When Baby S. first arrived at PhysioActive , his parents were concerned. His head always seemed to tilt and turn to one side, making it difficult for him to breastfeed comfortably. His mom noticed that he preferred nursing on only one side, often becoming fussy and frustrated. Over time, they also began to see a flat spot forming on one side of his head, accompanied by some minor hair loss in the same area.
Wanting answers, they consulted with a Physiotherapist (PT) and an Osteopathic Manual Practitioner (DOMP) at PhysioActive. Through a comprehensive assessment, we identified several key issues:
Restricted cranial movement, limiting natural head turning.
Tension at the back of the head—specifically where the skull meets the spine—affects nerve function.
Irritated nerves impacted the muscles responsible for the head position (sternocleidomastoid (SCM) and upper trapezius fibers), which were causing the torticollis.
Involvement of the vagus nerve, contributing to discomfort and baby fussiness.
With just four gentle hands-on treatments, combined with parent education on movement stimulation and repositioning techniques, Baby S. experienced a remarkable transformation. His torticollis resolved, his breastfeeding improved, and his fussiness significantly decreased. His parents were thrilled but expressed one regret:
“We just wish we had known this kind of care existed sooner. We would have come much earlier!”
At PhysioActive, we believe that early intervention can make all the difference. If you notice your baby showing signs of head preference, difficulty breastfeeding, or developing a flat spot, don’t wait—help is available! Gentle, effective therapy can improve function, comfort, and overall well-being, setting your baby up for a healthy start in life!
Plagiocephaly & Torticollis Awareness Month
At PhysioActive we are dedicated to educating families about plagiocephaly (a condition where a baby’s head develops a flat spot) and torticollis (tight neck muscles). Plagiocephaly can be linked to musculoskeletal conditions like torticollis and may arise from positional factors, such as how the baby was positioned in utero (particularly in pregnancies of multiples), prolonged time spent in one position, and extended use of car seats or strollers.
Plagiocephaly is more than just a cosmetic issue. When left untreated, plagiocephaly can lead to a variety of long-term complications, some affecting appearance but others potentially more serious.
The severity of long-term effects depends on the degree of plagiocephaly and how early treatment is started. Early intervention with repositioning techniques and therapies like Osteopathy and Physiotherapy can significantly reduce the risk of complications.
Many of these complications are associated with facial asymmetry, and many of the current therapies for plagiocephaly are focused much more on addressing only the shape of the back of the head, rather than the structures that can lead to long-term and more serious consequences.
To help new families better understand Torticollis and Plagiocephaly, we have reviewed two key studies that highlight their potential impact on development. Our goal is to raise awareness and provide guidance on early intervention options. If you have any concerns, we’re here to support you.
Study 1: Neurodevelopmental Delays in Children with Deformational Plagiocephaly
Deformational plagiocephaly (DP), often referred to as “flat head syndrome,” is a condition characterized by an asymmetrical head shape resulting from external pressures on an infant’s malleable skull. While traditionally considered a cosmetic issue, emerging research suggests a potential association between DP and neurodevelopmental delays.
Study Overview
A pivotal study published in Plastic and Reconstructive Surgery aimed to investigate whether infants with DP exhibit cognitive and psychomotor developmental delays compared to standardized populations.
The study prospectively followed 110 consecutive patients diagnosed with DP, assessing each infant using the Bayley Scales of Infant Development-II. This assessment provided two primary scores: the Mental Developmental Index (MDI) and the Psychomotor Developmental Index (PDI).
Key Findings
Mental Development : None of the infants with DP were categorized as having accelerated mental development. Approximately 90% were within the normal range, while 7% exhibited mild delays, and 3% had severe delays.
Psychomotor Development : Similarly, none showed accelerated psychomotor development. About 74% were within the normal range, 19% had mild delays, and 7% experienced severe delays.
These findings indicate that infants with DP are at a higher risk for both mental and psychomotor developmental delays. Notably, the absence of accelerated development in any of the subjects underscores the potential impact of DP on early neurodevelopment.
Implications and Recommendations
The study’s results suggest that DP may not be merely a cosmetic concern but could also serve as a marker for underlying developmental issues. While the exact mechanisms linking DP to neurodevelopmental delays remain unclear, several hypotheses have been proposed:
Environmental Factors : Prolonged positioning that leads to DP might also limit an infant’s exposure to varied stimuli, potentially hindering development .
