Flat or Misshapen Heads in Children
Many parents have seen or know infants who must wear a special helmet throughout the day but are not sure of what purpose the helmet serves. In most cases, the reason for the helmet is a flat or misshapen head. The infant wearing the helmet may suffer from brachycephaly, scaphycephaly, or plagiocephaly, which are the official medical terms used to describe a head that is too flat, narrow, or asymmetric; respectively. Infants with these conditions may be prescribed helmet therapy, which encourages symmetric shaping of the cranium during normal skull growth, simply by wearing a corrective helmet. There are several possible causes of a flat or misshapen head and most are preventable and/or treatable. If left untreated, a flat or misshapen head may affect physical appearance, but not brain development.
A flat or misshapen head can occur if movement is constrained in utero, causing the infant to remain in the same position for a prolonged period of time. This can be seen during multiple births or simply if the pelvis of the mother is too small to allow for comfortable movement of the infant in utero. Infants born premature are also at risk of developing a flat or misshapen head because the skull of a premature baby is usually much softer and malleable than the skull of a full term baby. A softer skull is more susceptible to outside forces that can affect its growth.
Full term infants who had plenty of room to maneuver in the womb can still develop a misshapen head if they spend a prolonged period of time on their backs. This is seen more and more as infants sleep on their backs, use certain child restraint systems, carriers, and toys. Frequently repositioning the head of an infant while it sleeps or remains restrained is recommended to prevent a misshapen head. Encouraging “tummy time”, by placing an infant on its stomach, will also help prevent a misshapen head. Tummy time should only be done when the baby is awake and closely monitored, as to reduce the risk of Sudden Infant Death Syndrome (SIDS). Car seats and certain toys, like swings, can affect the growth of the infant’s skull if the head is allowed to lean or rest against the back or sides of the restraint system for a prolonged period of time. During car trips the infant’s head should be repositioned frequently to encourage normal skull growth. If the infant is being held, the person holding the infant should remember to regularly switch the infant from one arm to the other, to ensure no one side of the head remains rested in the same position for too long.
Exercises and repositioning of the infant on a regular basis are often enough to treat a mild to moderate case of flat or misshapen head, with more serious cases being treated with the help of a corrective helmet. The helmets themselves are made of a hard outer shell and strong foam lining that is both durable and lightweight. The helmet is designed to encapsulate the head and encourage the skull to grow in some directions and not others, literally reshaping the skull into a normal shape as it grows. The length of treatment depends on the age and severity of the infant’s head. The helmet is worn around the clock and adjustments are typically made on a weekly basis.
About the Author
Dr. Rosenfeld is a San Diego Pediatrician who has been in practice for 35 years. She is also a member of Children’s Physicians Medical Group. More information about flat or misshapen head available in the site.
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