Is your infant’s head shape cause for concern?
Mothers are usually the first to notice when an infant’s head has an uneven shape. It may appear lopsided or flat, particularly in the back. The uneven shape can be the result of many factors that can occur during pregnancy, delivery or the neonatal period. The condition is common and may affect as many as one in five infants.
In the first few weeks or months of life, the asymmetry can appear to get worse. This is because babies spend a lot of time on their backs in the crib, car seats and carriers. Diagnosed as positional plagiocephaly, it is important to recognize and address the problem early, while the baby is just a few months old.
During this time period, the asymmetry can be significantly improved with a disciplined home regimen, often accompanied by physical therapy. Parents are encouraged to increase “tummy time” or tummy time equivalent and to decrease the “awake time” the baby spends in equipment or on their backs. These steps can make a difference in the majority of cases and will successfully address the asymmetry in two-thirds of the babies.
For other infants, more aggressive intervention may be necessary to achieve the desired head shape. One of those modalities is a specially sculpted cranial orthotic or “helmet.” Thanks to state-of-the-art technology, it takes only 2 seconds for a laser-guided digital scanner to provide a three-dimensional view of a baby’s head. Then a helmet is molded within a half-millimeter of accuracy to correct deficits in symmetry. The baby wears the helmet 23 hours a day, seven days a week, typically for three to five months.
“The results are amazing,” says Dr. Frank Vicari, a pediatric plastic/craniofacial surgeon at Advocate Children’s Hospital in Park Ridge, Ill. “I have seen a 95 percent success rate with a helmet.” Dr. Vicari, who leads the Head Shape Evaluation Program at Advocate Children’s Hospital, states that the helmet is more of an adjustment for the parents than for the babies. “Once babies get accustomed to wearing the prosthesis/helmet, they appear not to be aware of it,” says Dr. Vicari.
In those rare cases where the misshapen head is caused by a fusion of the cranial bones, known as craniosynostosis, surgery may be required. Surgery can be very successful in separating the fused bones and reshaping the head. “As with many surgical issues, early diagnosis and treatment affords the opportunity for the best possible surgical result,” says Dr. Vicari. “It is best if we see infants in the first two or three months of life.”
If you are concerned about the shape of your infant’s head, talk with your pediatrician about treatment options.
About the Author
Evonne Woloshyn, health enews contributor, is director of public affairs at Advocate Children's Hospital. Evonne began her career as an anchor and reporter in broadcast news. Over the past 20 years, she has worked in health care marketing in both Ohio and Illinois. Evonne loves to travel, spend time with family and is an avid Pittsburgh Steelers fan!