Why You Shouldn’t Wait to Talk to Your Pediatrician About Baby Flat Head Syndrome

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Being a parent comes with plenty of stress and worry. Even when you are equipped with all the tools you need to be a great parent, the worry is still part of the process. When it comes to your baby’s health, the stress can be even greater. Many parents find themselves wondering when it the right time to talk to their pediatrician about baby flat head syndrome. Let’s take a look at why you shouldn’t wait.

The Best Time is Before There’s a Problem

Like just about everything, the right time to address a problem is before it becomes one. This is why it is smart to talk to your child’s pediatrician at the beginning of your baby’s care. Let your doctor know that this is a concern for you and they can share tips on how to prevent the diagnosis.

It is also helpful for your doctor if they can give you some things to look out for to avoid trouble. So, from that very first pediatrician appointment, talk to your doctor about your concerns regarding baby flat head syndrome.

Earlier Treatment is Key

If you already suspect that your baby’s head may have some flattening waiting and seeing is not the best course of action. Recent research is showing that earlier treatment of baby flat head syndrome, or plagiocephaly, is much more effective.

In the August of 2017 issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS) they published an article outlining that treatment before the age of 24 weeks leads to more successful treatment.

In this study of 144 infants, the babies were grouped into three age groups: before 24 weeks, between 24 and 32 weeks and 32 weeks or later. Notations were also made regarding the severity of the flattening. They found that Helmet therapy improved flattening in all three groups. However, treatment was more effective when started at younger ages. The infants in the mild-to-moderate group had a success rate of 83 percent when starting before 24 weeks. The success rate dropped to 69 percent for infants starting treatment between 24 and 32 weeks and 40 percent when treatment was started at 32 weeks or later.

Sooner May Mean Shorter Treatment

A side note of this and related studies is that earlier treatment may also mean a shorter course of treatment. A 2011 study set out to investigate if earlier Helmet therapy would lead to a shorter course of treatment. The study included 62 infants, randomly assigned into two groups: group A with infants under 6 months and group B with infants older than 6 months. What they found was that the duration treatment was 14 weeks for group A and 18 weeks for group B.
So, if you have a suspicion that your baby may be experiencing a flattening of the skull, there is no reason to wait to talk to your doctor.

No parent is eager to put their child through any kind of medical treatment. However, if you have a hunch that your baby’s head is flattening earlier treatment is more effective and much briefer. Shaving a few weeks off of treatment is a wonderful thing for baby and parents.

Potential Outcomes of Skipping Cranial Remolding Therapy

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Your pediatrician recently diagnosed your baby with plagiocephaly and it’s up to you as the parent to figure out what is your next step. Perhaps your child’s flat head syndrome is mild enough that your doctor suggested repositioning as the first course of action. But what happens when the doctor thinks that cranial remolding therapy is a must? The question is – do you have the right to say no and what will happen if you do.

Can you refuse remolding therapy?

As the parent you are the person ultimately responsible for deciding what is best for your baby. It is up to you to balance information provided by your pediatrician with what you think is right. So, yes – you do have the right to try other treatment courses like repositioning and physical therapy before helmet therapy. Ideally your child’s doctor is someone you trust. If you have questions about the best course of treatment you can also consider a second opinion from a specialist.

Should you refuse remolding therapy?

Hearing something is “wrong” with your baby isn’t easy. In fact, it’s downright scary. When your doctor recommends your baby wear a medical device nearly round the clock it compounds the fear and worry. In reality, plagiocephaly treatments are generally much easier and more comfortable than most parents anticipate. The time that baby is required to participate in the therapy is usually very brief. The helmets and bands currently available are lightweight, breathable and more comfortable than they often look. It’s important to consider each angle when making a decision.

What will happen without cranial remolding treatment?

The real question that most parents want to ask is what will happen if they do not complete cranial remolding therapy. This is a legitimate question to ask. In some mild cases this treatment can be avoided in favor of repositioning. This means to move baby’s position throughout the day to make sure she never spends too much time lying on one side. In more severe cases, this may not be enough.

