Hi @lhouiseyhanna9038 - are you asking if its too late if your child is 4 months old? At 4 months old there is still a lot of growing to do, so there is still potential for improvement depending on what could be going on. As for needing medical attention, positional plagiocephaly typically does not but it doesn't hurt to have your medical practitioner involved. This way there is a record of where you were at and the progress you make, and if the need arises you may get a quicker response due to there being a previous record. The vast majority of these cases that I see do not require medical attention, but I write letters to their medical practitioners to let them know what I am doing. Does that answer your question?
how can you tell if it's due to position or fused sutures? I noticed my baby's forehead on the right was sticking out more. I brought it up at the 1 month appointment and pediatrician said it was likely how my baby was positioned in utero since I noticed the first week. Now that my baby is almost 2 months I have noticed the right side of forehead is still sticking out, the back of the head almost comes to a point. The head is elongated like your last example. Baby prefers to turn head to the right. On the side of the head, left side sticks out further than the right.
Hi there ChuyChuy, So if its fused sutures, it has a very particular feel. I am very fortunate to have seen a couple of these now, and even better I had one parent who was comfortable enough for me to demonstrate them at a seminar I was presenting. Your paediatrician will (hopefully) know the difference between the two. If you would like, send me a few pictures looking at all directions to askdrchristian@gmail.com and I can review. Now, if it is the fused suture, don't panic; most cases they don't do much until around 4-6 months old and bub is a little more developed. If it isn't, I'd advise getting some musculoskeletal work done to see if you can improve things a bit!
Thank you for the very thorough information! I learned a lot from this video. My 3 months baby hasn't been diagnosed with plagiocephaly since the pandemic because of the lockdown and high in COVID case where we are at. She likes to sleep facing left and I can see the indication of plagiocephaly such as bald spot on the back of the head, flattening on the left side of the head compare to the right side, and left forehead is bulging slightly more. We are doing anything we can with the stretching and light massaging to the neck. After several googling and talking to fam and friends, they mentioned to use a positioning pillow for the baby when she is awake. We can't find it here where we are since I think it is considered not safe. What is your opinion on this pillow? And do you suggest we take her to a pediatrician to start the treatment? Will the treatment change the headshape back to normal? Sorry for the grammar error and any typo. Thank you in advance.
Hi and thanks for reaching out! The positioning pillows can work quite well, but I'd be really making sure that you are getting proper movement to the neck. Chatting to your paediatrician or health care professional is a good start, and this way we can rule out other conditions that can cause changes to head shape. They may recommend some additional therapy to what you are doing, maybe physio/osteo/chiro to promote movement. The other big helper is tummy time! But again, if the neck is a bit unhappy then this can make for a bit of a cranky baby too. So after all that, the pillows we frequently recommend are Mimos Pillows, but then we also give some other sneaky suggestions... Which I might make a video of in the future!
Hi! My son is 3 months old and his back head is flat. I am afraid that It is like brachycephaly. What should I do??? Is it possible to treat it at home?
Hi Suhrob, Firstly, I am very sorry for my delayed reply - I've been a little busy! If you think it is like brachycephaly, the first thing to do is find out why he isn't turning his head freely in both directions. To help this at home you may be able to do some repositioning work, but this has limited effectiveness. Best thing to do is have a chat to a local health professional who works with the musculoskeletal system and see if there is anything that can be addressed. All the best, Christian
Hi! Sir my baby is of 2 months & she has a flat head on right side & left back side her head is elongated 😢 im extremely worried on my previous visit to pediatrician almost 2 weeks ago he said it will go on its on just do repositioning but i don't see any improvements even it feels like it's getting worse
آسف إذا لم تكن هذه ترجمة واضحة، فأنا أستخدم ترجمة جوجل. إذا استطعت، فإن الخيار الأفضل هو إعادة التموضع أو التمدد. أدر رأس طفلك بلطف إلى الجانب الآخر، أو استخدم وسادة لتعزيزه في الاتجاه الآخر.
My baby has plagiocephaly straight up , due to neck restrictions possibly because of breech postioning can't turn one side than the other head one side flattening
What did you do to cure the plagiocephaly? My baby is having the same issue she has positional plagiocephaly & it's getting worse despite repositioning
Hi Dr. Christian, I have a 1 in a half month old baby. I was so concerned seeing that his head shape was asymmetrical. I'm also realizing after watching your video that I always put him on his right side to sleep and just now I put him on his left side and his body was slanted. He looked uncomfortable. I want to know if it's not too late to correct this problem? I do plan to keep lay him on his left side now
Hi Judith - first up; congratulations! At 6 weeks old, you still have plenty of time to be able to address what is causing this positional preference. Best thing to do is to have a review with your health professional who will look out for any indications of any particular disorders, as well as any potential musculoskeletal reasons, and give you some stretches/advice/management options for you. Hope that helps!
Hi Dr.Christian. My baby is 6 months old. He has a flat head on the left side as a result of torticolis. We visited an orthotist and the measurements said it is 12.8 MM asymmetry. Anything less than 10MM is fine they said. They suggested to put a helmet for few months. Is there any other way we can do to correct the shape without helmet? Would it correct on its own? Thanks.
Hi Naveen, thank you for your question. At 6 months old, the rate of change is slow without a helmet. You can try a few things like stretches or even special pillows that may help promote normal shape, but to me the key question is the cause. Did that torticollis just disappear or did you need some treatment? Were there other areas of problem, for instance in the neck? At 12.8mm that asymmetry is classified as severe. Left on their own, severe asymmetry is less likely to spontaneously resolve or get significantly better. Just to be clear as well, "normal" is considered 3mm or less. On a side, any concerns with your son's development? He's rolling well in both front to back and back to front? He's sitting unsupported by himself when placed on his backside? Propping up well when on his tummy?
