Flathead and Plagiocephaly in Infants

What is Plagiocephaly (Flathead)? 

Phagiocephaly or Flathead is the name given to any deformity of the cranium or head. Although in babies this can be quite aesthetically disturbing it is important to know that it rarely causes any severe problems and will usually resolve within the first few months after birth.

At birth, the bones of a baby's cranium or skull are not entirely formed. They are cartilaginous or flexible which makes babies much more resilient than we often allow. There is also space between the bones. This flexibility and space allow for the bones to mould and overlap during passage through the birth canal. Without this flexibility, it would be impossible for the baby to pass through the birth canal and be born. 

On a historical note; Aztec aristocracy thought a sloping forehead to be a sign of upper-class breeding so would bind their baby's heads to influence the shape. They suffered no ill-effects. 

A note on bones 

It is important to understand that bones are living tissue. They can be classified as organs and are responsible for producing red and white blood cells and also platelets which are essential for clotting. 
They can be likened to a living tree branch which is flexible and springy, only becoming dry and brittle when dead or removed from the tree.

A baby's bones have not yet ossified (hardened) and are even more malleable than those of adults. 

Causes of plagiocephaly 

Just the passage through the birth canal will cause changes in the shape of a baby's cranium. Where there is intervention such as forceps or suction, this will be increased.

Vaginal birth is always preferable for many reasons. The forces experienced by the baby passing through the birth canal will mould and shape the cranium and trigger various reflexes in the baby. This includes the extension reflex which is essential for strength in a human being. 

Postpartum laying the baby in the same position can influence the shape of the cranium and also develop a torsion or rotation in the body that can lead to imbalances in later life and issues with structure and movement. It is good to change the position of your baby and to make sure their head is turned to alternate sides, not always facing straight up. 

Treatment for Cranial Deformities 

It is important to remember that just because a baby is born with deformities in its cranium, it is not the end of the story and usually will cause no problems. 

In most cases no treatment is necessary. The typical actions of suckling, yawning and moving will normalise the cranium. The repetitive movements working to balance the cranial tensions. Ideally, the baby will be breastfed. If bottle feeding it is a good idea to use your finger or thumb to stimulate suckling - make the child work to suckle. Pacifiers will not achieve the same result. 

Osteopathy for Cranial Deformities 

Many would consider this to be the first line of treatment along with positional therapy. It is a dynamic treatment that works with the baby's body and can be used literally from the time of birth. 
It is best done within the first three months, although it can be beneficial after this.

It works with the plasticity of the bones and equilibrate membranous tensions and can address the imbalance in the bones themselves (the Trabeculae or struts within bone). The osteopath will apply subtle pressure which can affect the alignment and arrangement of these struts. The baby's body will appropriate the changes and grow more balanced and aligned.

It is sometimes necessary to work with another part of the baby's body as the physiological chains of the body continue into the cranium and may be the source of any distortion. 

What can you expect? 

The child will be placed on a treatment table, and the osteopath will assess sacrum, cranium, movement of the head, arms and legs and also reflexes.

The reflexes are our genetic, pre-programmed movements of the body. They are essential for all other motor, emotional and cognitive function. The neurological system develops along with the reflexes; movement develops the nervous system, in the womb and after birth. The action begins in the fetus as early as four weeks after gestation.

It is normal for the baby to cry during treatment - it is their way of communicating with us, of telling their story, although as a parent it can be upsetting at first. There is the distress cry when they are hungry or uncomfortable, and there is a very different cry when they are just communicating .. "I was stuck in the womb, wedged up against mum's hip, couldn't move. Wah, wah, wah."  
They will also wave a fist towards an area of their body, or twist themselves sideways, or arch back; this is normal, and the experienced osteopath will pay attention to this communication. 

After the session, there may initially be no visible change as the baby will take a time to integrate the treatment. Usually, a short course of treatments will be needed, and these may be several weeks apart to allow the child's body time to assimilate each visit. 

Positional therapy 

This works by removing or changing the pressures on your baby's head. There are several things you can do: 

Alter the part of the head that is against the bed or seat. Make sure to encourage your baby to face different directions when sleeping - try placing them at opposite ends of their crib as they often turn away from a wall, or using a mobile to attract them to look one way. 

Feed them on alternate sides - this happens naturally with breastfeeding. 

Tummy time - place your baby on their tummy for short supervised hours when awake and for longer as they get older. 

Cranial Orthotic Therapy, a Helmet 

One option used by the medical profession is a helmet. This forces the cranium to take a particular shape. It is usually applied after six months of age. One down side is that it is not dynamic, forces the body to grow in a certain way and does not work with the body's natural healing mechanism.
  
As with many western interventions, it uses outside mechanical force to direct the body instead of facilitating the body to heal itself. 

If you would like more information, please book a complimentary meet and greet with Robert to discuss your needs and how cranial osteopathy can help. 

An interview with Robert Black, Osteopathic Manual Practitioner, written by Sue Taylor, Clinic Director, Ottawa Holistic Wellness