Potential physical outcomes

Physiological outcomes are largely based on the severity of the diagnosis. If you child has a very mild case of baby flat head syndrome, the pediatrician may prescribe a course of repositioning therapy. When the flattening is mild the skull will generally grow typically over time. If the case is more severe and goes untreated it can lead to more outward symptoms. Some of the possibilities include:

– Mild to moderate facial asymmetry
– An open mouth posture
– Problems with eating and drinking
– Shortening of neck or trunk muscles
– Decreased strength
– Misshaping of the skull

While these are by no means a likely outcome, in moderate to severe cases of infant plagiocephaly, they are possible if the flattening is left untreated.

Possible developmental outcomes

In addition to physical symptoms, there are possible developmental implications. Studies have shown that baby flat head syndrome can lead to a number of developmental issues, specifically when no treatment is provided. The delays include both fine and gross motor delays and delays in reaching typical childhood milestones. The data suggests that when children receive timely and appropriate treatment for the diagnosis, the delays are minimal.

So in the end, parents have plenty of say in how their son or daughters plagiocephaly diagnosis will be treated. When flattening is in the moderate to severe range cranial remodeling may be the best course of treatment. It is important to work with the pediatrician to find a balance between comfort and the best treatment.

How Do I Know When to Talk to the Pediatrician About Plagiocephaly?

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Maybe you are a first time parent or maybe you have other children but never noticed head flattening before. Perhaps a friend or relative commented on the shape of your infant’s head. Regardless, you may wonder how flat is too flat when it comes to your infants head. Here are some helpful hints to help you determine when it’s time to make an appointment and talk to the pediatrician.

Monitor Your Baby’s Head Shape

A good first step when thinking about whether you need to talk to a doctor is to take a good long look at the shape of your baby’s head. One way is to enlist the help of a spouse or other family member to hold baby while you carefully observe. Have that other person hold baby quietly in their lap so you can look at the head shape from above, behind and face-to-face. Look for things like flattening and asymmetry. A typical head shape for an infant would be approximately 1/3 longer than it is wide. Babies experiencing flat head syndrome may have a head shape that appears flat on one side, wide towards the back, or long and thinner than normal.

Monitor Any Changes in Shape

Another important part of the process is to monitor your baby’s head shape. If you begin to offer baby more time upright, on her tummy or in a carrier you may notice a reduction in the flattening. However if you feel like it is advancing, make an appointment and have baby evaluated by a doctor.

Check Baby’s Ear Alignment

Another telltale sign of flat head syndrome is misalignment of the ears. If you place baby in your lap and place your fingers at the same spot on each ear you can look to see if your fingers are aligned. If they are spread wide apart this is a good sign that you should make an appointment to have baby assessed.

Take a look at Baby’s Facial Symmetry

Facial symmetry is another way to determine the severity of baby’s head flattening. Because you look at baby every day, you might not even see a lack of symmetry. To check for symmetry you might want to ask a friend or family member to help you. Using a mirror look at baby’s face and check for things like eye shape or cheek fullness. If you begin to notice that things are slightly asymmetrical, this would be another sign you should make an appointment for baby to be seen.

When in Doubt, Talk to a Professional

All parents know that when you are in doubt, pediatricians welcome questions and concerns. By working with your child’s doctor you can start the process of evaluating and treating flat head syndrome.

Plagiocephaly is a highly treatable condition with the great possibility of no long-term impact on baby. That being said, it is best to start treatment as early as possible. So if you have concerns, talk with your pediatrician and put baby on the path to healthy development.

Three Important Ways to Avoid Plagiocephaly

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Plagiocephaly has seen a dramatic spike in the number of babies diagnosed each year over the course of the past twenty-two years. Finding ways to avoid plagiocephaly has become increasingly important. This spike has largely been associating with the “Back to Sleep” campaign, which encouraged parents to put their infants to sleep on their backs, rather than their stomachs. This campaign was highly effective at reducing the rate of sudden infant death syndrome (SIDS), with a more than 50 percent reduction in the death rates since the start of the 1994 campaign. An unexpected outcome of this highly successful movement was the rise in plagiocephaly diagnoses. Some studies have shown that the diagnosis has risen by at least 21 percent. Because SIDS is dramatically more dangerous than plagiocephaly, sleeping on the back is important. So many parents ask, what can they do to avoid flat head syndrome but adhering to recommendations on back sleeping?