Hey my son had the exact same problem only doctos didn't listen to me and get him a helmet until 10 months, I never forced him to wear it because it was painful for him. But he is 3 and his head isn't as bad, but still definitely noticeable and makes me feel bad that we didn't do something sooner. I'm afraid to cut gis hair bc of it so please have your kid wear the helmet and do anything to fix it now because it won't go away his head will be lopsided always. Might even out a little, but won't completely go away, thats the shape of his head forever unless corrected early.
My baby has had a bit of a flat spot on one side as far as I can rmb. I never thought too much of it until recently listening to a talk about plagiocephaly. The mchn has not mentioned anything about his head at anytime even though my bubs head is so huge to begin with. :/
Hi there mimprincesa, The smaller ones can be difficult to spot if you aren't looking for it! In Aus, with lockdowns etc and video consults going on a LOT were missed. I hope you have had a chance to chat to a health professional about things though! Christian
Thankyou so much sir for the video...my baby has left torticollis so she developed a flat spot on right side...we have consulted pediatrician what he told was torticollis will be self resolved...later on plagiocephaly...my baby is 2 mnths old...can u just tell me roughly by which month she can get rid of torticollis
Hi Kosireddi and thank you for your question. This is a really hard question to answer as there is no definite period of time for resolution. While most cases of torticollis will self resolve, not all do. While a percantage of plagiocephaly will self resolve, not all do. I typically find that if you have not corrected the torticollis (and I am presuming here that it is a specific type of torticollis called "Congenital Muscular Torticollis") by 2 months of age, then there may be a need for further investigation or therrapy. As for the head shape/plagiocephaly, again after 3 months of age I find the rate of correction to begin to slow down. Tummy time will be your friend in helping to restore normal shape, but this must be done supervised as if she has a torticollis, this can increase the risk of more serious complications.
@@AskDrChristian thankyou for your reply sir means a lot for me...I am very much worried about her condition.i have my delivery through vaginal birth using forceps...is congenital muscular torticollis self resolving without any therapy??and baby is becoming really cranky while doing tummy time and could not be able to keep her head straight...will this cause problem for her roll over??looking forward for reply
Hi again Kosireddi, Yes, most cases of that congenital torticollis do self resolve, but the hard part is knowing when. What if you leave it thinking it will get better and it doesn't? This is where having someone assess may be helpful to better guide you with potential outcomes. Sometimes all that is needed are some basic stretches and a couple of mobilisations to get things moving properly and that may be enough. If bub is very cranky with tummy time, then it is likely that her neck is upsetting her. Babies feel pain. Have you ever had an episode of neck pain? And when you get put in a position that is not comfortable you are going to let people know about it - that is what she is doing. As for rolling, there may be an impact on this, especially if she is turning one way all the time. What I have seen happen previously is that they lose awareness of there being another side, so she may roll, but more easily over on the side that she is looking toward. I sincerely hope that all goes well for you! I'm happy to respond to any other questions you may have :) Christian
Thankyou and very informative vedio. My kid has developed plagiocephaly, now he is almost 20months old. As a result I can see one side of his face been slanted/ uneven. This is very prominently show on mirror. Making me very much worried. Can you please suggest how it can be reversible.
Hi Vanitha, At 20 months, its not the easiest to tackle. He may need a helmet to help with re-shaping the head, but may also need additional work on his neck at the same time. At 20 months it's difficult to get them to lay on pillows as they wriggle away from them, and he will also pull at the helmet all the time too. Your best bet is to talk to a health care professional and see whats causing it, get it measured, and see what can be done.
Hi there Jolina, At 6 months you certainly can get some changes, it just happens to be slower. Talk to a health professional and ensure that you are working with a deformational type, and then some treatment aimed at restoring neck motion, tummy time etc will be very helpful. Christian
Hi Dr Christian, my baby is 6 weeks old on Saturday and has a real preference for leaning his head to the right whilst feeding, sleeping or resting. I've noticed no flattening as such, but a slight bulge in the skull on just the right side of frontal bone. Could it be connected to the positioning?
Hi Jessie, First, thanks for the comment. I think that there could be an association. Think of a box. If you put pressure on the back right, it will start to push the right side forwards, and this would be seen as a bulging of the forehead on the right. Now, with plagio, we normally see the ear moving forward on that same side too. If you are not seeing ear movement or the back of the head changing in shape, there may be a different process going on, in which case I would consider having a review with your health professional/health care nurse just to get a trained set of eyes inspecting things. Hope that helps! Christian
Hey, im having the same exact issue with my newborn. He's 6 weeks and right side dominant with that slight buldge on his right side of his forehead. Did the baby skull even out and do you have any recommendations?
Hi Shaiza, So firstly, the back of our heads shouldn't be flat; there should be a nice curve to the back. So if it is not getting flat, then I wouldn't worry as that is normal. HOWEVER, when you say the front is narrow, do you mean the whole head looks narrow? Or is the forehead coming in to a bit of a ridge at the front? I want you to search the term "trigonocephaly". Does it look like that? If it does you need a review with a paediatrician!
How would you track progression of plagiocephaly to determine if it is improved enough by the 4-6 month mark to warrant continued treatment via repositioning and tummy time?
