Repositioning Therapy to Correct Flat Head or Plagiocephaly

Plagiocephaly is the term for the flattening of the side of the head. I read about what is called “repositioning therapy” and banding. When Plagiocephaly is caught early (earlier than 6 months), repositioning is usually the first thing that is tried.

Repositioning simply means that the baby must be repositioned constantly as to avoid lying on the flattened side of the head. By doing this, the flat side will round out more as the head grows. Repositioning is usually helpful with mild to moderate cases and should be used for several months to in order to see improvements. If there is no improvement, then other more aggressive ments are usually the next step.

At 9 weeks, Katie’s left side of the head was more rounded, which made the right side of forehead bulge more than the left side. Her ears were also not in the same plane (the right ear is more forward than the left). I was so distressed over this. Thankfully, I found a Yahoo Group called All About Plagiocephaly .    With this group, I found support, encouraging words and most importantly, techniques to keep my twins off of their flat side.

The girls are now 7 months, so I have been repositioning for 5 months. And today, we finally saw a Pediatric NeuroSurgeon that told me I have done a great job and that there is no need for a band!!!!!

Repositioning Techniques: (These are all the things I did):

• Make baby sleep on the opposite side of the flat head.
• Use rolled up blanket to prevent baby from turning to the other side.
• If baby still rolls, put the rolled up blanket slightly under the back. This way, even if baby rolls, she still can’t roll to the flattened side.
• Check in the middle of the night several times and reposition if needed.
• Have as many superivised tummy time as possible. Some babies hate this, so even a few minutes is fine , just do it often.
• Look into getting a sleep positioner. There is a specific sleep positioner for “molding” baby’s head called NightForm . If your baby is on the small side and is still able to move around on this, use a rolled up thin blanket on the back to prevent turning.
• Limit time in the carseat because it’s a hard surface. If you’re like me, I pick up my eldest from preschool, so I have my girls in the carseat about 1 hour each day. In this case, roll up a small towel or blanket and put it on the side of the flat head to prevent as much turning to that side.
• Use Bumbo. This is great since at a very early age, babies can start sitting upright, even if they cannot do it themselves yet.  If your baby is on the small side and find her head fall back, use a magazine and position it on the back, to act as a head rest. (Remember that bumbo must not be used on high surfaces.)
• Use a stationary playstation (exersaucer). This is great for amusing babies while keeping them upright.
• When holding the baby, avoid holding where they rest on the flat side of the head.  If the flat side is on the right side, you’ll want to hold baby with her head on your right arm, not the left.
• Position the baby’s bassinet/crib so that there is nothing interesting on the side of the flat side.
• Always check on your baby and always turn her heard so that she is lying on the rounded side instead of the flat side.
• Take a picture of the head from the top every week, or every 2 weeks, in order to see changes. It is hard to notice a change because you are with your baby all the time. (I apologize that I don't have progressive pictures to show. My hard drive crashed and I lost a lot of pictures).

The more aggressive you are with the Repositioning Technique, the better. It sounds almost neurotic, but this is what has to be done in order to avoid having to use the band.

Some babies with Plagiocephaly also have Torticollis. Torticollis is the shortening of the muscle in one side of the neck, making the baby tilt her head on that side. If this is the reason for the Plagiocephally, then it is important address this also. Consult your pediatrician. Sometimes home exercises such us regular tilting of the head on the opposite side on a regular basis is necessary.

Give the Repositioning Therapy several months, because it takes that long to notice change. And if you are not seeing change, consult your pediatrician. If the face is becoming more and more asymmetrical, consult a specialist. Perhaps a band is necessary.

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