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Positional Plagiocephaly
The sleep habits of America's infants have been changed by the babies' doctors and the result is a very positive impact on the rate of Sudden Infant Death Syndrome (SIDS). A side effect of the back to sleep movement, however, is an increasing occurrence of "positional plagiocephaly", flattening of the back of the head which may be symmetrical or asymmetrical associated with sleep positions. A baby with positional plagiocephaly will have a flattened occiput, the ear on the flattened side may be pushed forward and if severe, the baby may have additional bulges on the side opposite of the flattening and may even have an asymmetrical forehead. Occasionally, a more serious condition, synostosis, where skull sutures designed to remain open to allow for brain growth closed prematurely, can cause an alteration in skull growth which can mimic the more benign positional plagiocephaly. The appearance of this more serious condition, however, is characterized by a bony ridge over the abnormal suture as well as by a more posterior position of the ear on the affected side and a skull distortion that becomes increasingly severe as the child grows older. Positional plagiocephaly, on the other hand, is usually characterized by improvement with passing time.
Treatment
When this positional molding deformity is detected, parents and doctors work
together to change the child's sleeping position more frequently to keep
them off the flattened side. Occasionally, a neck muscle on the affected
side is shorter than it should be which results in a tendency to hold the
head in one position and promotes positional plagiocephaly. This problem can
be solved by neck stretching exercises taught by the doctor or physical
therapist. Most parents begin to see correction of the positional
plagiocephaly within a month or two after utilizing repositioning and neck
stretching. Babies who are severely affected can also be placed in a molding
helmet or band which acts like a brace to encourage growth where the skull
is flattened and to discourage growth where the skull is more protuberant.
As babies grow older, they begin to position themselves spontaneously
while sleeping and are not as dependent on their parents for frequent
repositioning.
The outlook for children with positional plagiocephaly is excellent. A vast
majority require nothing more than repositioning. A few require a molding
band or helmet and most look normal or near normal by one year of age. A
severe, persistent deformity can be corrected by surgery, usually performed
between 12 and 18 months of age. However, very few affected infants will
require this reconstructive surgery.
For more information call:
Dr. Kimberly Bingaman, Pediatric
Neurosurgery, (706) 721-5568
Erika Doster, PA-C or Dr. Jack Yu, Plastic Surgery,
(706) 721-8585