Plagiocephaly ( play-jee-oh-SEF-uh-lee) is the fancy word for a flat head. This flat spot is often on the back or side of the head. While this condition is sometimes considered an aesthetic issue, research and practicality are taking us in quite a different direction. On a very simple basis, plagiocephaly can negatively impact your child’s ability to wear glasses, cause facial asymmetries, make safety equipment (like a bicycle helmet!) difficult to perform it’s life saving job, and may cause issues with jaw alignment and TMJ issues.
Those are concerning issues, but let’s start at the beginning: Almost all babies born vaginally will, for the first few hours to days, have a misshapen head; this is simply by design because something’s got to give and soft little cranial bones are far more malleable than say, the bony structures of the pelvis. It is normal for baby’s head to round out, thus providing the ideal pathway for cerebrospinal fluid as well as blood flow.
Next on the list of concerns is cranial plate movement. This topic is pretty polarizing, with the majority of medical professionals saying that the cranial plates move during birth, but after birth movement is unnecessary. However, Stanford Children’s health says that if the plates fuse in an improper way, this can lead to underdevelopment of parts of the brain, and can lead to developmental and aesthetic issues.
Torticollis is a congenital (meaning, present at birth) usually muscular and neurological issue that causes baby’s head to be turned to one side. Often this action is coupled with a tilted chin in the opposite direction of the contracted sternocleidomastoid muscle (SCM). Kiddos with torticollis will commonly favor one breast over the other during breastfeeding. They will have a difficult time with spanning a room with their neck mobility during tummy time. Neurologically, this is a major issue because the rooting reflex, a primitive reflex babies are born with, is stunted on one side due to the baby’s inability to rotate their head. Also the coupled motion of neck rotation and thoracic spine movement means that babies may have a difficult time initiating a cross-crawl pattern when the time comes to crawl. We often hear of babies who “skipped crawling”, and this is not ok! That cross-crawl pattern is necessary for making intestinal peristalsis stronger. The cross-crawl pattern also strengthens communication from the left and right hemispheres in the brain!
The fascinating thing about these two conditions, is that they are very commonly related. A baby with torticollis will lie in a position that is most comfortable, and due to the head tilt, the flat spot will most often develop where the baby’s head is most at ease. Remember that torticollis is an active contraction of the SCM muscle, so baby will most likely not be able to rotate their head much, so they are essentially stuck in this position. After weeks of being stuck in this position, a flat spot will form where baby’s head touches their bed.
One of the easiest things for people to understand is this: the muscle is contracted, but what tells that muscle to contract? A nerve. And where does that nerve come from? The brain! Torticollis is a very straight forward action and consequence: birth trauma, or sometimes space constraints in utero causing interference with the communication between the brain and the body. The body does not do what it is supposed to do, if the message from the brain isn’t clearly relayed. Chiropractors provide gentle and specific adjustments to remove that interference, allowing the muscle to calm down. Chiropractors will also suggest very simple and gentle exercises for home use. These things in combination have shown to be the most effective method at reducing and repairing the torticollis.
Xia J, Kennedy K, Teichgraeber J, et al. Nonsurgical Treatment of Deformational Plagiocephaly. Archives of Pediatric Adolescent Medicine. 2008; 162(8):719-727
Dr. Samantha Curtis is a Chiropractor at the Beacon Clinic of Chiropractic in Grover Beach, CA. She places special emphasis on chiropractic for fertility, pregnancy and pediatrics. To book a consultation, please call 481-1566.