We utilise a series of measurements; CVAI and diagonal differences being the most frequently used. At 4MOA+ we also have much more accurate scanning options available. Also, we look to include treatment beyond those two modalities: journals.lww.com/jcraniofacialsurgery/Abstract/2019/10000/Treatment_of_Deformational_Plagiocephaly_With.22.aspx
Hii doctor, my baby is 16 months old. He has a flat head on right side. Left side was so pointed. When I consulted my pediatrician, she said it is mild. Nothing to worry and will round by its own. I started trying repositioning from 4 th month. But after some time he will turn to the flattened side. There was no improvement till one year. And now I started using mustard pillows. It is improving slowly. Will it round to normal shape when he is 2 year? I m really sad because I was not able to care him as I have a toddler too when I delivered him. Plz help.
I'm very sorry to say this, but after 6 months of age, the rate of improvement is incredibly slow, and may not fully resolve. In research we had published, we (and two other publications on the same topic) found restrictions of neck motion to be present in over 90% of cases - meaning you need someone to assess her neck and make sure she is moving properly. Sorry I can't help you more there. If you need to discuss this further, I can be emailed at askdrchristian@gmail.com Sincerely, Christian
Hi there Shilpa, Firstly, thank you for reaching out. How old is your baby? This plays an important part in managing, as if he is younger than 3 months, then it may resolve with improving his ability to turn his head side to side. If he is older than 6 months, then he may need a special helmet to help re-shape his head. Hope this helps! Christian
Hi again Shilpa, So, depending on what else is going on, repositioning at this age *may* be able to help. In a paper we had published, as well as two others on this topic, over 90% of kids with head shape issues had restrictions in neck motion. If this is going on, he may resist repositioning. The good news is that at 3 months old, you can get some pretty rapid improvements if all works well... I'm sorry to hear that helmets are not easy to access. I can't think of much else to be able to help you from such a distance. Maybe I need to move to India - I feel like this is not uncommon over there! Christian
Hi Naila, and I'm sorry but somehow your comment was not visible until today! Elongated head can be one of a couple of options; it could be a positional preference where they have their head turned completely to the side as they lay on it, it could be a normal variant from a vaginal delivery, or it could be other conditions affecting skull development. If you are concerned, have a chat to your GP or paediatrician.
Hi, Dr. Christian! This is about frontal bossing... not plagiocephaly. My daughter always had a protruding forehead. It looks like two balls on both sides... like where you would see horns appear on the devil's forehead in movies. It doesn't look as noticeable now but it's still visible at the age of 6. Her forehead is pretty wide and high too. Parents and grandparents... small to normal. It was never brought up by any doctors. I just read about it today and I'm worried because many sites state it can cause brain damage from the bones fusing prematurely and leaving no room for the brain to grow. She was diagnosed with Autism and is non-verbal. Any suggestions? Thanks!
Hi there Amy-Lee, and thanks for reaching out. So, the fusing of bones early is more of a concern at younger ages when the brain is growing much more rapidly. At 6 years old, the areas of concern have pretty well closed over and the joints of the skull are similar to that of an adult. Now, if there are concerns of fusion, ultrasounds can pick up on this pretty quickly. And I think regarding the brain damage, I wouldn't have that as high on my concerns list at this age, as if there was something wrong with the bones of her skull you would have already found out about it. Regarding her autism, this could be associated with her skull issues, but I doubt that it is the only reason for her developing autism. So many things influence our development! Whereabouts in the world are you? I'd be considering an assessment with someone along the lines of an osteopath/chiropractor/physio with craniosacral training who can give that skull a good review and ensure things are moving the way they should be. Additional paediatric could be useful too, and if they happen to have a QEEG device handy for ASD assessment, well, that would be the jackpot!
Hi Prabha, If your baby faces one way all the time, it can cause the head to flatten on that side. You might need to have them checked to see if there is a problem causing that to happen!
Our baby was born with a long head (his cephalic ratio was low since 30th week of pregnancy). And now because of it, he can't sleep on the back of his head. Even when he tries, his head naturally rolls to the one side or another, like a long cobblestone. And now, because he always sleeps with his head turned to the side, I'm afraid it will make his head even longer. Is there any way to break this cycle?
Hi there Anton - GREAT question. This is a bit of a tricky situation; firstly you're not really supposed to put anything in the bed with them due to SIDS risks, and secondly, this could still be an indication of something in the neck not quite right yet! One thing I have found to be helpful though is a beanbag/wheatbag. Place that under their heads, and it will create a bit of a hollow that bub can rest in. You could try using that for a short time while they are awake and see if they are comfortable with it. If it is something in their neck though, this may create an irritation in which they will start squirming around trying to get their head to the side. This won't be super comfortable for them so I would recommend stopping with the bag and getting their musculoskeletal system assessed by a health care practitioner :) Thanks! Christian
Hi there Lorena! So there are a couple of values we can use here. For plagiocephaly, I use diagonal differences (measuring in an "X" shape over the head) in which normal is considered 3mm difference or less. Some use an index called the Cranial Vault Asymmetry Index (CVAI), where the difference in length is divided by the longer value then multiplied by 100, with a normal score being under 3.5. But that involves a bit more maths!
Dear Dr thank you for the video. My son has positional plagiocephaly . He is almost 2 months. We didn’t knew that he need to turn his head so his right side is flat. I know that for the treatment we need to change the head position while the baby is sleeping. The question is that: we need to do turn it only to the one side only so the flat side to not have pressure or or we need to turn it to both sides?
