Plagiocephaly - Flat spot on head

DD has developed a flat spot on one side of her head. To me it stands out quite a bit when look from the top of her head down towards feet, but I wouldn't say it is extreme. I took her for her 8wk health nurse visit today and asked about it. She said she has Plagiocephaly (the fancy word for the flat spot on head), and to try facing her head the other direction when sleeping. This is all good and well but I have tried this and she still favours and will often turn her head back to the flat spot. What made me upset was, when I said "will this fix itself and is there a point that I should be alarmed?" the health nurse said "no, she just may end up with a flat spot for ever but her hair will cover it" I was so shocked and upset inside that I just said nothing because I felt like I'd get nowhere. Am I over reacting?

I have been putting her to sleep on her side using a safe sleeper positioner, I'm hoping this will help. Is there anything else I can do. Don't get me wrong, it's not extreme (although you can start to see a change in the shape of her forehead also) but I think early treatment would be best and at 8 wks I thought that there would be time. I don't want DD to have an odd shaped head if we can help it as I'm sure you'd still notice it with hair covering it anyway.

What do you think? Any suggestions?

It's time like this that I really hate being in the middle of nowhere!

Bump - no one has any advice? :( Maybe I am over reacting??

Hi darl,

Jazz was diagnosed with Plagiocephaly and Torticollis (tight neck muscles) around 4ish months.

The Torticollis was stopping her from turning her head away from the flat spot, which is how she got it in the first place. Her neck muscles being shorter and too tight on one side, and looser on the other, meant it was easier only to look to one side. Not sure if this is an issue you are having? But its a common cause, and side-effect, of plagiocephaly (side effect: if they have a flat spot, its hard for them to turn, so they don't and the muscles on one side become tight, and the other become too loose).

It's also important to keep up-to-date with head circumference measurements. We need x-rays and things to make sure everything was still open amd growing. Flat spot can (but hardly ever does) indicate a skull growth issue. Sometimes the plates fuse and cause bulges, facial deformaties, 'diamond' shapes, and flat spots. BUT this is rare, and the 'shapes' are much more distictive.

Her's was quite severe, it was starting to impact of her forehead and ear position (one ear was more 'forward' than the other), and there was talk of a helmet at one point if it started to effect her facial features and jaw, but we got our MCHN to refer us to the hospital physio, had a few appointments, we got some advice on how to stretch her neck (simple stretching in the opposite direct of the shorter muscles to stretch them out). We did this 3+ times a day, as well as getting her off her head.

Our sling was a HUGE help, and I had her in that ALOT of the time, sleeping tummy-to-tummy so she wasn't resting on her head.
Also, this is mostly for the Torticollis, the physio said to put her in the sing on our hip (Jazz head neck control thouh and could hold her head up as she was a bit older) so that when she looks forward she's stretching the opposite way she usually does (another way to stretch the neck muscles).

We bought a Bumbo (again, Jazz was a bit older, but I'd suggest buying once once she gets get neck control and can hold her head up, if she still has the flat spot), and had jazz in that ALOT of the day. We did this at the physio's advice too. Some people will say not to, but we took our professionals advice, and it has a short back, so she can't rest her head on anything. We did this up to 3 hours a day.

Jazz hated tummy time, but we had to persist with that too. Also, when she is laying on the ground, play with her on the opposite side, so she is turning onto the 'bump' and away from the 'flat'. Bathtime, hold her so that when she looks at your she is turning her neck the 'opposite' way (thats more neck stretching, it won't directly help with the flat spot, BUT if she's like Jazz, it will end up helping).

Some same acupressuce and cranial... something... helps, but we never did that. If you are interested, search for plagiocephaly in the search function ^^^ at the top. You shold find some posts be me, Divvy, and Jakabella... two other members who I know have gone through this as well.

