External forces from compression in utero or from molding by lying on the back of the head can cause an abnormal head shape known as deformational plagiocephaly. The compressed back part of the head induces a compensatory bulging of the forehead on the same side leading to the classic trapezoidal shape skull when viewed from above. . Sometimes this can be the result of neck muscle spasm (torticollis) which may require physical therapy to allow the head to fully move from side to side.
The treatment involves repositioning your child, tummy time, and sometimes a molding helmet may be needed for 4-6 months. Earlier intervention leads to superior outcomes. It is important to not overlook the possibility for craniosynostosis as a cause of the abnormal head shape, which would not get better without corrective surgery.
Will an abnormal head shape affect my child’s intelligence or development?
Deformational plagiocephaly unlike craniosynostosis has not been linked to intracranial pressure (ICP) and thus is not thought to result in any developmental delay. However, children with poor muscle tone and developmental delay have been shown to have higher incidences of deformational plagiocephaly (since they do not move their heads to relieve the forces).
When should we start helmet therapy?
Typically 6 months
How many hours a day must the helmet be worn?
23 hours/day ideally