Preventing Flat Head Syndrome in Babies with Torticollis

As parents, your baby’s healthy growth and development is your top priority, and any concerns regarding their physical growth can be worrisome. Two common conditions that affect infants are torticollis and plagiocephaly (flat head syndrome). While these terms may sound unfamiliar, understanding these conditions is crucial for ensuring that your baby receives the appropriate care. In this blog, we will explore what torticollis and plagiocephaly are, how they are connected, and the best treatment options for your little one.

Torticollis, also known as "twisted neck," is a condition where a baby has difficulty turning their head due to tightness in the neck muscles usually related to the sternocleidomastoid muscle. Specifically, the muscle that runs along the side of the neck from the collarbone to the back of the head becomes tight, causing the baby to tilt their head to one side and rotate it to the opposite side.

Signs of Torticollis

The most noticeable sign of torticollis is a head tilt to one side. Other signs include:

• Limited range of motion when turning the head.

• A preference for looking in one direction.

• Flattening on one side of the head (often a result of consistent pressure on one area due to the head tilt).

Early detection of torticollis is essential for preventing further complications, such as plagiocephaly, which is often a secondary symptom.

Plagiocephaly, commonly referred to as flat head syndrome, occurs when one part of a baby’s head becomes flattened due to prolonged external pressure. Infants’ skulls are soft and malleable, which means that sustained pressure on one spot can cause the headshape to develop asymmetrically.

Causes of Plagiocephaly

There are several reasons why plagiocephaly may develop, including:

• Prolonged Back Sleeping: Babies who sleep on their backs or in car seats for extended periods with a positional preference can develop flat spots on the back or side of their heads.

• Limited Movement: Babies who are unable to turn their heads freely, as in cases of torticollis, are more likely to develop plagiocephaly due to prolonged pressure on one side.

• Multiple Births: Twins or multiples are more prone to plagiocephaly due to restricted space in the womb, which can lead to asymmetrical head shapes at birth.

Types of Plagiocephaly

Plagiocephaly is an umbrella term describing various head shapes that have flattening on the back or side of the head. The three most common types of head shape asymmetry include:

• Positional Plagiocephaly: Flattening on one side of the back of the head, causing asymmetry.

• Brachycephaly: Flattening across the entire back of the head, leading to a wider head shape.

• Scaphocephaly: A long and narrow head shape, typically caused by prolonged side-lying positions.

Signs of Plagiocephaly

The most common signs of plagiocephaly include:

• Flattening on one side or the back of the head.

• Asymmetrical head shape.

• Misaligned ears (one ear may be pushed forward more than the other).

• Asymmetry in facial features, such as an uneven forehead.

• A wider than normal head shape with minimal occipital bone development.

• A longer and narrower headshape with a prominent occipital bone.

Torticollis and positional plagiocephaly are often closely connected because torticollis limits a baby’s ability to move their head freely. This restricted movement means that babies tend to rest in the same position, leading to consistent pressure on one side of the head. Over time, this can cause positional plagiocephaly and asymmetry to develop.

Without early intervention, these conditions can compound and potentially lead to more severe asymmetry in the head shape and facial features.

Can You Develop Positional Plagiocephaly From Torticollis?

Yes, positional plagiocephaly can develop as a direct result of torticollis, and is one of the main factors contributing to plagiocephaly. When a baby has torticollis, their head is often tilted or rotated to one side, which restricts their movement. This leads to uneven pressure being applied to one area of the skull, particularly when the baby is lying down.

Positional plagiocephaly caused by torticollis is common, but it is important to understand that this form of flat head syndrome is preventable and treatable if identified and addressed early. By addressing the underlying cause (torticollis), the risk of plagiocephaly can be significantly reduced.

The good news is that both torticollis and plagiocephaly can be treated effectively, especially when addressed early. Early intervention provides the best chance for a successful outcome, as an infant’s head shape can be more easily corrected in the early months.

1. Torticollis Treatment

Treating torticollis typically involves a combination of body work, stretching exercises and positioning techniques to improve the baby’s range of motion and encourage head movement in all directions. Pediatric health professionals like a physiotherapist, osteopath or chiropractor often work with families to develop a series of exercises that help loosen tight neck muscles and promote healthy head movement.

Some common approaches include:

• Neck stretches: These exercises help lengthen the affected neck muscles, allowing for greater movement.

• Tummy time: Encouraging babies to spend more time on their tummies helps strengthen the muscles in the neck and back, reducing the risk of developing plagiocephaly.

• Positioning: Encouraging babies to turn their heads in different directions by using toys, lights, or sounds can help relieve pressure from one part of the head.

2. Plagiocephaly Treatment

Treatment for plagiocephaly depends on the severity of the condition. For mild cases, simple positioning techniques may be enough to correct the head shape if identified early where repositioning techniques can be successful. These include:

• Alternating the baby’s sleeping position.

• Increasing tummy time to relieve pressure from the back of the head.

• Limiting time spent in reclined positions such as car seats, swings, or bouncers.

For moderate to severe cases, a cranial remodelling orthosis (CRO) may be recommended. This involves fitting the baby with a helmet that gently redirects growth to achieve a more symmetrical head shape. ROKband’s custom-made CROs can be utilized as early as 4 months and are designed for maximum comfort and effectiveness.

3. Combining Torticollis and Plagiocephaly Treatment

When torticollis and plagiocephaly occur together, treatment often involves addressing both conditions simultaneously. Stretching exercises for torticollis, combined with head repositioning techniques for plagiocephaly, can help alleviate the impact of both conditions. In more severe cases, treatment by a pediatric health profession along with a CRO may be required to achieve the best results. The CRO primarily helps with head shape symmetry, while body work and exercises by a pediatric professional addresses the tight neck muscles and range of motion affected by torticollis.

The role of an Orthotist in Plagiocephaly and Torticollis Treatment

At ROKband, our team of expert orthotists specializes in treating positional plagiocephaly caused by torticollis and other factors. We use cutting-edge 3D scanning technology to create custom-made helmets that gently guide the growth of the baby’s head into a more symmetrical shape. Our orthotists also collaborate with pediatric health professionals to ensure that your baby receives a comprehensive treatment plan, addressing both torticollis and plagiocephaly simultaneously.

Our Cranial Remodelling Orthosis (CRO) is designed to be lightweight, breathable, and comfortable, ensuring that your baby can wear it for the recommended 20-23 hours a day with minimal discomfort. We take a customized approach to each treatment plan, ensuring that your baby’s progress is carefully monitored and adjusted as needed.

Torticollis and plagiocephaly are common conditions that affect many infants, but with early detection and appropriate treatment, they can be managed effectively. If you notice signs of torticollis (head tilt, limited head movement) or plagiocephaly (flat spots, asymmetrical head shape) in your baby, it’s important to consult a healthcare professional as soon as possible.

By addressing these conditions early, you can help ensure your baby’s head develops symmetrically, and they grow up with healthy, unrestricted movement. At ROKband, we specialize in providing comprehensive, customized treatment options for headshape asymmetries, ensuring that your baby is in expert hands.