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A baby with brachycephaly typically has a flat spot on the back of the skull, and the head appears to be widened. It is similar to plagiocephaly, which occurs when only one side of the baby’s head is flattened.

There are several common causes of brachycephaly. All of the causes are related to the fact that an infant’s skull is soft and the bones can be molded. This means that pressure on one area will cause the skull to change shape. As a result, brachycephaly is often referred to as “positional skull deformity” or “flat head syndrome.”

Causes of brachycephaly include:

  • Premature birth, because the skull of a premature baby is softer than that of a full-term baby
  • Low amniotic fluid volume (oligohydramnios)
  • Multiple births
  • Large babies
  • Babies who spend a long time lying on their backs after birth, often due to illness
  • Craniosynostosis, or premature fusion on the bony plates of the skull

 

Prevention of brachycephaly is easy. Newborns need at least a few minutes of time on their stomachs, while awake, several times a day. This encourages muscle development in the neck and back and takes pressure off the back of the skull.

When holding or feeding your baby, alternate sides so pressure is applied to different sides of the head. When putting your baby in his or her crib, alternate which direction the head is facing to help reduce the pressure on one side. If your baby appears to have a resting head preference — meaning they prefer to look to the right or left, or always sleep with the head positioned to the same side — there might be a problem with a neck muscle. One side may be tighter than the other, discouraging the infant from rotating his or her head away from the tight side.

Your pediatrician will examine for positional skull deformities. They will notice head shape and any head tilt preference. A baby with early brachycephaly will respond well to positioning changes. Limiting time spent in car seats and bouncers can also help. Tight neck muscles can be gently stretched with mild exercises suggested by a doctor. At times, pediatricians refer children to a physical therapist to assess the neck and work with the family to improve head shape. When brachycephaly is noted early, treatment is very effective.

In severe cases where the features of the face or ears are affected, helmet therapy may be indicated. However, this is much less common today than in the past. Rarely, babies with brachycephaly caused by premature fusion of the sutures of the head (craniosynostosis) require surgery.

There is no role for craniosacral therapy in the treatment of positional skull deformities.

Takeaways

  • Brachycephaly occurs when the back of your baby’s head is flattened.
  • It can be caused by multiple things, including resting in one position for a long time.
  • It is typically easy to prevent.
  • Treatment for mild cases is not difficult.

 

References

  1. Pediatrics. Prevention and Management of Positional Skull Deformities in Infants.
  2. Pediatrics. Plagiocephaly and Brachycephaly in the First Two Years of Life: A Prospective Cohort Study.

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