Treatment Guidelines for Positional Plagiocephaly

One out of every 300 babies born result in a baby plagiocephaly-torticollis-deformation. Sounds scary, right?! It isn’t. Positional plagiocephaly is the flattening of one side of the head with forward progression of the ear on the same side. Have you ever had friends or family members who wear glasses and they’re lopsided? Many times, that is because of an ear shift. Does your baby like to turn their head to the same side while sleeping or resting? They may be at risk for Positional Plagio­cephaly. Back sleeping and preferred positioning for extended periods of time, cre­ates pressure on one area of the head, which prevents it from growing at the same rate as the rest of the head. This may create an asymmetrical head. Since the “Back to Sleep Campaign,” the percentage of infants with this condition is much higher.

Do all Cranial Deformities look the same?

Types of Cranial Deformities

What is the “Back to Sleep Campaign?”

1n 1992, the American Academy of Pediatrics began to encourage parents to place sleeping infants on their backs to prevent the risk of SIDS (Sudden Infant Death Syndrome). This became known as the “Back to Sleep campaign. This program led to a reported 70% reduction in the case of SIDS; however, has also resulted in an increase in the number of infants with cranial asymmetries.

Is My Child At Risk For Positional Cranial Deformity?

  • Multiple Births
  • Breech Births
  • Long Labors
  • Time in the NICU
  • First Born Child
  • Male Sex
  • Neck Muscle Tightness
  • Poor Muscle Tone
  • Positioning
  • Spine Abnormalities

What Can I Do To Help Prevent Positional Cranial Deformities In My Child?

What is Repositioning?

An infant’s skull is flexible and is at risk for flattening when against any surface for extended periods of time. Doctors recommend alternating positions which will allow for growth to be evenly distributed. Using toys and other colorful or musical items will tempt a child to look in the opposite direction, allowing the pressure to redistribute. If you notice a flattening on your little one’s head, try to create distractions, and reposition his or her head in the opposite direction. This will prevent any contact with the side that is not forming as quickly as the rest of their head. Repositioning is the conservative treatment of treating cranial asymmetries in infant under the age of 6 months.

Tips for Repositioning:

  • Change the location of your child’s mobile in their crib
  • Alternate the arm used while cradling your baby when breast feeding or bottle feeding
  • While diapering or changing their clothes, alternate sides in which you stand. If your child prefers a certain side, stand on the opposite side.
  • While traveling by vehicle, change the car set location so your child can look out both windows.
  • When in a stroller, be sure to monitor the direction in which your baby is looking. Use attachment toys on the opposite side to encourage them to look the other way.
  • Encourage tummy time

What is Tummy Time?

It is recommended that infants should spend at least half of their time awake on their tummies. Tummy time counts as any time your baby’s Chin is facing the ground. Tummy time is imperative for the development of your child, and helps to prevent against positional cranial asymmetries.

There are several instances of Tummy Time:

  • Baby lays on a blanket with toys and stimulus
  • Mommy, Daddy, or caretaker cradles child face down
  • Caretaker or parent lays with child laying on their chest
  • Baby laying face down on a parent’s lap

What are the options in treating a Child with a Positional Cranial Deformity?

The Plagio Cradle was developed by Gary Rogers MD and James Miller, CPO at the Children’s Hospital of Boston. This product is for preventing or treating early signs of Plagiocephaly, not brachycephaly or scaphocephaly. The Plagio Cradle is typically recommended for Children who are 0-3 months of age and must be discontinued immediately when the child exhibits signs of being able to roll over.

The Boston Band is typically recommended for children who are 3-18 months in age and have any kind of cranial asymmetry that has failed to improve with conservative measures (such as repositioning techniques and/or the Plagio Cradle). How long your child may need to wear the Boston Band depends on how flat the head is and the amount of growth remaining.

Other Cranial Orthosi Related Services