadian study published in 2013 which found that 46.6% of a sample of 440 infants at two months had some form of positional plagiocephaly.

Source: The incidence of Positional Plagiocephaly: A Cohort Study: Pediatrics peds.  2012-2009; published online July 8 2013

FAQs:

This is very much dependent on how fast your baby is growing. The faster the growth, the more frequently your baby will be seen so that the helmet can be adjusted. In general, reviews will happen at two to four-week intervals.

The price of treatment covers:

  • all your baby’s required appointments from start to the end of treatment, no matter how many are required to achieve the improvement in head shape that you are happy with;
  • the cost of manufacturing the LOCband and supply of appropriate cleaning fluid for the band;
  • all reports to your GP/paediatrician/ cranial osteopath/physiotherapist, including a final scan report with objective measurements of change achieve;
  • full telephone support from your clinician during treatment, and, if necessary, extra review appointments at short notice.

Yes - All babies that have completed their course of treatment with us have achieved a measurable improvement in head shape. However, you don’t have to take our word for it.

Recent independent research conducted by a University Hospital in Germany has endorsed the treatment for babies with moderate or severe plagiocephaly.

A larger, retrospective study has just been published that found complete correction was achieved in 94.4% of babies treated with helmet therapy.

The results were conclusive: repositioning achieved acceptable correction in 77.1% of cases, but 15.8% were moved onto helmet therapy because re-positioning was not working. Meanwhile, 94.4% of the infants who started in the helmet-treated group achieved full correction, as did 96.1% of those who were transferred from the repositioning group into the helmet-treated group.

Further information can be found on our Plagiocephaly Research page.

If your baby has a temperature or a fever due to illness you must remove the band. The band can be put back on once the temperature has returned to normal.

The optimum age for treatment is between four and seven months.

This is because the skull is most malleable at this age and improvements to head shape tend to take less time and are more dramatic. That is not to say that helmet therapy should be ruled out if the baby is older than seven months. Routinely, babies up to the age of 16 months can be treated very successfully.

The cut off age is around 18 months when the fontanelles (soft spots on the head) are no longer malleable. As babies grow and develop at different rates, it is always worth checking if you are not sure. There have been cases where a baby’s fontanelles have not fused yet by the age of 18 months, who have achieved successful, but less-marked results with cranial remoulding therapy.

Torticollis is a condition in which a tight or shortened muscle in one side of the neck causes the head to tilt or turn to one side, resulting in the infant resting its head in the same position. In 2013, we analysed the data from all first appointments in our Kingston clinic and found that 20% of the babies examined had some kind of neck condition that was causing head immobility.

The clinics and clinicians that provide this treatment in the UK will have received similar training and experience. However, we are the only clinic that manufactures its own helmet and our clinicians are closely involved with the process for each individual helmet that we produce.

In addition, we do not restrict review appointments to a set number, we are extremely flexible and respond to individual parents' needs so that the best outcome can be achieved for each baby.

The LOCband is non-invasive and works by applying gentle, constant pressure over the areas of the baby’s skull that are most prominent while allowing unrestricted growth over the flattened areas. The band consists of a soft foam layer inside a thermoplastic shell. As the baby grows, the band will be adjusted frequently to gently guide the skull into a more symmetrical shape.

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