Perhaps the only known variable in parenthood is the unexpected. No matter how hard we prepare ourselves for what parenting entails, we will always be faced with surprises, some pleasant and some less so.
Equipping ourselves to handle the unexpected can help us remain calm, strong and confident in situations where we otherwise may have felt we had failed.
When my daughter was a few months old, I noticed that one side of her head was flatter than the other. A few years earlier, I might not have even recognized the subtle difference. However, a friend’s child wore a helmet to correct a similar problem, so my radar was up.
As a mom, I needed to understand what caused this and, more importantly, how I could fix it. (Don’t we always think we should be able to fix everything for our children? How “Supermom” of us!)
Plagiocephaly — misshapen or flattened head — can occur for many reasons:
_ Congenital muscular torticollis, or a twisted neck present at birth
_ Hydrocephaly, a condition in which fluid surrounds the brain
_ Craniosynotosis, which occurs when skull sutures close too soon
_ Positional plagiocephaly.
Positional plagiocephaly happens when a fetus is too crowded within the womb or, more frequently, when an infant stays too long in one position — on the back, for example. When infants are born, their still-soft skulls are made up of several movable plates. This allows for flexibility so that the head can move through the birth canal.
Sutures, also known as fontanels or “soft spots,” are the spaces between these movable plates that leave room for the brain to grow. If a baby lies in the same position for too long, movement of the plates can leave a flat spot on the head.
The “Back to Sleep” campaign, introduced in 1992, urged parents to place infants in a supine position to prevent sudden infant death syndrome (SIDS). Since the inception of this campaign, cases of plagiocephaly have increased. However, while some might argue that Back to Sleep is to blame for these rising numbers, others believe that the condition is more heavily diagnosed because of increased awareness and recognition.
My acute awareness of “flat head,” triggered by others in my circle of friends, led to my questioning whether I’d used too soft a mattress in my daughter’s co-sleeper. Maybe I shouldn’t have been rejoicing at how well she slept at night, I thought, as her oft-waking older brother never exhibited a flat head. Was this my fault?
Our pediatrician suggested “rotisserie baby” — rolling my daughter’s head from side to side throughout her sleeping hours, or moving her to different areas of the crib to encourage her to move her head into different positions. In the end, her flat spot corrected itself, and I knew I’d worried unnecessarily.
As parents, many of us have a tendency to worry about even the small things. After all, we are our child’s protectors, and our primary job is to keep them safe and healthy.
But we also, as humans, are fallible, even when we do the best we can. Babies commonly suffer from positional plagiocephaly from not being given enough tummy time during waking hours, not being held upright for enough time, or spending too much time in bouncy seats, car seats and baby carriers.
A baby’s flat head, then, can be a gentle invitation for us to reconnect with our babies, to hold and cuddle them. I always felt especially connected to my infant children when I held them close to me in a sling or baby carrier. These devices allow us to stay close to our babies while still juggling other responsibilities, including chasing after older siblings!
Even when attachment is not an option, positional plagiocephaly can be prevented and sometimes even corrected through repositioning the baby. This takes weight off of the baby’s head so that one area doesn’t flatten from too much pressure.
Tactics such as tummy time during waking hours can also help a developing baby build muscles in his neck, head and shoulders that are so important for learning to crawl.
There are corrective options for more severe cases when treated early, preferably by six months of age, when the skull has not yet hardened. Some parents opt for a custom helmet, or custom bands that can reshape a baby’s head.
Both of these treatments usually last two to four months. A health care practitioner can advise parents whether these options are recommended for their child.
Sometimes, though, it’s best to stop worrying and just enjoy our children while they are infants. According to the National Institutes of Health, most flat spots correct themselves once children begin to sit up and crawl.
Unless the case is severe, chances are it will work itself out, as so many things will in our children’s lives. Accepting this and letting go a little may well be one of the hardest lessons in parenting.
“Positional Plagiocephaly.” National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health & Human Development. Web. 12 Sept. 2011. http://www.nichd.nih.gov/health/topics/positional_plagiocephaly.cfm
"Baby's head shape: What's normal? - MayoClinic.com." Mayo Clinic. Web. 12 Sept. 2011.
"Plagiocephaly and Brachycephaly in the First Two Years of Life: A Prospective Cohort Study." Pediatrics. Web. 12 Sept. 2011. http://pediatrics.aappublications.org/content/114/4/970.full.
Reviewed September 14, 2011
by Michele Blacksberg R.N.
Edited by Jody Smith