Positional Plagiocephaly

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This can be due to 2 primary reasons. Positional plagiocephaly and Lambdoid 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 plagiocephaly, the head shape becomes like a parallelogram. And the ear on the flat side is displaced forward.

In Lambdoid synostosis, the head shape is a bit like a trapezoid and the ear on the flat side is pulled backwards.

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 and encouraging the child to place the head on the prominent side instead of the flat side. 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. Changing the direction of the bed (Eg From North-South to South-North) can encourage the child to change the position of the head voluntarily because babies always have a preferred part of the room that they enjoy looking.
4. Using special pillows like Mustard pillow or Doughnut pillow also can help.
5. 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 plagiocephaly 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 severe positional plagiocephaly, especially when the condition affects the forehead region also, we usually recommend Orthotic Helmet Therapy for a period of 3-4 months for complete correction.