Plagiocephaly

Well oh well, finally I brought Charissa to Cranial Technologies for a consultation of her abnormal headshape. The right side of the back of her head is flatten. I first noticed that when she was around 2 months old and her pediatrician diagnozed her with Plagiochephaly when I brought her in for her 4 month check up and immunization. However, I was advised to wait till Charissa is 6 month old to get her consulted with the headband technician as getting a headband too early may result in more bands needed in the treatment. The cost of the headband including the weekly/bi-weekly office visit cost USD3300. With insurance we still need to pay around USD2000 after satisfying the deductible!!! Since the dianogsis, I've been trying to re-position her when she sleeps. I see some improvement but still needed a band. Those pics shown below was taken during the consultation. The words are way too small to be read after I scanned the pics but here is what it says:

Charissa is a 6 3/4 month old female who has been diagnosed with plagiochephaly. She was referred to Cranial Technologies in Charlotte by Catherine Ohmstede, MD. She was seen in our office on 12-28-07 for a consultation. On examination, Charissa presented with the following: right parietal-occipital flattening, left frontal flattening, right ear and orbit anterior to the left side of the face, increased right side and posterior head height, narrowed left orbital fissure.


There is a very interesting research paper written by Tim Littlefield. M.S., and Kevin Kelly, Ph.D on Plagiochephaly.

"Position in the womb can affect head shape"

Over the past several years, we have studied the development of abnormal head shape (plagiocephaly) in multiples. Our first investigation, published in the March 1999 issue of Pediatrics, documented that multiple birth infants were several times more likely to develop a misshapen head than their singleton counterparts. Higher incidence of plagiocephaly among multiples was determined to be the result of these infants being exposed to several risk factors including prematurity, low birth weight, torticollis (wry neck), nack-sleeping and a restrictive intrauterine environment.

A follow up to this study (Pedistrics January 2002) examining 140 sets of twins, found that the twin in the lower part of the uterus (Baby A) was more likely to be affected. These findings confirm the relationship between a restrictive intrauterine environment and the development of plagiocephaly. Causes of intrauterine constraint include a small or abnormally shaped uterus, an excess or lack of amniotic fluid, increased uterine or abdominal muscle tone and of course the presence of more than one fetus,. To make up for the lack of toom, one od the babies may be pushed down into the mother's pelvis, or id the child is in a breech orientation, the head may become wedged under the mother's ribcage.

During the later part of pregnancy, the infants run out of room to move and may be stuck in one position. Often, the lower in uteri infant;s head can become engaged in the pelvis and many mothers report pain in the hip or radiating into the leg due to pressure of the child on the pelvic wall.

The study also found that the lower in utero infant was more likely to develop a congenital muscular torticolis (CMT) or some other form of next dysfunction that restricts the normal range of motion of the infant's head. The restriction has been linked to the development of plagiocephaly because it causes the infant to hold its head against the mattress in the same position. Infants with torticollis typically exhibit a notable head tilt and favor turning to one side. In most cases, torticollis may be successfully treated with physical therapy.

Recognizing that this condition may begin in the womb emphasizes the importance of early diagnosis and intervention. When caught at an early age, conservative measures such as a simple repositioning of the child off the flat spot of the head at night, physical therapy for portcullis and allowing the child to have supervised tummy time while awake can have a significant impact in correcting this condition. Parent of multiples and sungletons can lessen their child's risk by limiting the amount of time infants spend in devices such as swing and carriers that put prolonged pressure on the back of the head. For moderate to severe cases, or for hose infants for whom repositioning has been unsuccessful, treatment with a cranial headband may be considered.