Positional Brachycephaly

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This can be due to 2 primary reasons. Positional brachycephaly and Bicoronal or Bilambdoid Craniosynostosis. It is important to differentiate the 2 conditions because both conditions need a totally different approach. A thorough assessment by a Craniofacial surgeon is necessary.

This is more common in preterm babies and babies who are sick and are placed in NICU for a long period. This is usually because preterm and sick babies are weak, with very low muscle tone and are not able to move their head often enough.

In Deformational brachycephaly, the head is flat but there are no major forehead or eye deformities. The brain is not affected because the sutures are open.

In Bicoronal synostosis, the head shape is flat and is associated with other deformities like towering (Tall head), eye deformities (Harlequin deformity and Exophthalmos) and facial deformities (Midface hypolasia - Dishface).

Once Craniosynostosis has been ruled out, you can try many techniques to improve the shape of the head.

1. Changing the position of the head of the child often. Ask your doctor for a detailed explanantion.
2. Increasing tummy time can greatly improve the shape of the head as the head is no more in contact with the bed for long hours.
3. Using special pillows like Mustard pillow or Doughnut pillow also can help.
4. The traditional Indian saree Jhula also has been shown to decrease the incidence of positional problems.

The requirement of treatment depends on the severity of the condition.

Mild to moderate positional brrachycephaly can be managed expectantly using the measures mentioned previously. Mild cases almost always get better. Moderate cases might need further treatment if there is no response. In comparison to plagiocephaly, we are very conservative in advising any treatment for brachycephaly.

In severe positional brachycephaly, especially when the condition affects the facial appearance also, we usually recommend Orthotic Helmet Therapy for a period of 3-4 months for complete correction.