Flat Heads In Newborns And How To Prevent Them
Alison Mason is a paediatric physiotherapist working out of Step By Step Physiotherapy in Myaree. FitRight is lucky enough to have her as a guest blogger to talk about a couple of very common issues in newborn babies that specialist physiotherapists can help to treat!
As physiotherapists working in paediatrics, plagiocephaly and torticollis are the two most common presentations in the babies that we treat.
So what are plagiocephaly and torticollis?
Plagiocephaly refers to an asymmetrical flattening of the baby’s head. This can also be associated with asymmetry of the facial features and ears. Although the baby’s appearance is often really concerning for parents, plagiocephaly does not affect the development of the baby's brain or cause brain damage.
Torticollis is a tightness of the neck muscles which restricts the baby’s ability to turn to one side. Although most people first notice torticollis as a head turn preference it often also causes the baby’s head to tilt to one side (often the opposite to the preferred turn side). You may notice this as the baby’s ear sitting closer to one shoulder when their head is in the midline. Plagiocephaly and torticollis are frequently but not always seen together.
Both plagiocephally and torticollis usually resolve with the implementation of some basic physiotherapy strategies like stretches and positioning.
When does it develop?
Sometimes plagiocephaly or torticollis are noticed from birth. This asymmetry is likely a result of the baby’s position in utero or their journey through the birth canal. In many cases this will be recognised by the midwife, child health nurse, hospital physiotherapist, or paediatrician in the baby’s first few days. They will recommend some exercises themselves or refer the baby to a physiotherapist.
In other cases the asymmetry develops after the baby is born. In their first few months babies are still developing their head control. For the first few weeks, even on their backs babies are unable to hold their heads in the midline and when held upright their heads often lean to one side.
As adults we are all asymmetrical, and whether left or right handed, caregivers quickly tend to form habits and hold or support the baby in the same way each day. In addition, as the baby’s vision is developing they are often attracted to a particular toy, light through a window, or a picture on the wall and will look towards it whenever they are placed in a certain location, like the cot or change table. Together, these factors can create asymmetry in the baby’s neck strength, and so they develop a preference to look to one side. If the baby spends a lot of time on their back looking to the same side this can then lead to the development of a “flat spot”.
To prevent torticollis and plagiocephaly:
- Sleep - place your baby down to sleep on their back and alternate their head position to left and right each sleep. The SIDS website has lots of great information on safe sleep positioning http://www.sidsandkids.org/safe-sleeping/. Placing your baby at alternate ends of the cot to sleep may help if they are turning towards anything particular in the room for example you, or the light , or the door.
- Play - encourage active turning to the left and right when playing by encouraging baby to turn towards a toy or your face. Try and use lots of different play positions like tummy time, side lying and supported sitting to play.
- Carrying - try and alternate the way you carry and handle your baby so they turn to both the left and right when in your arms.
Who can help?
Sometimes no matter what you try, you can’t get your baby to turn towards their non-preferred side, or they will turn a little bit but not the whole way. This may mean that your baby’s neck muscles are tight and need gentle stretching or some specific strengthening exercises. Your Child Health Nurse will be able to assess this and refer you to a physiotherapist for babies, alternatively you can contact a private paediatric physiotherapist directly and book in for an assessment.
FitRight highly recommends Step By Step Physiotherapy if you live in Perth:
Phone 6161 1241