My Baby Has a Flat Head!
Its’ technical name is plagiocephaly, although most people just know it as the flat head syndrome. It is what occurs when a baby spends so much time on their back that the back of their head and skull become very flat instead of rounded like it is supposed to be. In reality the definition of plagiocephaly is “a malformation of the head marked by an oblique slant to the main axis of the skull”. It is only since the “back to sleep” campaign began to cut down on the occurrence of SIDS that it has become more associated with newborns and children.
Most babies are born with an abnormally shaped head from their travel during the birth canal. The skull is formidable at this point and can change to accommodate its’ surroundings. This is good for labor, but not necessarily good for baby as he gets older. If your baby’s head shape doesn’t change to look more “normal” by six weeks, or if you see an increased, flat area, ask your pediatrician if he thinks it looks ok or if you should see a specialist. Prominent foreheads and misaligned facial features may be a sign of true plagiocephaly in your baby. Plagiocephaly can often be mistaken for craniosynostosis which is a more serious condition where the bones of the skull close too early not allowing enough room for brain to grow, leaving the head looking deformed.
In addition to the effort to cut down on the cases of SIDS, misshapening of the head can also happen in the womb from a baby being too cramped, either because of a lack of amniotic fluid or his position in the womb. It is common to see in breech babies and multiple births as the amount of space in the womb is drastically decreased as the baby gets bigger. The simple “back to sleep” cause of a flat head will most often reverse itself when the baby is sitting up, crawling and walking around during most of the day.
If your pediatrician refers you to a pediatric neurosurgeon there are several steps he might take. In most cases a simple x-ray can be taken to distinguish between plagiocephaly and craniosynostosis, however sometimes the doctor will choose to have your baby get a CT Scan instead. If the doctor confirms that it is positional plagiocephaly he will probably suggest that you begin changing the babies position when he is on his back to his sides, or if the flat area occurring on one side, he may suggest you keep him off that side and lay your baby on his other side and back. He may also suggest that you greatly up the amount of tummy time your baby has each day.
If the positional therapy does not work on your baby the doctor may decide to go with a band or helmet that is designed to fit and round out your babies head while keeping it out of immediate contact with the floor, mattress and other hard spaces. This helmet will generally be worn for 2-6 months, depending on when the problem was noticed and how severe it is, and your baby will need to be in the helmet almost 24 hours a day. When discovered early, the success rate of the helmet rounding out the head is very high.
Again, if you think that there is something wrong with the shape of your baby’s head, take him to see his pediatrician or ask during the next well-check. You doctor may tell you your baby’s head is perfect and normal, but it is always better to be safe than sorry and early detection drastically improves the chance of reversing the condition.
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