Hi Michael, thank you for the question. To help with head shape, we typically promote turning the head away from the side that is flat. But the hard part with this is whether there is something, like a muscle or joint restriction, that is limiting the movement. If this is the case, your son may need some treatment first otherwise you will find the process rather challenging and may risk hurting your son in the process. Hope that helps, Christian
Hi there Mejina, Best thing to do is find out why they are developing a flat head. Is it due to restrictions in motion? Have they developed a habit? Is there a point of discomfort? I wish I could help you with these over the internet, but in reality you will need to have your child assessed by a professional to find the why!
Please help me😭 my baby is already 4 month old and has sa sunken part at the back of her head around 2 inches wide and 1 inch height. The pediatrician that we have consulted didn't know much about it because the posterior fontanelle closes at 2 months... The sunken part is already there when my baby was still a new born.... Im really worried...my baby is not experiencing any discomforts or fever or what.... But im really afraid and worried that it would affect my baby's brain development in the future😭😭😭😭😭😭😭😭😭 i need your advice pleaaassee
I have seen in a patient once before a region where it feels like it dips in, and about those dimensions too. Was a very weird presentation that turned out to be the bony plates of her skull overlapping. To be honest, I'd be having a chat to potentially a different paediatrician. Does she need further imaging? Does she need ortho consults? I think there are still questions to be answered. You don't stop looking just because it isn't normal!
Hi I have a 17 month old baby boy. I have a concern here. My baby's head seems normal in front and the the back there's a curve. However one side seems to be point or have a bump which may me due to sleeping position. Now my worry is, will it affect his growth in the long run and can I still do something to fix this or should I not worry. Thank You
Hi there Pearl, and thank you for your comment. At 17 months, there are fixes available but they generally take a bit of time if it is just a positional deformation. Now, there are studies out there that do suggest an increased RISK of developmental delays, but it doesn't mean he WILL get them. If I were you, I would consider getting a review done; is he ticking all the right milestones, is he doing what he is meant to be doing, etc, and at the same time ensuring proper musculoskeletal function. This way you can ease your concerns knowing that you are doing the best for his development :) Christian
Are they little or big? Can they move? Couple of options to what this could be, but not what you would expect to find with straight plagiocephaly. I would consider getting a further review if you are concerned.
Hi there Muhammed, As much as I would like to, I can't say what is needed for your child! There are just too many aspects to consider. Best bet is to talk to a health professional about your concerns and get your child examined.
Hi there Inday - thanks for reaching out. There are many treatment options available; stretches, manual therapy, and head orthotic (helmets) are just some. But which might be useful depends on how old your child is, and what the reason is for the head shape occurring. Your best bet is to talk to your health care professional and get some appropriate guidance. Thanks! Christian
Hi doctor my baby was 2 years old . He had plagiocephaly . I noticed in 2 month, I tried opposite position to sleep baby . But now he is 2 years nothing difference in shape . His ear also one big another one is small. And his forehead looks like light bump. Is that any chance to remold his shape ?
Hi there Puneetha, and thanks for reaching out. At 2 years old, you can still attempt to correct the shape, but it may be a very slow process. I think the best thing you could do at this stage is a proper review with a health care professional and go from there. Christian
Hi Dr. My baby just turned 6 month yesterday and when asked his PD again about the flattened lower side of his head, dr said it’s not too bad and we wouldn’t qualify for helmet but it is nothing to interfere his brain development. Recommended a special pillow. Baby does favor one side but he’s had this since NB and Ive tried to reposition but I see it looks the same. Im worried no further exam has been done on my baby. Should I pay attention in case other worrying symptoms? Should I get 2nd opinion? Im worried. Thank you!
Hi there Melissa, So the research regarding brain development shows a 30-40% risk of developmental delay, especially in gross motor and language - with research now tracking kids through to school showing impact on academics. To say that it won't interfere with brain development is not precisely accurate, but not everyone is aware of this. Repositioning and the pillow can be tricky, especially at 6 months as they just ... move their head again. I would suggest having a musculoskeletal professional (chiro/osteo/physio/etc) to have a look at neck function, because if they have been turning to the side since birth, could it be a neck problem driving this whole process. Let me know how you go. Christian PS - where in the world are you? I know quite a few around the globe!
You're very informative. I appreciated your video and know that many other parents will appreciate it too. Thank you
Hi there Judith - thank you thats very kind for you to say that :)
Thank you so much sir... My baby is 3 months and I need this video thank you...good information
You are very welcome! Thank you for your kind comment!
is 4 months too late for this… and does really need medical attention.
Hi @lhouiseyhanna9038 - are you asking if its too late if your child is 4 months old?
At 4 months old there is still a lot of growing to do, so there is still potential for improvement depending on what could be going on.
As for needing medical attention, positional plagiocephaly typically does not but it doesn't hurt to have your medical practitioner involved. This way there is a record of where you were at and the progress you make, and if the need arises you may get a quicker response due to there being a previous record.
The vast majority of these cases that I see do not require medical attention, but I write letters to their medical practitioners to let them know what I am doing.
Does that answer your question?
how can you tell if it's due to position or fused sutures? I noticed my baby's forehead on the right was sticking out more. I brought it up at the 1 month appointment and pediatrician said it was likely how my baby was positioned in utero since I noticed the first week. Now that my baby is almost 2 months I have noticed the right side of forehead is still sticking out, the back of the head almost comes to a point. The head is elongated like your last example. Baby prefers to turn head to the right. On the side of the head, left side sticks out further than the right.
Hi there ChuyChuy,
So if its fused sutures, it has a very particular feel. I am very fortunate to have seen a couple of these now, and even better I had one parent who was comfortable enough for me to demonstrate them at a seminar I was presenting.
