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About Face

Treating Positional Plagiocephaly

By Teri Brown

"There are rare cases of facial problems resulting from severe asymmetry, including problems with vision, chewing and eating, but these almost never occur, especially if the problem is recognized in the first few months of life," says Dr. First.

Dr. First feels it's important to note that the condition does not affect brain growth or cause developmental delay. "The simplest treatment is repositioning of the baby's head by simple maneuvers such as alternating the direction the infant is placed in the crib each night or moving the orientation of the crib so that the baby is not always looking out using the same head position each day," he says. "It is best to give the baby lots of 'tummy time' when [the baby is] awake to strengthen Baby's muscles in the arms, legs and neck, as well as to reduce the external pressure on the back of the head."

Dr. First suggests having an X-ray taken if the problem persists during the ages of 4 to 6 months to make sure the bones of the skull are coming together properly. If the skull bones look normal, a custom molding helmet may be recommended to help redirect the skull's growth.

Plagiocephaly is on the rise, according to recent studies. In 1992, the American Academy of Pediatrics initiated a "Back to Sleep" campaign to fight the number of SIDS cases. The campaign has been incredibly successful, with some estimates putting the decrease in SIDS at 50 percent a year. However, there has been a six-fold increase in the incidence of positional plagiocephaly. Most pediatricians feel that, given the excellent prognosis of plagiocephaly, the benefit of preventing SIDS by putting babies on their backs to sleep far outweighs the risk of a temporary flat head.

Want to see more?

• Newborn Surprises: Skin Transformations, Bizarre Behavior and Other Perfectly Normal Oddities that Worry First-time Parents
• Talk about it!
• Sleepy-time Stress: Reviewing Sleep Strategies
• SIDS: Facts and Prevention

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