Her 'flat' and 'bump' were evening out nicely by 6 months so she never needed the helmet, and by 10 months it was almost normal looking. If she ever does a 'shaved head' pahse she'll find she has a bumpy head ;) but it's not out of the 'normal' range of bumpy IYKWIM. Her hair covers it now, and I can't feel anything 'odd' when i touch the back of her head so :D

Hope this helps :hug:


ETA: Co-sleeping seemed to help also. I breastfed (still am ;)) and slept on the left, so she had to turn towards me to feed, which got her off her flat spot. She also cuddled into me, which meant she slept on the bump not the flat, which i think had a HUGE impact. Not sure if this is doable or necessary for you, but if you find it getting worse and not better, might be something to consider?

Leasha - Thank you!! Thanks for making me not feel like I was stupid for being concerned that we should just let it go. I have swithed DD sleeping end of cot but that hasn't helped. I am constantly going in and trying to change her head direction. I use the sling a lot - so glad to hear that it helped your little one. I guess, what I was mostly stressed about was that we had been told to just leave it and she'll probably end up with a flat spot in her head. When the answer I was looking for was similar to what you said, "if x starts to happen" we need to see physio/doctor whatever it may be. I will try your suggestions. We are becoming conscious of which arm we hold her in but the bath is something that hadn't registered.

I'll use the search tool and have a read. Thanks again.

Hi there! Only just saw this. I had a similar thing happen with DD.
At 8 weeks the MCHN said to keep a real close eye on it and do everything I was already doing. I decided to take her to an osteopath. From her first appointment, I noticed a change. DD no longer preferred one side of her head to the other. She has now had 4 appt with the osteo over 3 months and the flat spot has nearly gone. I credit it to the osteo.

I've also got a Bumbo that DD loves, and she enjoys tummy time for short periods. Once she starts sitting on her own, I think it will completely correct itself, but If I hadn't have seen the osteo, I'm not so sure it would have worked out this well.

Niadla - glad to hear that your DD has had success! We are quite remote and either 1600km or minimum $250 flight each way to a Osteo, but obviously would happily find a way to make it possible to take her there if need be. Perhaps I should be looking at this now, or do you think I should see what happens for a bit?

Cranial osteopathy is what you'd be after, that or a paediatric chiropractor. Paediatric chiros tend to be easier to find than cranial osteos, I hope that gives you an easier option. Leasha has given you some great advice which I'll try not to repeat but yes, I totally agree that you shouldn't just accept a flat patch on your baby's head and you need to minimise the time your DD spends on her back when awake and try as much as possible to encourage lying on the side, tummy time etc.

My DS had a forceps birth and actually has a scoliosis in his neck from it...I picked up at about the age of 4 months that there was something not quite right...it was as if he wanted to roll but it hurt him to do so. One session with a cranial osteo and he rolled 3 times that very afternoon. He actually had to go for regular treatment until he was about 2 or so because he was growing so fast the osteo wanted to make sure everything stayed loose. Now he'll just need to go once or twice a year for a check.

DD on the other hand had a slight torticollis and was quite obviously favouring one side from when she was born so I was right back to the osteo straight away (when she was 2 weeks old) and I've had a few people comment on what a lovely head shape she has - I have been really vigilant because I do really hate seeing flat patches on babies' heads.

It sounds to me like your DD's neck needs a bit of treatment and the good news is that not only will that help her mobility and help discourage that preference for one side, if she hates tummy time a couple of treatments should help with that too. A good friend of mine's DS simply could not do tummy time at all, he just couldn't get his head up and one session with a paediatric chiro sorted him right out.

If you google osteopathy Australia you should find their website which lists practitioners all over the country and it will often list if they have a particular interest in treating babies or children. Alternatively just find any chiro or osteo convenient to you and ring them up to see if they treat babies and children. It is actually a specialised additional qualification in addition to the base osteopathy or chiropractic qualification and is becoming more and more popular.

Good luck!

ETA: I would get on to it as soon as possible. The younger they are, the easier they are to treat.