Underlying Neurological Conditions : DP could be an external manifestation of pre-existing neurological impairments that contribute to both skull deformation and developmental delays.
Given these associations, it is crucial for healthcare providers to ensure the following:
1. Early Screening : Implement routine developmental screenings for infants diagnosed with DP to identify and address potential delays promptly.
2. Parental Guidance : Educate parents on preventive measures, such as supervised tummy time, to reduce the risk of DP and promote motor development.
3. Interdisciplinary Approach : Collaborate with specialists, including pediatricians, neurologists, and physiotherapists, to provide comprehensive care for affected infants.
While deformational plagiocephaly has often been viewed through a cosmetic lens, emerging evidence highlights its potential association with neurodevelopmental delays. Recognizing DP as more than a superficial condition emphasizes the importance of early detection and intervention, aiming to optimize developmental outcomes for affected children.
Study 2: Visual Field Defects in Deformational Posterior Plagiocephaly
Deformational posterior plagiocephaly (DPP), commonly known as “flat head syndrome,” is characterized by an asymmetrical flattening of an infant’s skull due to external pressures. While primarily considered a cosmetic condition, emerging research suggests potential associations between DPP and visual field abnormalities.
Study Overview
A study published in the Journal of AAPOS investigated whether infants with DPP exhibit visual field defects. The researchers aimed to determine the presence of such abnormalities and assess their implications for early visual development.
Key Findings
The study revealed that infants with DPP might experience visual field abnormalities. These findings suggest that the asymmetrical head shape associated with DPP could influence the development of the visual system, potentially leading to visual field defects.
Implications and Recommendations
The association between DPP and visual field abnormalities underscores the importance of early detection and intervention:
1. Early Screening : Healthcare providers should incorporate visual field assessments into routine examinations for infants diagnosed with DPP to identify potential abnormalities promptly.
2. Parental Guidance : Educating parents on preventive measures, such as supervised tummy time and varying head positions during sleep, can help reduce the risk of DPP and its associated complications.
3. Interdisciplinary Approach : Collaborating with pediatricians, ophthalmologists, and physical therapists, osteopaths, ensures comprehensive care for infants with DPP, addressing both cranial shape and visual development concerns.
While deformational posterior plagiocephaly has often been viewed as a cosmetic issue, emerging evidence highlights its potential impact on visual development. Recognizing the association between DPP and visual field abnormalities emphasizes the need for early detection and intervention, aiming to optimize both cranial and visual outcomes for affected children.
Supporting Your Baby’s Development with Gentle, Targeted Care
Baby S.’s transformation highlights how specialized therapy can ease discomfort, improve function, and promote healthy development. His parents’ initial concerns—trouble breastfeeding, head preference, and a developing flat spot—are struggles that many families face. Yet, with just a few sessions of hands-on therapy and guided at-home techniques, Baby S. saw a remarkable improvement.
The research on plagiocephaly and torticollis further reinforces the importance of early intervention. Conditions that may seem minor at first can have lasting effects on neurodevelopment, motor skills, and even vision. At PhysioActive, our approach goes beyond cosmetic concerns—we focus on the root causes, helping babies move, feed, and grow with greater ease.
If you’re noticing similar signs in your little one, you’re not alone, and support is available. Let’s work together to ensure your baby has the best start in life. Call us today at 905-695-0372 to learn how we can help .
References
Kordestani, R. K., Patel, S., Bard, D. E., Gurwitch, R., & Panchal, J. (2006). Neurodevelopmental delays in children with deformational plagiocephaly. Plastic and Reconstructive Surgery , 117 (1), 207–218. https://doi.org/10.1097/01.prs.0000185604.15606.e5
Plank, L. H., Giavedoni, B., Lombardo, J. R., Geil, M. D., & Reisner, A. (2006). Comparison of infant head shape changes in deformational plagiocephaly following treatment with a cranial remolding orthosis using a noninvasive laser shape digitizer. Journal of Craniofacial Surgery , 17 (6), 1084–1091. https://doi.org/10.1097/01.scs.0000244920.07383.85
Siatkowski, R. M., Fortney, A. C., Nazir, S. A., Cannon, S. L., Panchal, J., Francel, P., Feuer, W., & Ahmad, W. (2005). Visual field defects in deformational posterior plagiocephaly. Journal of American Association for Pediatric Ophthalmology and Strabismus , 9 (3), 274–278. https://doi.org/10.1016/j.jaapos.2005.01.011
