Repositioning Techniques for Deformational (Positional) Plagiocephaly

All new parents spend endless hours watching and wondering over their infants. This puts them on the front line so far as noticing when things seem amiss.

Parents are almost always the first to notice the signs of positional plagiocephaly, the medical term for an unusual flattening of the skull. It is usually on the back or on one side of the head, and it can be identified by the position of the bald spot that all babies get as they rub their heads on the bed covering. Positional plagiocephaly is common and found in as many as one in 30 infants. It occurs when an infant's malleable skull is moulded by constant pressure. Often, that pressure may be part of the uterine environment. In other cases, that pressure is exerted when babies spend too much time sleeping in a single position or it can be associated with torticollis, a tightening in te muscle on one side of the neck.

If you notice your baby developing a flat spot on his or her head, consult your health visitor or GP right away. With the correct advice, and if noticed early enough the flat spot can be effectively treated through simple repositioning techniques. Plagiocephaly repositioning techniques are a form of physiotherapy for infants, and should not be implemented without input from a health care professional.

Repositioning Techniques for Plagiocephaly

Which part of your baby's head is flattened? A useful guide here may be to think of the top of your baby's head as a clock with the 12:00 mid day position at your baby's nose. If you notice that your baby's flattened spot is at the five o'clock position, at the back and right of your baby's head, then you need to choose seven to nine o'clock positions deliberately as contact points and keep these in mind during all your interactions with your baby.

Positioning Your Baby While Awake

If you breastfeed, try feeding so that pressure is put on the side of your baby's head that does not show flattening. Take care not to hold the part of your baby's head that's affected by positional plagiocephaly.

If you bottle feed, move your baby around so that no pressure is on the flattened part of the head. Position that point against your chest or arm. If your baby falls asleep in your arms, again be turn your baby's head away from the flattened area. Yes, your baby may be disturbed when he or she is repositioned, but this is something you are doing for your baby's own good.

When you take your baby out in a buggy or carrier, use a small towel to lift the flat part of your baby's skull away from the hard surface inside the carrier. Do the same thing in a car seat or a bouncer. Whenever possible, make sure there is visual stimulation so that your baby will have plenty of incentive to turn his or her head so that the flat part does not make contact. Make sure your baby has plenty of supervised tummy time during the day!

Positioning Your Baby While Asleep

The Foundation for Sudden Infant Death Syndrome (SIDS) recommends that you should always place your baby on the back to sleep. This advice has saved thousands of baby's lives. If your baby has a plagiocephaly position the head so that the flat spot does not touch the cot mattress. There are several pillows and cushions on the market. If you decide to use these always follow the manufacturer's advice to ensure safety in sleeping. If the flat spot is at the back of your baby's head, this may mean making a little pillow that can move your baby's head off the affected spot. If you do this, make sure to clear it with your infant's physician so that you are complying with his or her recommendations.

If by the age of four to five months, you are not seeing any improvement, you may consider using a helmet to gently correct the head shape as your baby continues to grow.

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