Hi
My DS was diagnosed with the torticulus problem too....and was getting the diamond head effect. Initially I raised it to the Dr and they were not concerned at all....basically made me feel like an idiot! But at 5 months our nurse noticed it and was concerned enough to get us a referal to the physio straight away!
Same as what happened with Leasha....we had the ears and forehead becoming out of alignment too and the nurse said if it continued as is my DS's left hand would not reach the same level of co-ordination as the right.
So we got the excercises too and in only afew weeks the physio says there has been huge improvement!
Youve already been given some great advise from Leasha there with focusing bubs to look the other way, always making the weaker side more interesting.
I still have the excercise sheets I was given, feel free to pm me with your email addy if you would like to have a look at them I can scan them and email them thru, but you will probably find alot of similar stuff onthe net too
Good luck with it all :)

Just thought I'd update on what's been happening with DD. We saw the MCHN for 3month visit and again she told me "her hair will cover it" :wall: So I asked her how she supposes we get a bike helmet to fit when she is older? Or how we cope with the teasing at school. I think that stumped her. Ended up she thought that DD had issues with gross motor skills because she wasn't doing push ups at 14wks or 10wks corrected so she sent us to a visiting pead.

Paed visit was good. No issues what so ever with her gross motor skills. But the Plagiocephaly was identified as an issue. Turns out she has torticollos and we are supposed to start physio. We haven't heard from the physio yet though so I'm getting a little impatient. Paed also said if by the time she turns 1 her head shape isn't right then we need to get a helmet. That is what I was concerned about. From what I've read Helmets should be used between 4-8months of age to be most successful. DD has her ears misaligned now, her forehead on the right is protruding and when she feeds I can often feel a clicking of her jaw :doh:

Do you think I should go to the doctor and ask to see another specialist? We have private health cover. She is 4 months on Thursday and I don't want to get down the track to have someone say we should have done something earlier. TBH I'm starting to think the last couple of days, I'd rather just get a helmet on, align it all back up and continue witht he positional treatment after that. What do you think?

I would try a paed chiro or cranial osteo as a PP suggested. DD1 had an awful flat spot - same deal with her ear etc. She could not turn to one side at all this meant that no matter how hard we tried to encourage turning/stretching she just couldn't. At 4 months we started seeing a chiro and within 2 weeks we saw a noticeable change - at 3 months you couldn't tell. I was referred by a fab MCHN - was the best thing we did. Good luck - perhaps ask around for someone????
PS I was very sceptical and was keen just to get it fixed (re helmet). Good luck and keep persisting if you are not happy.

i would most certainly see someone privately and have her assessed for a helmet NOW, i would not wait regardless of cost, at 12 months its almost too late to fix the problem.
DD1 had/has a flat spot, i notice her head is out of alignment :( it saddens me that we didnt do
anything about it even though others tell us they cant see the problem, i know its there and i notice it more now she is wearing her hair up more

Absolutely yes, get her seen by someone as soon as possible. The earlier you start, the easier and quicker it is to fix.

You don't need a referral for a chiropractor, osteopath or physio - you should just be able to book in. If she has a torticollis, that means she doesn't have freedom of movement and while she wouldn't be in pain, she certainly isn't as physically comfortable as she should be. 4 months old is not too late, my DS wasn't seeing his osteo till nearly 5 months of age.

I presume the physio your paed has recommended is a specialist in this field, and I don't see why you can't ring the paed's office and get the contact details for the physio and chase them up yourself.

Time to start jumping up and down and being a protective mummy bear, hun.

Thanks. We actually live remote and saw a visiting public paed. She sends a letter to the physio who then calls us... but we've not heard anything yet so will follow up this week. The physio is not a specialist and is here 2 part days a week. I think that we will try go back to perth see a private doc and find osteo in one visit as it costs us at least $500 per person to get there and back plus accom.

Thanks for making me feel like I'm not being OTT. Will call docs tomorrow.

As you are living remotely, when you find an osteo I'd see if you can actually speak with him or her on the phone before you travel down, rather than just making the appointment. It sounds like you might be in for a couple of trips down to Perth and you'd want to maximise your time there...you might be able to get two treatments done in the one visit, for example.

Good luck!

Can I be nosy and ask whereabouts in WA you are??:)

Have u see the phsysio yet? I know your paed said twelve months but most paed. Physios reckon it doesn't help after nine months - if you do need to go the route of a helmet it should be by then. How was your physio appt?