Your paediatrician will (hopefully) know the difference between the two. If you would like, send me a few pictures looking at all directions to askdrchristian@gmail.com and I can review.
Now, if it is the fused suture, don't panic; most cases they don't do much until around 4-6 months old and bub is a little more developed.
If it isn't, I'd advise getting some musculoskeletal work done to see if you can improve things a bit!
Thank you for the very thorough information! I learned a lot from this video.
My 3 months baby hasn't been diagnosed with plagiocephaly since the pandemic because of the lockdown and high in COVID case where we are at. She likes to sleep facing left and I can see the indication of plagiocephaly such as bald spot on the back of the head, flattening on the left side of the head compare to the right side, and left forehead is bulging slightly more. We are doing anything we can with the stretching and light massaging to the neck. After several googling and talking to fam and friends, they mentioned to use a positioning pillow for the baby when she is awake. We can't find it here where we are since I think it is considered not safe. What is your opinion on this pillow? And do you suggest we take her to a pediatrician to start the treatment? Will the treatment change the headshape back to normal?
Sorry for the grammar error and any typo. Thank you in advance.
Hi and thanks for reaching out!
The positioning pillows can work quite well, but I'd be really making sure that you are getting proper movement to the neck. Chatting to your paediatrician or health care professional is a good start, and this way we can rule out other conditions that can cause changes to head shape. They may recommend some additional therapy to what you are doing, maybe physio/osteo/chiro to promote movement.
The other big helper is tummy time! But again, if the neck is a bit unhappy then this can make for a bit of a cranky baby too.
So after all that, the pillows we frequently recommend are Mimos Pillows, but then we also give some other sneaky suggestions... Which I might make a video of in the future!
The tortle hat is great too
My boy is of 5 weeks and his crown of head is up how to settle it
Hi! My son is 3 months old and his back head is flat. I am afraid that It is like brachycephaly. What should I do??? Is it possible to treat it at home?
Pleasee answer😢
Hi Suhrob,
Firstly, I am very sorry for my delayed reply - I've been a little busy!
If you think it is like brachycephaly, the first thing to do is find out why he isn't turning his head freely in both directions. To help this at home you may be able to do some repositioning work, but this has limited effectiveness.
Best thing to do is have a chat to a local health professional who works with the musculoskeletal system and see if there is anything that can be addressed.
All the best,
Christian
Hi! Sir my baby is of 2 months & she has a flat head on right side & left back side her head is elongated 😢 im extremely worried on my previous visit to pediatrician almost 2 weeks ago he said it will go on its on just do repositioning but i don't see any improvements even it feels like it's getting worse
Will it go on its own? Or I should do something about it! Now it looks extremely bad! Can I send you the pics?
دكتور ابني عمره 6 اشهر وراسه مسطح ولا يوجد خوذة في الدول العربيه كيف يمكنني اصلاحه 😢😢😢😢
آسف إذا لم تكن هذه ترجمة واضحة، فأنا أستخدم ترجمة جوجل.
إذا استطعت، فإن الخيار الأفضل هو إعادة التموضع أو التمدد. أدر رأس طفلك بلطف إلى الجانب الآخر، أو استخدم وسادة لتعزيزه في الاتجاه الآخر.
My baby has plagiocephaly straight up , due to neck restrictions possibly because of breech postioning can't turn one side than the other head one side flattening
Hi @debbieakraam - have you had anyone address those neck restrictions? How old is your baby?
Yes he attended physio the neck is much better than before I'm doing neck exercises with him
He's now 4mths old his head circumference flat spot is going away shaping out nicely
Great to hear!!
What did you do to cure the plagiocephaly? My baby is having the same issue she has positional plagiocephaly & it's getting worse despite repositioning
Hi Dr. Christian, I have a 1 in a half month old baby. I was so concerned seeing that his head shape was asymmetrical. I'm also realizing after watching your video that I always put him on his right side to sleep and just now I put him on his left side and his body was slanted. He looked uncomfortable. I want to know if it's not too late to correct this problem? I do plan to keep lay him on his left side now
Hi Judith - first up; congratulations!
At 6 weeks old, you still have plenty of time to be able to address what is causing this positional preference. Best thing to do is to have a review with your health professional who will look out for any indications of any particular disorders, as well as any potential musculoskeletal reasons, and give you some stretches/advice/management options for you.
Hope that helps!
Hi Dr.Christian. My baby is 6 months old. He has a flat head on the left side as a result of torticolis. We visited an orthotist and the measurements said it is 12.8 MM asymmetry. Anything less than 10MM is fine they said. They suggested to put a helmet for few months. Is there any other way we can do to correct the shape without helmet? Would it correct on its own? Thanks.
Hi Naveen, thank you for your question.
At 6 months old, the rate of change is slow without a helmet. You can try a few things like stretches or even special pillows that may help promote normal shape, but to me the key question is the cause. Did that torticollis just disappear or did you need some treatment? Were there other areas of problem, for instance in the neck?
At 12.8mm that asymmetry is classified as severe. Left on their own, severe asymmetry is less likely to spontaneously resolve or get significantly better. Just to be clear as well, "normal" is considered 3mm or less.
On a side, any concerns with your son's development? He's rolling well in both front to back and back to front? He's sitting unsupported by himself when placed on his backside? Propping up well when on his tummy?
