We know pediatricians have a long list of things to address when seeing a newborn, including plagiocephaly treatment. Plagiocephaly is a condition for which it is critical that preventative education is started immediately. Here are a few things that the therapists out in the trenches would like to share with you. Together, we know we can beat this flat head thing!
- Early intervention is critical. Baby head shape should be monitored at the very first visit and every one thereafter until 6 months of age. A pediatric therapist should address any skull or neck asymmetries immediately, even if it seems mild. The longer you “wait and see” the more likely the baby will need a helmet and/or extensive therapy. Two-month olds are perfect candidates for plagiocephaly treatment.
- Ask about container usage. The use of inclined containers has skyrocketed and is directly related to the higher incidence of plagiocephaly. It is important to ask where the baby is sleeping, especially at the first few visits. A popular one right now is the “Rock n Play” sleeper. If parents are using such a device, they should be advised to get the baby sleeping on a flat surface immediately (crib, bassinet, pack n play). This, in and of itself, will prevent many cases of plagiocephaly and torticollis.
- Tummy time clarification. We know you explain tummy time but a lot of parents still just don’t get it. A quick demonstration and encouragement to try it whenever the baby is awake will make a world of difference. Setting specific time limits leads to crying sessions that leads to stress, which then leads to not enough tummy time.
- Strategic repositioning works. As much as helmet providers would like us to believe the only plagiocephaly treatment to correct skull asymmetries is by using a cranial orthosis, it is simply not true. By using straightforward repositioning strategies, the bed surface can actually reshape the skull (and it’s a lot cheaper). The key, though, is the age of the baby. These techniques are most effective when used between birth and 5 months of age.
- Neck stretches are intimidating. As medical professionals, we know infants are actually pretty tough. New parents, however, think the exact opposite. Just giving the parents a handout on neck stretches or only giving a quick demonstration is not going to be enough to sufficiently train the parents. They need more hand holding and different options for stretching their baby’s neck without discomfort. Even one visit with a therapist can set them in motion for success.
- Helmets should not be our first line of defense. Our first call to action should be clear and simple: EDUCATION. Our second should be THERAPY for repositioning and effectively treating the torticollis. And finally, if these types of plagiocephaly treatment are not correcting the problem and the family is still concerned about the head shape, a helmet referral can be made. Parents want options and will often do whatever they can to fix the problem before it leads to bigger issues. In my experience, these approaches have substantially reduced the need for helmets.
That is a lot of babies and even more very happy parents! If therapists and pediatricians continue to work together, we can maintain this trend and eventually plagiocephaly will be an occasional occurrence, not “the norm.” Let’s get started!
I first met Jennifer from Baby Begin during an informative visit to our office 5 or so years ago. She was and is extremely personable and her mission to treat head shape irregularities and torticollis with positioning, stretching and other non-invasive physical therapy measures resonated with me. My oldest child, Holden, was born with quite a bit of plagiocephaly (asymmetric head shape that can cause some facial asymmetry) and torticollis – from intrauterine positioning and low amniotic fluid towards the end of my pregnancy. I was living in Denver at the time, and the pediatrician I saw, told me not to worry about it, that it would correct with time. Because I had just finished med school, I had some knowledge regarding torticollis, but honestly not enough. I didn’t worry about it… Luckily, Holden is as handsome as they come, but he does still hold his head tilted slightly to the side and if you really look, he still has some plagiocephaly. Of course, no one is perfectly symmetric, but if I knew then what I know now, I would have sought physical therapy services and potentially a cranial helmet. Perhaps, with early PT, I could have avoided the latter. This is why I quickly refer to Baby Begin. They see my patients in their own homes, which as a busy parent, sometimes of multiple young children, is an enormous benefit. They show them within their own environment how best to position for sleep, tummy time etc. It is much easier to mimic an expert’s techniques when you have seen them demonstrated at your own crib, changing table etc. She has prevented several of my patients from requiring helmets to correct flat head, brachiocephaly and asymmetric head shape, plagiocephaly. We all know how expensive helmets can be, as well as cumbersome… In some cases, they are absolutely necessary, but Baby Begin’s therapy can help reduce the longevity of helmet treatment and improve the outcome in these cases as well. I honestly don’t know how many patients I have referred to Baby Begin, but I know all my parents found their services to be extremely helpful and a significant percentage of the treated babies did not require a helmet for additional correction after working with Baby Begin.” – Dr. Julie K. Linderman, Pediatrican at Inwood Village Pediatrics