What Happens If Plagiocephaly Is Left Untreated?

For parents, noticing a flat spot or asymmetry on your baby’s head can be concerning. While some may be advised the issue will resolve on its own, it’s important to understand what happens if plagiocephaly is left untreated. 

In this blog, we’ll explore what plagiocephaly is, why it occurs, whether it can correct itself, and the possible implications of leaving it unaddressed. Most importantly, we’ll discuss effective treatment options to help ensure your baby’s healthy development.

Plagiocephaly is a cranial condition characterized by a flat spot on one side of the back of the head. This condition is typically caused by external pressure on a baby’s soft and malleable skull during the first few months of life.

Signs of Plagiocephaly

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

• Misaligned ears, where one ear appears further forward than the other.

• Facial asymmetry, such as a slanted forehead or uneven cheekbones.

Plagiocephaly is primarily caused by prolonged pressure on one side of the baby’s head. Here are the most common contributing factors:

1. Positional Preference

Babies naturally prefer turning their heads to one side while sleeping or resting. For example, a baby may fall asleep looking toward their parent, a nearby light, or a toy, causing repeated pressure on one area of the head.

2. Torticollis

Torticollis is a condition where tight or shortened neck muscles make it difficult for a baby to move their head freely. This can lead to a restriction for resting in the same position, increasing the likelihood of plagiocephaly.

3. Back-Sleeping

Placing babies on their backs to sleep is essential to reducing the risk of SIDS. However, without alternating head positions, this can result in flat spots on one side of the head.

4. Limited Tummy Time

Tummy time helps strengthen a baby’s neck, shoulders, and upper body, reducing the time spent lying on their back. Without adequate tummy time, babies are more prone to developing flat spots.

5. Prematurity

Premature infants often have softer skull bones and weaker neck muscles, making them more vulnerable to positional flattening, especially during prolonged time in the NICU.

Plagiocephaly, can improve naturally with early intervention techniques in some mild cases, particularly when addressed early during the first few months of life. This is because a baby’s skull is soft and malleable during this period, allowing for natural correction through repositioning techniques. 

How Repositioning Works in Early Infancy

Repositioning techniques are a first-line approach for treating plagiocephaly in young infants, usually under 4 months of age. These methods work by relieving pressure on the flat spot and encouraging natural head shape correction through growth. Examples include:

• Tummy Time: Placing your baby on their tummy while awake reduces the time spent lying on the back, relieving pressure from the flattened area and strengthening the neck and shoulder muscles.

• Alternating Sleep Positions: Changing the direction your baby’s head faces during sleep prevents consistent pressure on one spot.

• Engaging in Active Play: Encouraging your baby to turn their head in different directions during play helps reduce positional preference and promotes symmetrical neck movement.

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However, moderate to severe cases often require more targeted intervention to achieve noticeable improvements. 

Why It Becomes Harder as Babies Get Older

1. Skull Becomes Less Malleable: After 4 months of age, the baby’s skull begins to harden and becomes less responsive to repositioning techniques.

2. Increased Mobility: As babies start to roll, sit, and crawl, it becomes harder to control their positioning during sleep and play. This mobility limits the effectiveness of repositioning strategies.

3. Growth Rate Slows: Rapid skull growth during the first 0-4 months provides the best opportunity for reshaping with repositioning techniques. After this period, the growth rate slows, reducing the window for natural correction.

   
   

When Early Correction Isn't Enough

If repositioning techniques and tummy time don’t yield noticeable improvement by 4 months, additional interventions may be necessary. In moderate to severe cases, cranial remodelling orthoses (CRO), like the ROKband, are often recommended to guide new head growth into a more symmetrical shape.

By understanding how repositioning works and why its effectiveness reduces with age, parents can better appreciate the importance of early detection and proactive steps in addressing flat head syndrome.

Leaving plagiocephaly untreated can lead to a variety of challenges, both functional and cosmetic, depending on when it is identified and the severity of the condition. While not all cases result in long-term implications, here are some potential outcomes:

1. Persistent Asymmetry

The severity of untreated plagiocephaly can greatly influence the level of asymmetry that develops. In moderate to severe cases, it can result in a permanently asymmetrical head shape. This may include noticeable facial alignment issues, with one side of the face appearing flatter or more slanted than the other, depending on the extent of the condition.