Hey my son had the exact same problem only doctos didn't listen to me and get him a helmet until 10 months, I never forced him to wear it because it was painful for him. But he is 3 and his head isn't as bad, but still definitely noticeable and makes me feel bad that we didn't do something sooner. I'm afraid to cut gis hair bc of it so please have your kid wear the helmet and do anything to fix it now because it won't go away his head will be lopsided always. Might even out a little, but won't completely go away, thats the shape of his head forever unless corrected early.
My baby has had a bit of a flat spot on one side as far as I can rmb. I never thought too much of it until recently listening to a talk about plagiocephaly. The mchn has not mentioned anything about his head at anytime even though my bubs head is so huge to begin with. :/
Hi there mimprincesa,
The smaller ones can be difficult to spot if you aren't looking for it! In Aus, with lockdowns etc and video consults going on a LOT were missed. I hope you have had a chance to chat to a health professional about things though!
Christian
Thankyou so much sir for the video...my baby has left torticollis so she developed a flat spot on right side...we have consulted pediatrician what he told was torticollis will be self resolved...later on plagiocephaly...my baby is 2 mnths old...can u just tell me roughly by which month she can get rid of torticollis
Hi Kosireddi and thank you for your question.
This is a really hard question to answer as there is no definite period of time for resolution. While most cases of torticollis will self resolve, not all do. While a percantage of plagiocephaly will self resolve, not all do. I typically find that if you have not corrected the torticollis (and I am presuming here that it is a specific type of torticollis called "Congenital Muscular Torticollis") by 2 months of age, then there may be a need for further investigation or therrapy.
As for the head shape/plagiocephaly, again after 3 months of age I find the rate of correction to begin to slow down. Tummy time will be your friend in helping to restore normal shape, but this must be done supervised as if she has a torticollis, this can increase the risk of more serious complications.
@@AskDrChristian thankyou for your reply sir means a lot for me...I am very much worried about her condition.i have my delivery through vaginal birth using forceps...is congenital muscular torticollis self resolving without any therapy??and baby is becoming really cranky while doing tummy time and could not be able to keep her head straight...will this cause problem for her roll over??looking forward for reply
Hi again Kosireddi,
Yes, most cases of that congenital torticollis do self resolve, but the hard part is knowing when. What if you leave it thinking it will get better and it doesn't? This is where having someone assess may be helpful to better guide you with potential outcomes. Sometimes all that is needed are some basic stretches and a couple of mobilisations to get things moving properly and that may be enough.
If bub is very cranky with tummy time, then it is likely that her neck is upsetting her. Babies feel pain. Have you ever had an episode of neck pain? And when you get put in a position that is not comfortable you are going to let people know about it - that is what she is doing.
As for rolling, there may be an impact on this, especially if she is turning one way all the time. What I have seen happen previously is that they lose awareness of there being another side, so she may roll, but more easily over on the side that she is looking toward.
I sincerely hope that all goes well for you! I'm happy to respond to any other questions you may have :)
Christian
Thankyou and very informative vedio. My kid has developed plagiocephaly, now he is almost 20months old. As a result I can see one side of his face been slanted/ uneven. This is very prominently show on mirror. Making me very much worried. Can you please suggest how it can be reversible.
Hi Vanitha,
At 20 months, its not the easiest to tackle. He may need a helmet to help with re-shaping the head, but may also need additional work on his neck at the same time. At 20 months it's difficult to get them to lay on pillows as they wriggle away from them, and he will also pull at the helmet all the time too.
Your best bet is to talk to a health care professional and see whats causing it, get it measured, and see what can be done.
Hi Vanitha now ur baby head was round shape or not please tell me
Sir what I can do now for my baby 6month old it is possible that his head will go back to normal head
Hi there Jolina,
At 6 months you certainly can get some changes, it just happens to be slower. Talk to a health professional and ensure that you are working with a deformational type, and then some treatment aimed at restoring neck motion, tummy time etc will be very helpful.
Christian
Hi Dr Christian, my baby is 6 weeks old on Saturday and has a real preference for leaning his head to the right whilst feeding, sleeping or resting.
I've noticed no flattening as such, but a slight bulge in the skull on just the right side of frontal bone.
Could it be connected to the positioning?
Hi Jessie,
First, thanks for the comment.
I think that there could be an association. Think of a box. If you put pressure on the back right, it will start to push the right side forwards, and this would be seen as a bulging of the forehead on the right. Now, with plagio, we normally see the ear moving forward on that same side too.
If you are not seeing ear movement or the back of the head changing in shape, there may be a different process going on, in which case I would consider having a review with your health professional/health care nurse just to get a trained set of eyes inspecting things.
Hope that helps!
Christian
Hey, im having the same exact issue with my newborn. He's 6 weeks and right side dominant with that slight buldge on his right side of his forehead.
Did the baby skull even out and do you have any recommendations?
My baby is 6 months old and his forehead looked so narrow and also head is not getting flat on back .plz guide me what shoud i do
Hi Shaiza,
So firstly, the back of our heads shouldn't be flat; there should be a nice curve to the back. So if it is not getting flat, then I wouldn't worry as that is normal.
HOWEVER, when you say the front is narrow, do you mean the whole head looks narrow? Or is the forehead coming in to a bit of a ridge at the front? I want you to search the term "trigonocephaly". Does it look like that? If it does you need a review with a paediatrician!
How would you track progression of plagiocephaly to determine if it is improved enough by the 4-6 month mark to warrant continued treatment via repositioning and tummy time?
We utilise a series of measurements; CVAI and diagonal differences being the most frequently used. At 4MOA+ we also have much more accurate scanning options available.
