Severe plagiocephaly baby

[10AngelO]

Hi all, I’m after some advice and/or reassurance. My 10 week old has severe plagiocephaly, or flattening of the back of the head. It seems to noticeable almost overnight at 7 weeks. He does favour sleeping on his back at night, we have tried turning his head but most of the time he turns it right back. We try and keep him off his head as much as possible during the day, plenty of tummy time, using the carrier instead of the pram. He has a special pressure pillow for the bouncer and changing mat. No matter what we do nothing seems to help, and I have never seen a baby in person with flattening like this. It’s got to the point where I hate taking him out without a hat for fear of judgy looks and comments. I’m a FTM and people seem to think I just leave him on his back all day which is not the case. It’s making me so upset and stressed , I am obsessing over it. The suction cup was used at birth so he came out with a slight cone head, which I’ve heard could play a part. Some people have said when he is mobile and sitting up it will even out, but it’s so flat I can’t imagine it happening. The hv didn’t seem worried at all. And the gp was useless, just told us to keep repositioning. I don’t have the money for a helmet and I’ve heard they are a waste anyway. I’m praying time will sort it out as he keeps growing. Has anyone been in the same boat? Did the flattening get better naturally over time, if so, when? Any help or advice appreciated. Thank you! Photos attached

Hi OP

only in an associated boat due to being an adult with this condition. It’s always been noticeable even with long hair. I wish a helmet had been an option for me. Yes it doesnt always resolve.

It resolves about as often as it does with a helmet.

Helmet therapy also has failures. Hopefully any reputable provider of a helmet will make that clear to parents.

Basically studies that look at helmet therapy alone show really good results, but when studies compare the therapy with usual care both groups show really good results.

People don’t want to know about the science!
Participants 84 infants aged 5 to 6 months with moderate to severe skull deformation, who were born after 36 weeks of gestation and had no muscular torticollis, craniosynostosis, or dysmorphic features. Participants were randomly assigned to helmet therapy (n=42) or to natural course of the condition (n=42) according to a randomisation plan with blocks of eight.
Interventions Six months of helmet therapy compared with the natural course of skull deformation. In both trial arms parents were asked to avoid any (additional) treatment for the skull deformation.
Main outcome measures The primary outcome was change in skull shape from baseline to 24 months of age assessed using plagiocephalometry (anthropometric measurement instrument). Change scores for plagiocephaly (oblique diameter difference index) and brachycephaly (cranioproportional index) were each included in an analysis of covariance, using baseline values as the covariate. Secondary outcomes were ear deviation, facial asymmetry, occipital lift, and motor development in the infant, quality of life (infant and parent measures), and parental satisfaction and anxiety. Baseline measurements were performed in infants aged between 5 and 6 months, with follow-up measurements at 8, 12, and 24 months. Primary outcome assessment at 24 months was blinded.
Results The change score for both plagiocephaly and brachycephaly was equal between the helmet therapy and natural course groups, with a mean difference of −0.2 (95% confidence interval −1.6 to 1.2, P=0.80) and 0.2 (−1.7 to 2.2, P=0.81), respectively. Full recovery was achieved in 10 of 39 (26%) participants in the helmet group

Bmj study also shows side effects
The evidence fir helmets is poor. But as a parent we need to feel like we are doing something rather than waiting 🙅‍♀️

"In the intervention group all parents (35/35) reported one or more side effects related to helmet therapy: problems with acceptance of the helmet (8/33, 24%), skin irritation (32/34, 96%), augmented sweating (24/34, 71%), unpleasant odour of the helmet (25/33, 76%), pain associated with the helmet (9/27, 33%), and feeling hindered from cuddling their child (24/31, 77%). "

Op, what a cutie he is!

OP have you taken your baby to see an osteopath in regards to torticollis? My son had what your little one does. Unfortunately due to lockdown no one would see him and he has still now a flattish head and it was bad like your sons as an infant. He had torticollis and couldn't fully turn is head. He's 4yrs old now and his hair mostly covers it but I wish I'd got him sorted. I couldn't afford the expensive helmets.
My daughter also had torticollis and I took her to the osteopath at 8 weeks old after her head went all flat as she couldn't turn it. The osteopath sorted it in one session. Released all the muscles in her neck and she could freely turn her head and the flatness resolved within a couple months.

Definitely get baby checked out now as releasing the tight muscles will help him to relax and let you move his head back and forth when sleeping to take the pressure off.

My DS1 had plagiacephaly. He also had uneven creases in his back and buttock area causing concerns about his hips (family issue).

We took him to a consultant, who concluded that he was just a 'mouldy baby'. The rationale was that I was very compact in my pregnancy and he moulded to this. He was completely normal within 6 months. He is totally fine after 32 years.

It wouldn't have done.

Because my dd was 10 months old when she got the helmet and there had been no improvement in that whole time

They would not. She had no change in ten months other than it getting worse.

I think your tone leaves something to be desired.

Are you an expert in the field?

My ds had plagio from birth and torticollis midwife referred to physio.
Treatment.. You're not going to enjoy but worked ime, relentless repositioning on less favoured side so ideally you want to reposition head when he's asleep on the left and right as much as possible rather than him lying flat on the back of the head.
It was stressful and awful as I would wake up and see him on the flat side in the night and daytime napping and have to reposition, but 6 months later when he started sitting up and looking around more it sorted itself.. Well it didn't get any worse.
Now hair is covering it you can't tell.

Our DD had a flat patch at the back. I bought the 'perfect noggin' for her to sleep in and it has improved the roundness of her head. It cost approx £120.

I took her to 'Align Clinic' and as I noticed it when she was young and got appointment the same week (11 weeks) turning her has improved it a lot. It is possible to make a lot of difference with this up to 4/5 months.

We also used those pillows and tried to sit her in a jumbo style seat / use the carrier etc from when she was physically ready to hold her head.

I feel she has improved enough not to need the helmet x

We're in a similar position to you but DS is 9 months now.

DS has a flat patch at the back of his head. We went to the physio but she wasn't concerned since it's not that asymmetric.

We got a kind of donut pillow for him to lie to relieve the pressure at the back of his head but I'm not convinced that it helped.

I think his head looks slightly better now since he can hold himself up and do longer periods on his tummy. TBH I'm expecting a slow improvement as he grows because their heads grow much slower as they get older. We're not getting a helmet.

Also: adorable photos! 😍

Thanks for the replies everyone! I’ve booked in to see an osteopath, and from today I’ve started using the perfect noggin in his cot. Will update if these work 🤞🏻 if not I will probably go down the helmet route, it may as well sort itself over time but as a previous poster said it’s not a risk I want to take when it comes to the permanent appearance of my DS 😁

Simple plagiocephaly (flat head) will correct itself naturally over time. Absolutely fine for people to choose a helmet for their child but the evidence that they make any significant difference overall is very limited / none.
It's hard to reposition your child because they will naturally lie on the flattened part which makes it worse, however as they spend less time asleep and more time sitting up so the flattening will reduce.

There is no evidence at all for cranial osteopathy.
You're doing a great job!

I see where you're coming from but in welshweasel's defense, it may have resolved on its own. It appears lots do.