Plagiocephaly: the newborn has a 'flat head'

Plagiocephaly: the newborn has a 'flat head'
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Plagiocephaly: the newborn has a flat head

La plagiocephaly o flat head it is caused by the position in which the baby is put to sleep. The classic belly-up position is recommended for fear of SIDS (Sudden Infant Death Syndrome), a phenomenon known as cot death. Since the American Academy of Pediatrics has come forward giving indications on the position of the newborn in the first months of life, the cases of SIDS have decreased but the cases of plagiocephaly have increased. Let's find out what it is, the causes, remedies and prevention.

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The newborn has a 'flat head': what to do?

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Plagiocephaly. This is the medical term for this type of infant deformity. Newborn flat head syndrome can have many different causes. Here's how to find a ...

Read also: Cranioostenosis in children

Craniosynostosis or plagiocephaly?

Craniosynostoses are malformations of the skull and in some cases also face caused by anomalies in the bone growth. Sometimes, head shape abnormalities due to craniosynostosis may be evident from birth. Other times, however, the doubt that there is something wrong can emerge during periodic checks by the pediatrician - health balances - if the doctor finds, for example, that the head circumference it does not grow as it should.

Still other times it is the parents who become suspicious and ask for further information, for example if they notice any anomaly in the shape of the head or of the eyes (which can be very protruding) or in the anterior fontanel, which in the case of craniosynostosis tends to close earlier than expected. 

Craniosynostoses are the responsibility of pediatric neurosurgeons.

Plagiocephaly: what it is

plagiocephaly or flat head of the newborn or infant is the crushing of an area of ​​the head, generally of the back and / or side.

Plagiocefalia: cause

But why does the baby have a flat head? It is rare for a newborn to be born with plagiocephaly. It can happen for multiple deliveries and for the position in the uterus. The most common cause in the infant is to be found in the same position of the baby's head over time and by the external pressure exerted on the bones of the skull.
In the first few months, the baby spends many hours lying on his back, generally with his head turned to the side. Even when placed on the baby food high chair or on a play mat, it tends to always rest its head on the same side. The bones of the cranial vault are still soft and more easily modifiable and malleable.


Plagiocephaly: prevention and remedies

The safest position for the infant to sleep is in the supine position, face up. However, here are some tips to prevent plagiocephaly.

  • Change the baby's position each time you put him to bed, gently turning the head first to one side, then to the other. Even if he sleeps.
  • Always alternate the arm with which you support the baby during feeding. Alternation is easier with breastfeeding, depending on which side it is attached to;
  • Don't leave him lying in the bed for too long.
  • If you are at home, help him strengthen his back muscles by putting him on his stomach and playing with him. The British invented tummy time. It consists of putting the baby on his stomach for 10-15 minutes 3 times a day (not to sleep, but during the day, while playing), not only to stimulate motor skills, but also to make him discover the freedom of movement at a level cervical. From the 3rd month of life, place the baby on his stomach for a longer time, even on the changing table, on the bed or on the mat.
  • Get a baby gym as soon as possible. Don't put the activity right over your head so that it has a chance to turn around.
  • If you are out and about for a walk, use a baby sling so you don't have to force them into the pram. And place your head first on one side and then on the other.

Not to do:

  • Do not use a flat head cushion or positioning cushion. Only a specialist (neuropedologist or neonatologist) can prescribe them.

If plagiocephaly persists over time it is helpful consult the family pediatrician to know what to do and who to contact.

Are plagiocephaly helmets effective?

In some cases, especially abroad, doctors resort to cranial orthoses, the so-called "helmets", to facilitate the correction of morphological anomalies such as plagiocephaly or brachycephaly.
However, several studies have expressed doubts about the use of these corrective tools, both because they seem to produce limited improvements and because they are uncomfortable for children. 

Fonti: Ospedale Pediatrico Bambino Gesù;; Libro "Un pediatra per amico", Mondadori Electa, in libreria dal 20 luglio 2022; Guidelines: Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on the Role of Cranial Molding Orthosis (Helmet) Therapy for Patients With Positional Plagiocephaly, PUBMED review; New guidelines review evidence on PT, helmets for positional plagiocephaly Sandi K. Lam, M.D., M.B.A., FACS and Thomas G. Luerssen, M.D., FACS, FAAP

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