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Causes of head deformities

Head deformities can happen for different reasons. It can be caused by premature fusion of the skull sutures. This condition is rare and often needs surgical correction. In contrast to this condition positional changes are much more common, but your doctor should rule out synostosis in the first stage of the assessment.

Positional plagiocephaly is caused by external pressure on the skull. It occurs after the baby has been born and differently to the birth related deformities (because of the birth process) they will not all improve by themselves (depending on how severe it is!)

The increased incidence of plagiocephaly is largely due to the "Back to Sleep" campaign, designed to reduce the incidence of "cot death". Since 1994, many pediatric associations have been recommending back sleeping positioning as a means of avoiding Sudden Infant Death Syndrome (SIDS).

Plagiocephaly and Brachycephaly Defined

Positional plagiocephaly is simply defined as a deformity or asymmetry in the skull shape, which typically occurs within the first 3-6 months of a baby's life.

Whereas it is completely normal for a skull to have minor abnormalities or small bumps, the condition of plagiocephaly refers to a large, unusual area of flattening.

The skull is made up of several plates, which are still soft and pliable under the age of 1 year. This means that the shape can be altered by external pressures, giving it a deformed or flattened look. In most cases, this is at the back of a baby's head.

Brachycephaly is similar to plagiocephaly, and is identified by a flatness across the full extent of a baby's head. There is often a corresponding flatness across the front of the head as well. Typically, brachycephaly results in a shorter, and wider than average headshape.

Plagiocephaly Brachycephaly

Signs of Plagiocephaly

Most incidents of plagiocephaly occur within 3-6 months of age. Some babies are born with a flat head, although this is usually a temporary deformity caused from the pressures of leaving the mother's womb. These birth related deformities usually get better by themselves.

Positional plagiocephaly can best be determined by looking down on the baby's head from above.

1) Parallelogram-shaped skull when viewed from above

2) Flattening on one side at the back of the head, with a bulge in the forehead (on the same side)

3) Unequal positioning of the ears

How Serious is it?

It is normal for a skull to have some abnormalities or bumps. Even in moderate cases, plagiocephaly has no adverse medical consequences and it is not associated with any form of developmental delay or other functional aspects. Although many cases of plagiocephaly can be referred to as "aesthetic", a misshapen head can be the source of distress for children as they grow up.

In severe cases, plagiocephaly can permanently alter facial symmetry (positioning of eyes, jaws, ears etc.). Major asymmetries of the skull base can influence the further growth of the lower jaw in a negative way. Malocclusion and anomolies of the lower jaw may result.

Your doctor will be able to assess the severity of your baby's condition and advise you how to proceed.

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