There are a number of things parents can do to avoid a plagiocephaly diagnosis; these are among the most important:

Using Supervised Tummy Time to Avoid Plagiocephaly

One of the best ways to avoid babies spending too much time on their back is by having them spend time on their belly. While tummy sleeping is not recommended, all childcare experts collectively recommend supervised tummy time. There are many ways you can safely engage your baby in tummy time. Younger babies may have difficulty holding up the weight of their head so a rolled towel or blanket can be placed under their chest to boost them upwards. You can also position baby on your chest so they must lift their head to see your face. Babies love to look at their parents face so this allows both tummy time and bonding. Older babies with stronger neck muscles can be placed on a blanket on the floor and you can encourage them to lift up their head and engage in play.

Using Repositioning to Avoid Plagiocephaly

Another tip that is recommended by doctors and childcare experts is to use repositioning to avoid plagiocephaly. This is a simple technique where you adjust where and how baby lies in their crib, swing or other safe space. By changing the location they lay in and the direction they face their head you can help minimize the potential head flattening. This can even be used to treat mild cases of plagiocephaly in infants under 4-5 months old.

Using Babywearing to Avoid Plagiocephaly

A newer suggestion for avoiding flat head syndrome is babywearing. By carrying baby in a pouch, sling, wrap or carrier you can help make sure that their head is not receiving the pressure that would be applied when laying down. By making sure that your carrier of choice allows baby’s head to be free you can spend hours where baby is safe and supported but not laying on their back.

These are three of the most important ways you can avoid your baby’s head to become flat. They are simple and effective, and ideally should begin as soon as baby comes home from the hospital.

What You Need to Know About Torticollis Massage for Infants

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What You Need to Know About Torticollis Massage for Infants When your little one is uncomfortable, the world seems like a rough place to live. For young infants, medicine often isn’t an option. Handling their pain may require alternative methods. In babies with infant torticollis, doctors sometimes suggest massage. Here’s what you need to know if your doctor recommends massage for baby’s torticollis:

What is Infant Torticollis?

Infant torticollis is a muscular condition that can restrict movement of the head, and is often congenital (present at birth). In some cases, you’ll be able to feel a lump in your child’s neck in the affected muscle fiber. Often, the only sign of the condition is that your child won’t rotate their head as far or as easily to one side or fails to breastfeed as easily on one side. If untreated, infant torticollis can lead to positional plagiocephaly or brachycephaly; 90% of torticollis cases are associated with positional plagiocephaly.

How Can Massage Help Infant Torticollis?

Massage therapy is a lot more than hot stones, candles, and massage oil. Although the media often downplays the effectiveness of massage, it has a true therapeutic role when administered by a trained professional. Infant massage has the benefit of providing skin-to-skin contact – something babies love and need – while stimulating circulation to the affected muscles and reducing inflammation.

Massage therapy offers a few additional clinical benefits for babies with torticollis – it lengthens the muscles of the neck and strengthens them at the same time. If treated with massage early enough, no other therapy may be necessary for your baby.

Who Should I Trust to Give My Baby a Massage?

There are multiple ways of handling infant massage therapy. Some pediatric massage therapists prefer to train parents to give the massage, while others do the therapy themselves. Never let an unlicensed massage therapist or a machine give your infant massage therapy for torticollis – it’s a very delicate task, and dangerous if done incorrectly.

Before any massage therapy commences, your child needs to have a complete diagnosis of infant torticollis, and the therapist needs to know how the SCM muscle is affected and if your child has a pseudotumor or not. If your therapist is ready to start working on your child’s neck without having all the necessary info, get a new therapist…one who is willing to ask all the necessary questions and keep your baby safe.

