What Causes a Childs Flat Head (Plagiocephaly)

There are many reasons why parents bring their children in to see a chiropractor. One of the more significant reasons with infants is plagiocephaly. Plagiocephaly simply put is asymmetry of the head. There is more than one type of this asymmetry, for the purposes of this, we are looking at positional plagiocephaly. (1-3)
 
Positional plagiocephaly typically occurs from mechanical factors applied over time, which can occur in utero, at birth or postnatally. In this condition there is flattening of one side of the occiput. The region of occipital flattening relates to the side that the head is toward when in the supine (on back) sleeping position. (1)
 
In 1994, the Back to Sleep campaign started, which saw the risk of sudden infant death syndrome (SIDS) drop by 40-60%. There was, however, an unfortunate side effect that was positional plagiocephaly, which increased by up to 600%. It has been suggested that this has exacerbated a lack of tummy time. (2)
 
This is where we as chiropractors come in. The research is showing that physical therapy is beneficial in increasing the range of motion for a child’s neck, which has been shown to be present in almost all cases of plagiocephaly. The cause of this is not fully understood, but is appear to be associated with multiple factors (as mentioned above) which restrict range of motion and joint dysfunction. Ultimately, this highlights that having a physical therapist, such as a chiropractor, in the treatment team may well help manage this type of plagiocephaly in your child. (1-3)
 
 
 References

1. Ellwood, J., Draper-Rodi, J., & Carnes, D. (2020). The effectiveness and safety of conservative interventions for positional plagiocephaly and congenital muscular torticollis: a synthesis of systematic reviews and guidance. Chiropractic & manual therapies, 28(1), 1-11.
2. Marshall, J. M., & Shahzad, F. (2020). Safe sleep, plagiocephaly, and brachycephaly: assessment, risks, treatment, and when to refer. Pediatric annals, 49(10), e440-e447.
3. Pastor-Pons, I., Hidalgo-García, C., Lucha-López, M. O., Barrau-Lalmolda, M., Rodes-Pastor, I., Rodríguez-Fernández, Á. L., & Tricás-Moreno, J. M. (2021). Effectiveness of pediatric integrative manual therapy in cervical movement limitation in infants with positional plagiocephaly: a randomized controlled trial. Italian Journal of Pediatrics, 47(1), 1-12.