The management of flat head or plagiocephaly in osteopathy

Flat head syndrome has become increasingly common since we started placing infants on their backs to sleep to reduce the risk of sudden infant death syndrome (SIDS).

The skull of an infant is very malleable until the fontanelles close and the cranial sutures fuse. The fontanelles close one after the other from the third month to the twenty-fourth month after birth.

Plagiocephaly is, by definition, a deformity of the skull, distinct from craniosynostosis, which is characterized by the premature fusion of the cranial sutures.

Plagiocephaly can be of two types :

Primary : This is due to intrauterine positioning or can occur during labor and delivery. In this case, it will be visible shortly after birth and will require prompt intervention for optimal results.

Secondary : This generally appears a few weeks after birth and develops in response to tensions located elsewhere in the body (torticollis, scoliosis, or abnormal posture). For example, lying on the back with the head always turned to the same side can lead to secondary plagiocephaly. This abnormal position is often seen as a comfortable position for the infant and thus ignored by parents. Unfortunately, to have noticeable effects, action must be taken as early as possible.

Risk factors for plagiocephaly include :

• Multiple pregnancies
• Prematurity
• Prolonged labor, epidural anesthesia
• Boys (studies show that boys are, on average, less active and mobile than girls of the same age)
• Bottle-fed infants (due to the preferential position of parents who do not think to alternate arms and thus change the baby's side)

Management of Plagiocephaly with Osteopathy :

Through gentle and adapted manipulations for infants, the osteopath performs a complete examination to find different tensions in the newborn's body.

The techniques used are painless and non-invasive.

Depending on the type of plagiocephaly, the osteopath will focus on different parts of the body. For some types of plagiocephaly, the bulk of the work will be on the child's skull and cervical spine, while for others, tensions will be lower in the dorsal or lumbar regions or even coming from the pelvis or limbs.

It is therefore important that your osteopath treats your baby as a whole.

Physiotherapy is very complementary to osteopathy in managing plagiocephaly.

Advice for Parents :

• Avoid leaving your baby in a bouncer or swing for too long.
• Prefer a baby wrap or carrier to avoid prolonged pressure on the back.
• During awake periods and under supervision, place your baby on their tummy to start developing neck muscles.
• Alternate arms when bottle-feeding, and do not always hold your baby on the same side.
• Position the crib in the room so the baby can see you entering and regularly change the direction the baby sleeps in the crib (head to feet and vice versa).
• Change the position of surrounding objects.
• During sleep on the back, try to have the rounded side of the head resting on the mattress and not the flat side.
• If the baby sleeps in the parents' bed, the mother should position herself on the unaffected side because the baby turns their head towards the mother when hungry to nurse.

For more information, feel free to contact your osteopath.

Magalie Quinti

Osteopath for baby

In Beausoleil, Monaco and Cap d'Ail