An in-depth look at treatment for positional plagiocephaly, brachycepahly, and scaphocephaly
When is treatment most effective
The effectiveness of treatment methods for flat head syndromes such as plagiocephaly, brachycephaly and scaphocephaly vary based on the age of the baby and the severity of the deformity. The following information should give you an idea of the treatments available for your baby’s case.
Natural treatment methods (tummy time and repositioning)
The use of natural treatment methods for flat head syndromes is usually recommended for babies who are younger than 6 months of age. Repositioning is the most common method and is most effective before 5-6 months of age, before infants begin to move on their own. Once your baby can get around by scooting, sitting up, or rolling over independently, the most effective natural remedy will be tummy time. Additionally, doctors recommend limiting the amount of time baby spends on their back during the day when the baby is awake. General treatment strategies encourage parents to promote daytime activities for infants that do not involve much time spent lying on their backs. By one year of age, natural treatment methods are generally ineffective, since most children are able to crawl or walk by this point. The earlier and more often you perform natural treatment methods, the more effective they will be.
In 2008, Xia et al conducted a review of existing studies comparing the effectiveness of repositioning therapy vs. cranial orthosis (helmet or band therapy). They reviewed over 3,000 cases and determined that the most effective treatment for positional cranial deformations is helmet or band use, regardless of age or indicators that might suggest a child is better suited for repositioning therapy. The authors did express caution that the number of studies available is small, and the need for further research is necessary as a result of flaws in some of the studies they examined.
Many insurance companies require that parents try repositioning and physical therapy before proceeding to helmet therapy. The cost of helmeting without insurance support might be too high for many parents to proceed directly to helmeting, even if it would be the most effective treatment method for their child’s case.
In any case, natural therapies are low risk and should always be used if you suspect your baby has flat head syndrome.
A 2011 study on the outcome of cranial molding helmet therapy at various ages determined that the best outcomes were achieved when children began helmet therapy between the ages of 5 and 6 months. The authors of the study suggested that physical therapy alone should not be the first course of treatment in severe cases. They advocated that helmet therapy in combination with physical therapy be used immediately in severe cases, since study participants with severe cranial deformations who began helmet therapy later did not manage to recover normal head shape.
Many parents whose children require helmet therapy are worried about long-term psychological effects. While there is some evidence to suggest that helmeted children recognize that they are somehow different, a 2008 study on the quality of life of children who had undergone helmet therapy discovered that 96% of patients and their families were satisfied with treatment results. Only two families had complaints regarding the treatment. In one case, pressure spots and hair loss resulted from helmet use, and in another normal head shape was not regained. If you are worried about how your little one will handle helmet therapy if it is necessary, remember that there are many types of helmets and bands available, and several offer customizable patterns or colors that your child may like.