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[Update January 15, 2021]
Update on plagiocephaly
It was the pediatrician who revealed to Antoine’s parents that one side of his head was flat. Yet when she was born, she was very plump. The explanation? In bed, his head rests too often on the same side. And his skull, still malleable, flattened. This is called plagiocephaly (unilateral flattening of the cranial vault). A very common disorder since putting babies to bed sur le two to prevent the risk of sudden infant death syndrome, which is not their physiological position. Between 7 and 14 weeks, 46% of babies have cranial deformity, according to the review Pediatrics (2013).
Flat head: habits to review …
How to react if your baby is affected? Quite simply in him avoiding supports on the flattened area. In case of plagiocephaly, the head will be positioned only from the opposite side to deformation, with an effective means (baby wedge or rolled towel), only during the day and under your supervision, up to 3 months. For brachycephaly (flattening of the entire posterior part of the skull), the baby’s head will be oriented sometimes to the left, sometimes to the right. Choose a mattress very firm, no shape memory model, in which his head would sink. And remember to place a mobile or a night light out of bed, to encourage him to look in the desired direction. When breastfeeding or bottle-feeding, taking a baby sling, consider alternating positions… Do not leave the baby inactive in his recliner for too long. His head may lean on the deformed side. Every day, put him on his stomach for a few moments when he is awake, so that he “muscle” his neck.
Plagiocephaly, a deformity from birth
The deformity of the skull can also be due to a congenital torticollis. In this case, osteo-physiotherapy sessions will be prescribed. Beyond 5 months, if the problem persists too strongly, the doctor may prescribe the wearing of a orthosis, a helmet to be worn 22 hours a day. This is the only solution left to effectively correct the deformation. But most of the time, this one will disappear on its own as baby grows and moves more and more. Either way, if taken care of properly, plagiocephaly should soon be a bad memory.
Baby’s “flat head”: the latest HAS recommendations to prevent plagiocephaly
Worried that your baby will have a flat head from sleeping on his back? The Haute Autorité de Santé reminds that plagiocephaly is not serious, and can be easily avoided and corrected with a few good gestures. But which ones? A memo sheet published by him for parents is now available.
Source of concern for parents, plagiocephaly, positional cranial deformities, are benign and disappear naturally around the age of two. It is a deformation of the child’s skull characterized by an asymmetry giving the head an oblique shape: we commonly speak of “baby with a flat head”. However, parents must be reassured, because these cranial deformations have no consequence other than aesthetic. According to the Haute Autorité de Santé (HAS), scientific data show that there is no causal link between plagiocephaly and neurodevelopmental delay, specific ophthalmological, oculomotor or vestibular disorders.
It is therefore intended for parents that the agency has just published an “advice sheet” to remind them that the plagiocéphalie can be easily avoided and corrected. “You have the means to act: continue to lay your baby on his back to reduce the risk of unexpected infant death, but leave him free to move his head and body, day and night. », She sums up. The document gives recommendations to follow also good when the baby is sleeping or awake. Thus, at night it is recommended to lay him down on his back, in his bed on a firm mattress and in a sleeping bag. Be careful not to put anything in his bed (neither soft toys nor toys) to prevent him from catching them and choking on them.
Promote spontaneous mobility in infants
Contrary to popular belief, it is not recommended to use bed reducers, head restraints and baby wedges, objects that prevent them from moving freely. Better also “to leave it look in all directions, without bed bumper. », Specifies the HAS. During the day, it is important that the baby is not constantly immobilized to avoid leaning his head on the same side. HAS recommends leaving the child free to move so that his neck is mobile, including on his stomach when awake, provided he is supervised. His positions must be varied during ground play activities with a simple trick: arrange his toys around him to encourage him to look to the sides.
