Deformational Plagiocephaly
Deformational Plagiocephaly is an abnormal shape of a baby’s head caused by external forces. The baby’s head may appear to be misshapen or asymmetrical immediately after birth, or the abnormal shape may become noticeable in the first few months of life. Parents, grandparents, and caregivers are often the first ones to notice the unusual shape of the head and they usually bring it to the Pediatrician’s attention during a regular visit.
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Causes
There are several causes of Deformational Plagiocephaly, and some of them occur before the baby is even born. Restricted space inside the mother’s womb can create excessive contact in certain areas of the baby’s head. This is often the cause of deformation in babies positioned in a breech position, cramped inutero due to multiple fetuses, or in babies who spend excessive time with the head confined in the birth canal. Suction or vacuum instruments can also create forces that can deform the newborn skull, which is soft and pliable. The skulls of premature babies are particularly susceptible to deformation because the bone is thinner and more fragile than the skull of full term babies.

The skull is made up of several plates with fibrous sutures between them. This allows the skull plates to slide over each other to ease the passage of the baby’s head through the birth canal.Usually, the baby’s head becomes more symmetrical and better proportioned within about 6 weeks after birth if the deformation forces are no longer present. However, the flattened areas may not resolve if the baby’s head continuously rests in the same position. This is particularly problematic if the baby has neck tightness at birth.
Other head shape deformities
head_shapesDeformational Brachycephaly is present when the entire back of the baby’s head is flat (central flattening) and the head is very wide. The forehead is often bossed or prominent on both sides and the height of the head is excessively high. In our experience, Deformational (symmetrical) Brachycephaly accounts for about 1 in 10 of the children referred for treatment.
Often babies with this problem have a history of excessive time in carriers, possibly due to gastric reflux or other medical conditions or circumstances that do not allow the baby to be placed on the tummy. Orthotic management attempts to correct the disproportion of the head shape and the associated deformities.

Asymmetrical Brachycephaly is a common type of Brachycephaly where the head is excessively wide and is also asymmetrical. Of the scans sent to Orthomerica for STARband fabrication, Asymmetrical Brachycephaly is second only to Deformational Plagiocephaly in incidence. Orthotic management focuses on improving both symmetry and the disproportion of the baby’s head.

Deformational Scaphocephaly is characterize by a long and narrow head shape, sometimes caused by consistent positioning of the baby on his or her side. Like Symmetrical Brachycephaly, Scaphocephaly is mainly a deformity of proportion although the elongated shape can also produce abnormal frontal and posterior changes in the head. Premature babies are particularly prone to Scaphocephaly because a side-lying position is often used in the Neonatal Intensive Care Unit (NICU) for easy access to monitors and other equipment. Orthotic management focuses on normalizing the proportion and overall shape of the head.
Before & After
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