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Nov 15

My baby has a funny shaped head!

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by Stacey Xydias

 

Plagiocephaly is a fancy term for misshapen or flat head – a condition defined as the asymmetrical flattening of one side of the skull.

 

We know that to avoid sudden infant death syndrome (SIDS) babies under the age of six months should be placed on their backs during sleep. Despite the benefit that this position may have in avoiding SIDS, this increases the amount time babies are spending on their backs.

 

Let’s for a moment think about how much time your baby spends in this position – in the car, the pram, during play time on the floor – it is the vast majority of their day.

 

At 6 months old, the soft spots on your baby’s head have not yet completely fused. By spending the majority of their day on their backs, the pressure on their skulls is increased. As your baby’s skull bones are soft and supple, this increased pressure can lead to them developing flat spots or plagiocephaly.

 

So how do you look for plagiocephaly?

 

Often we will assess whether you baby has plagiocephaly by looking at them while lying on their backs. Looking at them from the top of the head (like in the picture) you may be able to see whether there is any flattening on one side of the skull, if one ear is higher than the other, or whether one side of their forehead is further forward than the other.

plagiocephaly
Torticollis

Babies who have plagiocephaly are also likely to have torticollis or “twisted neck”. Torticollis can be caused either during pregnancy or after birth. It occurs when the muscles at the front of the neck (sternocleidomastoid) become tightened on one side causing restricted movement in the opposite direction. As you baby will find it difficult to move their head in one direction, they can become susceptible to developing plagiocephaly.

 

How can I tell if my baby has torticollis?

You can look for following signs that may indicate your baby has torticollis.

  • Your baby will look at you over one shoulder, rather than turning to follow you with their eyes
  • Will often prefer one breast when feeding and will have difficulty breastfeeding on the other side.
  • Is unable to turn toward you easily and becomes frustrated when unable to turn their head.

Treatment

The earlier the better –Torticollis and plagiocephaly are easily treated when seen by a paediatrician or physiotherapist as early as signs are detected. If you think you baby may have either condition, it is best that you seek the opinion of a professional soon as possible.

 

In the meantime, there are numerous at home stretches and changes to your baby’s environment you can make to avoid or limit the development of either torticollis and/or plagiocephaly.

 

If you are unsure or would like to double-check you are doing things correctly for you and your baby, Stacey can show you the best way.

 

Torticollis stretches

One of the most effective stretches can be done whilst breastfeeding. If you baby only turns their head to the right, you can encourage a gentle stretch to the left during feeding. While feeding from your left breast cradle them in front of you as you normally would. However when feeding from your right breast, take on an under the arm hold (see picture) so they are encouraged to turn their head to the left to feed. This way your baby’s neck is being gently stretched and they are being comforted/distracted by food.

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If you do not or are unable to breastfeed, you can still provide gentle stretches for your baby. This can be done through the way in which you cradle/hold your baby to your chest. If your baby persistently turns their head to the right, hold them facing away from you with their right ear on your right arm (see picture). To avoid them becoming grizzly/upset, it is best to try these stretches after a nap, feed or bath when your baby is relaxed.

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Repositional therapy

Let’s change it up a bit – try and modify the position your baby sleeps and plays in each day. Change the direction they sleep in their cot – face them towards the door one day and away from the door the next. Altering your baby’s position will mean they will also change which way they turn their heads – if they’re not always looking in one direction, they’re less likely to develop plagiocephaly or torticollis.

 

Tummy-Time

Tummy time should be an important part of your baby’s every day routine (and the reasons why can be found in our next paediatric blog post).

 

Encourage your baby to play on their tummies – this will help to avoid placing added pressure on the back of their skulls and decreases their risk of developing plagiocephaly.

 

If you think your baby may have torticollis, place any toys on the side which they avoid turning to while they play on their tummies – this will encourage them to turn in that direction and provide a gentle stretch.

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When do I see a physio?

If you think your baby has plagiocephaly and/or torticollis, you have tried our at home exercises and nothing has changed in 3-4weeks, then it is probably time to seek assistance from a professional.

 

Stacey can help you from the earliest stages – assessment and diagnosis – help you with positioning for feeding and carrying, ideas for playtime, and stretches you can do with your baby. She’ll also let you know if you need to see a paediatrician.

 

More information regarding plagiocephaly and torticollis can be found at the following links:

http://www.rch.org.au/kidsinfo/fact_sheets/plagiocephaly_misshapen_head/

https://www.schn.health.nsw.gov.au/parents-and-carers/fact-sheets/positional-plagiocephaly

https://www.gillettechildrens.org/conditions-and-care/torticollis/

 

If you think your baby may have any signs of plagiocephaly or torticollis, please feel free to call us on 8331 0552 to book in with Stacey for an assessment.