What is postural plagiocephaly?
Postural plagiocephaly is a deformity that occurs during the first months of life as a result of sleeping with the head always in the same position, to the right or to the left.
It is also known as asymmetrical head. If it is with posterior postural flattening and symmetrical, it is known as brachycephaly (child sleeps on the back). On the other hand, if it always sleeps on its side, the head is elongated and is known as scaphocephaly.
Why does it occur?
The most frequent cause is the baby’s sleeping posture, but the syndrome can also develop even before birth when pressure is exerted on the baby’s skull by the mother’s pelvis and also in cases of multiple births.
In addition, some babies have softer bones that favor the appearance of deformities.
Other causes that can lead to postural plagocephaly are:
- Restrictive uterine environment: when the baby has less space than it needs in the womb. It also occurs in cases of forceps or vacuum deliveries.
- Congenital postural torticollis due to muscle retraction: torticollis can cause the baby to adopt the same posture when lying down.
- Prematurity: on the one hand, because the bones of the head are weak and malleable and, on the other hand, because infants spend a long time on ventilators in the intensive care unit.
What are the symptoms?
Asymmetrical heads are observed with one pinna more forward than the other and even with asymmetrical hemicaras.
Other symptoms are:
- The back of the head is flattened.
- There is usually less hair in that area of the head.
In the most severe cases, the forehead is irregular and if it appears as a result of torticollis, both the neck and the jaw may be uneven.
How can it be prevented?
To prevent flat head syndrome, the following recommendations should be followed:
- Change the position of the baby’s head from one side to the other.
- Hold the baby in your arms and avoid keeping him/her for a long time in the strollers, since they maintain a fixed posture.
- Close observation by the pediatrician for early diagnosis of asymmetry.
Pillows specifically designed to prevent postural plagiocephaly can also be used. They have a hole in the center for the child’s head to be placed in such a way that this area is not under pressure.
However, it should be noted that this is not a problem that affects IQ and possible cosmetic sequelae can be corrected if diagnosed early.
Treatment of postural plagiocephaly
Some of the measures to correct flat head syndrome are:
- Correcting the position of the head while the child sleeps. That is to say, to rotate the head from one side to the other to avoid flattening.
- In cases where torticollis is present, physiotherapy treatment focused on stretching exercises of the neck muscles can also be initiated.
- Finally, bands or helmets can also be used when the problem persists for 2-3 months.
Another of the most commonly used techniques is the Contralateral Postural Repositioning of the Head (RPCC) and consists of supporting the head on the opposite side of the deformity.
In any case, flat head syndrome improves over time and does not affect the baby’s brain growth. Even so, it is important to remember that there is a greater likelihood of improvement when treatment is applied during the baby’s first year.
After 3 or 4 months of age and depending on the degree of severity, it is convenient to apply a treatment with dynamic cranial orthopedic bands if the deformity is marked. Between this period and 12 months of age is when the best results are obtained.
What specialist treats it?
A pediatrician will be the specialist in charge of performing and treating postural plagiocephaly, since his training is directed to the study of children and their diseases.