Also, we look to include treatment beyond those two modalities:
journals.lww.com/jcraniofacialsurgery/Abstract/2019/10000/Treatment_of_Deformational_Plagiocephaly_With.22.aspx
Hii doctor, my baby is 16 months old. He has a flat head on right side. Left side was so pointed. When I consulted my pediatrician, she said it is mild. Nothing to worry and will round by its own. I started trying repositioning from 4 th month. But after some time he will turn to the flattened side. There was no improvement till one year. And now I started using mustard pillows. It is improving slowly. Will it round to normal shape when he is 2 year? I m really sad because I was not able to care him as I have a toddler too when I delivered him. Plz help.
I'm very sorry to say this, but after 6 months of age, the rate of improvement is incredibly slow, and may not fully resolve.
In research we had published, we (and two other publications on the same topic) found restrictions of neck motion to be present in over 90% of cases - meaning you need someone to assess her neck and make sure she is moving properly.
Sorry I can't help you more there. If you need to discuss this further, I can be emailed at askdrchristian@gmail.com
Sincerely,
Christian
@amrithachandran70 How is your baby doing now? Is he still having flat head?
Hello sir my baby's forhead has just come out so what can I do please help me sir
Hi there,
Did this happen suddenly? Was there any trauma?? If so, it may be wise to seek medical opinion!
Hi doctor my baby has plagiocephaly..it causes ear misalignment...what is the solution to correct his ear shape?
Hi there Shilpa,
Firstly, thank you for reaching out.
How old is your baby? This plays an important part in managing, as if he is younger than 3 months, then it may resolve with improving his ability to turn his head side to side. If he is older than 6 months, then he may need a special helmet to help re-shape his head.
Hope this helps!
Christian
@@AskDrChristian he is 3months 15days old...his right ear looks pushed forward because of plagiocephaly..I am very worried..
And also the helmet is not easily available in India..I apply repositioning technique..is it enough to correct his ear and head shape?
Hi again Shilpa,
So, depending on what else is going on, repositioning at this age *may* be able to help. In a paper we had published, as well as two others on this topic, over 90% of kids with head shape issues had restrictions in neck motion. If this is going on, he may resist repositioning.
The good news is that at 3 months old, you can get some pretty rapid improvements if all works well...
I'm sorry to hear that helmets are not easy to access. I can't think of much else to be able to help you from such a distance. Maybe I need to move to India - I feel like this is not uncommon over there!
Christian
Is it normal for my toddler to have a symmetrical bump on both temples?
Hi Jes,
If you are able, send through a photo to my email and I'll have a look for you.
Christian
My child is 46 days old his head is elongated how I can shape it
Hi Naila, and I'm sorry but somehow your comment was not visible until today!
Elongated head can be one of a couple of options; it could be a positional preference where they have their head turned completely to the side as they lay on it, it could be a normal variant from a vaginal delivery, or it could be other conditions affecting skull development. If you are concerned, have a chat to your GP or paediatrician.
Hi, Dr. Christian! This is about frontal bossing... not plagiocephaly. My daughter always had a protruding forehead. It looks like two balls on both sides... like where you would see horns appear on the devil's forehead in movies. It doesn't look as noticeable now but it's still visible at the age of 6. Her forehead is pretty wide and high too. Parents and grandparents... small to normal. It was never brought up by any doctors. I just read about it today and I'm worried because many sites state it can cause brain damage from the bones fusing prematurely and leaving no room for the brain to grow. She was diagnosed with Autism and is non-verbal. Any suggestions? Thanks!
Hi there Amy-Lee, and thanks for reaching out.
So, the fusing of bones early is more of a concern at younger ages when the brain is growing much more rapidly. At 6 years old, the areas of concern have pretty well closed over and the joints of the skull are similar to that of an adult. Now, if there are concerns of fusion, ultrasounds can pick up on this pretty quickly. And I think regarding the brain damage, I wouldn't have that as high on my concerns list at this age, as if there was something wrong with the bones of her skull you would have already found out about it.
Regarding her autism, this could be associated with her skull issues, but I doubt that it is the only reason for her developing autism. So many things influence our development!
Whereabouts in the world are you? I'd be considering an assessment with someone along the lines of an osteopath/chiropractor/physio with craniosacral training who can give that skull a good review and ensure things are moving the way they should be. Additional paediatric could be useful too, and if they happen to have a QEEG device handy for ASD assessment, well, that would be the jackpot!
Hello sir my baby 11 month old one side flat head head shape chenge please explain
Hi Prabha,
If your baby faces one way all the time, it can cause the head to flatten on that side. You might need to have them checked to see if there is a problem causing that to happen!
Our baby was born with a long head (his cephalic ratio was low since 30th week of pregnancy). And now because of it, he can't sleep on the back of his head. Even when he tries, his head naturally rolls to the one side or another, like a long cobblestone. And now, because he always sleeps with his head turned to the side, I'm afraid it will make his head even longer. Is there any way to break this cycle?
Hi there Anton - GREAT question.
This is a bit of a tricky situation; firstly you're not really supposed to put anything in the bed with them due to SIDS risks, and secondly, this could still be an indication of something in the neck not quite right yet!
One thing I have found to be helpful though is a beanbag/wheatbag. Place that under their heads, and it will create a bit of a hollow that bub can rest in. You could try using that for a short time while they are awake and see if they are comfortable with it.
If it is something in their neck though, this may create an irritation in which they will start squirming around trying to get their head to the side. This won't be super comfortable for them so I would recommend stopping with the bag and getting their musculoskeletal system assessed by a health care practitioner :)
Thanks!
Christian
Hi Dr what percent does a head need to be to consider normal?