Conversely, it is better to avoid playing arches and mobile devices which will fix the baby’s attention in a single place and limit spontaneous head rotations thanks to tactile, visual and auditory solicitations. The moment of changing is an opportunity to get him used to being on his stomach, so that he can build his neck and back. The Haute Autorité de Santé also recalls the importance of hugging him often, as well as “remembering to change arms with each bottle or breastfeed: your baby will turn his head to catch your gaze. »Finally, it is better to limit the time spent in childcare equipment (deckchair, baby-relax, cozy) and reserve the shell seats for transport by car.
In which case should you consult?
It should be noted that in its previous recommendations dating from March 2020, the Haute Autorité de Santé emphasized that “the increase cases of plagiocephaly in babies and the associated worry can lead parents and some healthcare professionals to question lying on the back, with the idea of preventing the infant from always resting his head on the same side. »However, she insisted on strongly reaffirming, in association with the National Professional Council of Pediatrics (CNPP), that the sleeping on the back is imperative to prevent unexpected infant death. According to her, “since the 90s, this recommendation has reduced this risk by 76%. “
If plagiocephaly occurs in an infant and causes difficulty to move his neck (torticollis), it is therefore recommended to consult a doctor who can prescribe physiotherapy treatments. “In the absence of improvement in the cranial deformity after appropriate treatment, the doctor must refer the child early, possibly at the end of the first semester, to a competence center or reference for craniofacial malformations. In these rare cases of severe forms, a head deformity may be a symptom suggestive of an underlying disorder. », Concludes HAS. Exceptionally, experts will be able to prescribe a cranial orthosis for the baby.
Alexandra Bresson
Flat head: 3 testimonials from parents
“When my twins were 4 months old, I worried: Tom’s head was constantly tilted to the left and Nans’ skull was flattening over the days. Our pediatrician wanted to be reassuring and encouraged us to wait for it to recover on its own. But we were not convinced. So we undertook an intensive repositioning for each baby. I also contacted a family who encountered this problem. This allowed us to put words into what was happening to our little ones: Tom had plagiocephaly and Nanas had brachycephaly. We went to see an osteopath. Then a physiotherapist for Tom, who actually had a positional stiff neck. After a month, there were improvements for Tom but not for Nans. We then undertook a cranial orthosis treatment in Spain, with appointments every two weeks in Bilbao. The results were spectacular: his skull quickly found a bulge in the back. In total, the treatment lasted two months and Nans tolerated it very well. ” Séverine, mother of Tom and Nans, 18 months
“From birth, Liam couldn’t turn his head to the right. He slept with his head facing the same direction and always took his bottle from the same side. But it didn’t alert us more than that. During a visit to the pediatrician a few weeks later, he diagnosed torticollis and a small deformity on the side and back of the skull. On his advice, we took him to an osteopath. Liam was then seven weeks old. It was spectacular. In one session, his stiff neck was treated and the small deformities in his head were alleviated. The change was obvious the first time around. Today everything is going well. ” Nicolas, father of Liam, 2 and a half years old
Nathan arrived a month early. He stayed in the hospital for two months. When I got home, I saw that his head tended to hang on one side. A nursery nurse from the PMI spoke about stiff necks and recommended that I see a physiotherapist. Nathan had sessions for a year. No more osteopathy. Treatment for the torticollis was progressing but his skull was deformed. He who was born with a very round head! At 6 months, the diagnosis fell: severe plagiocephaly. His skull was in the shape of a parallelogram, with an asymmetry at the level of the eyes and ears. I then opted for a cranial orthosis treatment, in addition to physiotherapy and osteoarthritis treatments. For 6 months, we went back and forth to Barcelona almost every two weeks to see a specialist. It was very encouraging to see Nathan’s head reshaping so quickly. But the helmet became too small and the results were not yet optimal. I wasn’t looking for perfection. Just try to do the best. I decided to continue the adventure with a second helmet. Six more months of treatment. Today, I am delighted with the result. There is just a slight asymmetry left, imperceptible to anyone who does not know Nathan’s story. Marie-Sophie, mother of Nathan, 19 months