"Doc, I want our daughter to be able to wear different hairstyles when she is older and we are worried she won't be able to. Our pediatrician pointed out that her head is misshapen. We had measurements done. Her one ear is forward of the other and her jaw is pushed to one side. We are considering helmet therapy but aren't sure if it is the best choice. What do you think?"
This is a recent conversation I had with a parent. What they are describing is something called "plagiocephaly". As a pediatric Chiropractor this is something I see a lot in practice. I know as a parent myself I want my child to have a pretty head. It is unsettling when you first notice this as a parent.
Plagiocephaly or "flat head syndrome" has really increased over the past 30 years. In 1992 the "Back to Sleep" campaign was started to try and reduce Sudden Infant Death Syndrome. Because babies are sleeping on their backs all the time it can put pressure on their heads. This pressure can make one area of the head more flat and another area bulge out.
Is it only cosmetic?
Head shape is not only a cosmetic issue. I recently spoke with a mom over the phone whose baby is 10 months old. She told me that her baby's head shape is not normal and he is still not crawling at 10 months.
Studies have found that infants with plagiocephaly have significant delays in mental and psychomotor development. Psychomotor development is things like learning to crawl and walk. Mental development is learning to use language for example. Here is the study http://www.familyop.com/Library/Cranial%20Research%20Articles/Neurodevelopmental%20Delays%20%2001-06.pdf Not every child that they looked at in the study were delayed only some. But important to note is that none of the children studied had accelerated development.
Another study listed below followed up with families that had a diagnosis of plagiocephaly. They found that some of these kids were at higher risk for having problems in school. Perhaps they couldn't keep up in class or read at the same speed as everyone else. It depended on the child.
There is still more research needed to be done in this area but these studies raise concern. We want to give our children the best start to life and this is something that can slow them down.
Why does my baby's head become odd shaped?
As I mentioned earlier one reason is many more babies sleeping on their back. I'm 38 and my mom told me she let me sleep on my stomach all the time. There was nothing in public awareness at the time that stomach sleeping could be related to SIDS (sudden infant death syndrome). Since the "back to sleep" campaign of the 90's many more babies are sleeping on their backs. A baby's head is designed to change shape so they can pass through the vaginal canal. Pretty obvious when you think about it. When they spend a lot of time in the same position this starts to change the shape of their head.
Another cause mentioned frequently in the literature is intrauterine constraint. I know intra..what? Basically there is not enough room for developing baby in the uterus. Imagine you are wearing a shoe that to small. You can do it but over time your foot starts to hurt. If you do it long enough your foot may even change shape.
Why would a mom's uterus be to small. It could be how a baby is positioned in the uterus for example a breech baby. A breech baby is not head down so there is less room for their head. Another reason that I see in practice working with pregnant women is their spine doesn't move normally. This creates increased tension everywhere. 3rd trimester mom's that I take care of see the difference in how their baby is positioned after the adjustment.
For example a mom came in because she wasn't sleeping well and her back hurt at night. When I looked at her I could see the baby wasn't centered in her belly. Also her belly felt very tight. After the adjustment she was shocked to see how he was resting in the center of her belly. Her belly was also much softer and relaxed. She also slept a lot better.
Does helmet therapy help?
Helmet therapy is designed to put pressure on various parts of skull to help reshape it.
The baby typically needs to cut their hair super short and wear it for 23 hours a day. The study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4294410/ spoken about in this article indicates that it is not effective. They encourage pediatricians not to recommend helmet therapy. They say that when the deformation of the head is severe then parents should consider using helmet therapy. For mild/moderate deformation than there is little evidence to support using a helmet.
What to do at home
Keep moving your baby's head so it isn't in the same position all the time when they sleep. Obviously don't annoy them and wake them upLay your baby in the crib in both directions so it is different.Holding your baby more often can help because it takes pressure off the head.Practice tummy time. Do tummy rocking on a exercise ball with your baby. Obviously be careful https://youtu.be/n_2Qx67s5wU this also has the added benefit of helping the parts of the brain that control posture to develop.
How gentle cranial work can help reshape the head
In my practice I do cranial work on babies. As I have mentioned in previous post https://www.brightstartchiropractic.com/blog/why-does-my-baby-need-a-baby-chiropractor the brain can not function normally without the cranium (head) and spine moving normally. Plagiocephaly is a sign of abnormal movement of the bones that make up the head. The research studies above discussing odd head shape say that a possible reason that it can cause developmental delays is the brain doesn't have room to grow normally. You could think about wearing a hat that is too small and it giving you a headache.
I'm currently working with a 6 week old baby. He was quite fussy when we started. Didn't sleep much. He also kept his head bent to the right. His head shape was not normal. Since working with him he is sleeping more hours and is more calm. He keeps his head in a normal position now. His head is returning to normal shape. He is happier and so are the parents.
The cranial work I do with babies is very gentle. The goal is to help restore the normal movement of the cranial bones. This helps the baby's brain have room to grow normal. It helps the baby's be more calm. Parents often tell me their babies sleep all day after the treatment. Cranial work has also helped babies latch better when breastfeeding.
Weird head shape conclusion
Now you have a better understanding of why your baby's head shape is not round. We talked about why it can happen and what you can do at home to help it. As part of your path to help your child I encourage you to consider cranial work to help your child. Head shape is not just cosmetic but can influence your child's development.