2. Challenges with Fitting of Helmets and Gear 

An asymmetrical head shape can make it difficult for helmets and other protective gear to fit securely and comfortably. The uneven shape may cause improper rotation of the helmet, leading to discomfort or reduced functionality. In some cases, custom modifications to the helmet or gear may be necessary to accommodate the asymmetry, which can be both time-consuming and costly as your child grows.

3. Misaligned Ears and Jaw Issues

Untreated plagiocephaly can cause one ear to appear further forward than the other, potentially affecting the fit of glasses and protective headgear. The ear misalignment can also increase the likelihood of more frequent ear infections on the affected side due to the altered positioning. Additionally, misalignment may extend to the jaw, leading to potential issues with chewing, speaking, or starting solids. 

4. Impact on Neck Mobility

Babies with untreated plagiocephaly often have underlying tight neck muscles, leading to reduced cervical range of motion. This limitation can contribute to delays in motor milestones such as rolling, crawling, or reaching bilaterally.

5. Self-Esteem Concerns

As your child grows, visible asymmetry may affect their self-esteem and confidence. While this may not seem significant during infancy, it can have a lasting impact in later stages of life.

Fortunately, plagiocephaly is highly treatable, especially when addressed early. Treatment options vary depending on the severity of the condition and the baby’s age:

1. Repositioning Techniques

For mild cases detected early (before 4 months), repositioning techniques can help encourage natural head shape correction:

• Tummy Time: Start tummy time from birth, gradually increasing duration to 20-30 minutes daily by 3 months. This total time can be broken into shorter sessions throughout the day, making it easier for your baby to adjust and build strength.

• Alternate Sleep & Holding Directions: Change the direction your baby’s head faces in the crib each night to reduce pressure on one area. Additionally, alternate the arm you use to hold your baby during feeding or when carrying them to encourage equal head movement and reduce positional preferences.

• Engage in Active Play: Use toys or mirrors to encourage your baby to turn their head in different directions.

2. Pediatric Therapy

Consulting a pediatric physiotherapist, chiropractor, or osteopath etc. can provide tailored exercises and techniques to improve neck mobility and prevent further flattening, especially in early infancy. These professionals are particularly helpful if your baby has torticollis.

3. Cranial Remodelling Orthoses (CRO)

For moderate to severe cases or when repositioning alone hasn’t been effective, cranial remodelling orthoses like the ROKband are recommended.

• How It Works: The ROKband gently redirects skull growth to the flatter areas, creating a more symmetrical head shape.

• When It’s Effective: Best results are achieved when treatment begins between 4-6 months, while the skull is still highly malleable. However, treatment can be effective up to 18 months of age.

4. Regular Monitoring

No matter the severity, regular monitoring of your baby’s head shape during the first 6 months of life is essential. This ensures any changes are detected early and addressed promptly.

The earlier plagiocephaly is identified, the easier it is to address. Here’s why early intervention is crucial:

• Faster Results: Early treatment aligns with your baby’s rapid growth, allowing for quicker and more noticeable improvements.

• Reduced Stress: Early intervention ensures that treatment is as straightforward and effective as possible, giving parents peace of mind and allowing for quicker results.

• Better Long-Term Outcomes: Addressing plagiocephaly early reduces the risk of long-term challenges, ensuring your baby’s head shape develops symmetrically.

If you’re concerned about your baby’s head shape, don’t wait to seek help. At ROKband, we offer free head shape assessments to evaluate your baby’s needs and provide personalized treatment recommendations. Our custom-designed cranial remodelling orthoses are lightweight, breathable, and proven to deliver visible results.

Why Choose ROKband?

• Advanced 3D scanning technology for precise measurements.

• Custom-designed helmets by certified orthotists, tailored to your baby’s unique head shape.

• Comfortable, lightweight materials that allow for play and tummy time.

• Expert care and guidance from certified orthotists and kinesiologists.

Conclusion: Understanding the Impact of Untreated Plagiocephaly

While some parents may hope that flat spots will resolve on their own, untreated plagiocephaly can lead to challenges that affect your baby’s head shape, facial symmetry, and overall development. Recognizing the potential outcomes of leaving plagiocephaly unaddressed is the first step in understanding why timely action matters.

Whether your baby is showing early signs or you’re concerned about persistent flat spots, there are solutions to support their development—ranging from repositioning techniques to cranial remodelling orthoses like the ROKband. Taking action today can help prevent long-term complications and give your baby the best foundation for healthy growth.

If you’re unsure where to start, schedule a free head shape assessment with ROKband to learn more about your baby’s condition and available treatment options. Together, we’ll help your baby achieve a healthy, symmetrical head shape.