The outcome of infant and childhood congenital torticollis is usually quite good – even up to age 4, the condition seems to resolve well with treatment and rarely requires surgery. Although it’s hard to watch your little one deal with the condition, remember that you are taking the right steps to treating it. Soon enough they’ll be rolling their head easily from side-to-side.

Container syndrome – how modern products are impacting children’s health and development today

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Container syndrome – how modern products are impacting children’s health and development today

There are so many wonderful new products on the market today to help us care for our babies. Some of these are essential for safety, and some are designed just for our convenience. These products include infant travel systems that allow you to move your child from the car to a stroller without ever removing him or her from their seat, and other products such as bouncy seats, infant rockers, and swings. Babies tend to sleep well in many of these products, and they may end up spending a lot of time in them.

Because of the frequent use of these types of products today, many modern babies can end up staying basically in one position for much of their day. This has led to the development of a newer condition being dubbed “container syndrome”, which is a broad term used to describe delays in infant development which are related to babies spending too much time in these types of containers, and not getting enough tummy time. Tummy time is extremely important to do regularly with all babies.

The incidence of container syndrome has increased steadily over time, as more and more infant restraining devices have emerged on the consumer market. In the 1990’s in particular there was a sharp rise in the condition. Developmental delays have been noticed in roughly 22% of infants who spend the majority of time on their backs, and doctors believe that tummy time, time in slings or carrier pouches, and the use of seats which require infants to use their neck and back muscles rather than providing a head rest may prove beneficial in preventing container syndrome as well as related motor skill and developmental delays.

Combined with medical recommendations to place children to sleep on their backs, “container” use has caused many infants to have weak neck muscles and in some cases has contributed to the incidence of flattening of the head known as flat head syndrome. You can find a lot of information here on this site about this condition, and how to prevent and treat it.

Safely positioning baby for sleep

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This post was kindly submitted by Susan Slaughter, MS, OTR/L, of Carolina Kinder Development, which is is a practice devoted to infant development and preventing and treating torticollis, plagiocephaly, and brachycephaly. Founded in 2006 in Charlotte, NC, their services include baby classes, parent education videos, cranial bands, pediatric occupational and physical therapy.

Carolina Kinder Development offers a helpful 17 part infant development video series, which is designed to help parents and caregivers navigate the challenges of head shape and neck issues, and educate about related topics like tummy time, side lying & baby equipment (swings, carseats, etc).

Positioning Baby for Sleep

It’s important to position your baby safely for sleep and in a manner which supports development and head shape. Yes, even the position your baby sleeps in will nurture or hinder their development! It almost seems impossible doesn’t it? How could the position your baby sleep in help or hinder her development? Let’s look at it from a few angles.

One is that babies sleep multiple times a day. Upon first waking, most babies are in a calm alert state and it’s an ideal time for her or him to look at what is around them. In the photo below, the baby’s peripheral vision is blocked . . . and thus, her desire to move her head is limited. This is the tip of the iceberg on why an inclined position is not ideal for many babies’ development or head shape.

But let’s get back to sleep position. While “Back to Sleep” is essential for safety there is much more to the story. The American Academy of Pediatrics Safe Sleep Practices specify not only back sleeping but also a firm, flat surface (see http://www.healthychildcare.org/pdf/sidsparentsafesleep.pdf) .

When a baby has reflux or other issues, your pediatrician can instruct you how best to manage this.

Take a look at these videos for more information:

Equipment and Containers

Crucial information and a simple system to position safely while supporting development AND baby’s head shape. (6 min: 31sec)

http://carolinakinderdevelopment.com/product/equipment-and-containers/

Positioning Baby for Sleep (and normal head shape!)

http://carolinakinderdevelopment.com/product/baby-sleep-position/

Hope this helps!

Susan Slaughter, MS, OTR/L

www.carolinakinderdvelopment.com

-an occupational and physical therapy practice devoted to the prevention and treatment of torticollis, plagiocphely, and brachycephaly-