How Plagiocephaly Can be Treated & Prevented - Mayo Clinic

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hi my name is dr. Sheri Driscoll I'm a

pediatric physical medicine and

rehabilitation physician at Mayo Clinic

Children's Center babies often develop

head shape asymmetry and what I mean by

that is that I I see kids with head

shapes who are a little bit lopsided

they may develop a little bit of

flatness on one side or the back of

their head or they may be flat all the

way across the back of their head the

asymmetric head shape abnormality is

called positional plagiocephaly the

flatness across the entire back of the

head is called brachycephalic both of

these things are very common these days

because we're putting babies to sleep on

their backs as babies spend a lot of

time on their backs it's simply a

gravitational or gravity phenomena that

they put more pressure on the very soft

bones of their head and if they spend a

long time in a certain position they'll

simply become flat in that certain

position some babies become flat on one

side of their head because they have a

preference to turn their head and maybe

that was due to their position in utero

or maybe it's due to what they like to

look at outside of their crib but that

prolonged position can cause flatness in

that one region and then once they

develop that area of flatness it's

actually harder and harder for them to

turn over and start to look the other

way because they develop a little Ridge

on the back of their head and it makes

it more difficult for them to then turn

in the other direction

well that's flatness or asymmetric

flatness the plagiocephaly can actually

be treated and to some degree prevented

and I think we're doing a much better

job these days of teaching young

families about repositioning their

babies as often as possible now it's

still absolutely true that you should

put your baby to sleep on their back

there's no doubt about that

there there should be no pillows in the

bed nothing else that could cause any

concern for breathing in that baby but

when the baby's awake having the baby

spend some time on their tummy so

they're supervised supervised tummy time

and then spending time in other

so that they're not putting pressure on

the back of their head is fabulous so

that might mean holding your baby up

across your shoulder it might mean a

football hold so baby's lying on tummy

in your arms it might mean just

positioning the baby on your chest so

that you're face to face or on your lap

so that she's on you're on you're on her

tummy all these things are ways to get

the baby off of the back of the head and

help to prevent those head shape


now if head shape abnormality becomes

severe enough that is quite bothersome

to the parents and a concern for the

pediatrician or the other primary care

provider there are other strategies that

can be taken for example if a baby has

torticollis which means their head

turning is such that it's because of a

muscle pull and they actually become

stuck in one position that needs to be

treated by physical therapy the

torticollis needs to be treated before

the head shape can be treated secondly

if repositioning alone isn't sufficient

to help with the baby's head shape

asymmetry a helmet can be used i brought

an example of one this is called a

cranial orthoses it's custom-made for

the baby it can be used to place them

the baby's head so it's a nice round

surface so now baby can move her head

freely side to side and not spend so

much time on the one single position it

also allows for what we call guided

growth and so as baby's head shape is

growing we allow for space inside the

helmet where the baby's head is flattest

so that as her head grows it actually

fills out and becomes more rounded all

these reasons are things that you should

consider when you're contemplating

whether or not to bring your baby in for

evaluation if you have any concern about

your baby's head shape just take her

into your pediatrician and our family

practitioner or other primary care

advisor and they can decide with you if

further evaluation needs to be done