Hi there Lorena!
So there are a couple of values we can use here. For plagiocephaly, I use diagonal differences (measuring in an "X" shape over the head) in which normal is considered 3mm difference or less. Some use an index called the Cranial Vault Asymmetry Index (CVAI), where the difference in length is divided by the longer value then multiplied by 100, with a normal score being under 3.5. But that involves a bit more maths!
Dear Dr thank you for the video. My son has positional plagiocephaly . He is almost 2 months. We didn’t knew that he need to turn his head so his right side is flat. I know that for the treatment we need to change the head position while the baby is sleeping. The question is that: we need to do turn it only to the one side only so the flat side to not have pressure or or we need to turn it to both sides?
Hi Michael, thank you for the question.
To help with head shape, we typically promote turning the head away from the side that is flat. But the hard part with this is whether there is something, like a muscle or joint restriction, that is limiting the movement. If this is the case, your son may need some treatment first otherwise you will find the process rather challenging and may risk hurting your son in the process.
Hope that helps,
Christian
Hi from Romania, i am so sad my baby have the head flat on a side
Hi Alina! Don't be sad; if you have identified it, you might be able to do something about it.
Don't play music in background Whenever u speak
Good advice that I will use going forward!
My baby is four month now how can i get reduce my baby's flat head please help me sir
Hi there Mejina,
Best thing to do is find out why they are developing a flat head. Is it due to restrictions in motion? Have they developed a habit? Is there a point of discomfort? I wish I could help you with these over the internet, but in reality you will need to have your child assessed by a professional to find the why!
Please help me😭 my baby is already 4 month old and has sa sunken part at the back of her head around 2 inches wide and 1 inch height. The pediatrician that we have consulted didn't know much about it because the posterior fontanelle closes at 2 months... The sunken part is already there when my baby was still a new born.... Im really worried...my baby is not experiencing any discomforts or fever or what.... But im really afraid and worried that it would affect my baby's brain development in the future😭😭😭😭😭😭😭😭😭 i need your advice pleaaassee
I have seen in a patient once before a region where it feels like it dips in, and about those dimensions too. Was a very weird presentation that turned out to be the bony plates of her skull overlapping.
To be honest, I'd be having a chat to potentially a different paediatrician. Does she need further imaging? Does she need ortho consults? I think there are still questions to be answered. You don't stop looking just because it isn't normal!
Hi
I have a 17 month old baby boy. I have a concern here. My baby's head seems normal in front and the the back there's a curve. However one side seems to be point or have a bump which may me due to sleeping position. Now my worry is, will it affect his growth in the long run and can I still do something to fix this or should I not worry.
Thank You
Hi there Pearl, and thank you for your comment.
At 17 months, there are fixes available but they generally take a bit of time if it is just a positional deformation. Now, there are studies out there that do suggest an increased RISK of developmental delays, but it doesn't mean he WILL get them. If I were you, I would consider getting a review done; is he ticking all the right milestones, is he doing what he is meant to be doing, etc, and at the same time ensuring proper musculoskeletal function. This way you can ease your concerns knowing that you are doing the best for his development :)
Christian
Bumps on each side of my 4 month olds head right behind his forehead.
Are they little or big? Can they move? Couple of options to what this could be, but not what you would expect to find with straight plagiocephaly. I would consider getting a further review if you are concerned.
My baby age 2 years old his head large and not round head plz tel me round head make
Hi there Muhammed,
As much as I would like to, I can't say what is needed for your child! There are just too many aspects to consider. Best bet is to talk to a health professional about your concerns and get your child examined.
hi doc my twin son have uneven head..is there any treatment to make there head even??thank you
Hi there Inday - thanks for reaching out.
There are many treatment options available; stretches, manual therapy, and head orthotic (helmets) are just some. But which might be useful depends on how old your child is, and what the reason is for the head shape occurring.
Your best bet is to talk to your health care professional and get some appropriate guidance.
Thanks!
Christian
but they are 2 years old now..any good suggestion to make their head normal..
Hi doctor my baby was 2 years old . He had plagiocephaly . I noticed in 2 month, I tried opposite position to sleep baby . But now he is 2 years nothing difference in shape . His ear also one big another one is small. And his forehead looks like light bump. Is that any chance to remold his shape ?
Hi there Puneetha, and thanks for reaching out.
At 2 years old, you can still attempt to correct the shape, but it may be a very slow process. I think the best thing you could do at this stage is a proper review with a health care professional and go from there.
Christian
Hi Dr. My baby just turned 6 month yesterday and when asked his PD again about the flattened lower side of his head, dr said it’s not too bad and we wouldn’t qualify for helmet but it is nothing to interfere his brain development. Recommended a special pillow. Baby does favor one side but he’s had this since NB and Ive tried to reposition but I see it looks the same. Im worried no further exam has been done on my baby. Should I pay attention in case other worrying symptoms? Should I get 2nd opinion? Im worried. Thank you!
Hi there Melissa,
So the research regarding brain development shows a 30-40% risk of developmental delay, especially in gross motor and language - with research now tracking kids through to school showing impact on academics. To say that it won't interfere with brain development is not precisely accurate, but not everyone is aware of this.
Repositioning and the pillow can be tricky, especially at 6 months as they just ... move their head again.
I would suggest having a musculoskeletal professional (chiro/osteo/physio/etc) to have a look at neck function, because if they have been turning to the side since birth, could it be a neck problem driving this whole process.
Let me know how you go.
Christian
PS - where in the world are you? I know quite a few around the globe!
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