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  • Dr. Charlotte R Tribe

Plagiocephaly and Brachycephaly Developmental Delays


The research very strongly supports that developmental delays are associated with plagiocephaly.

It is important to note that the standard information that is being given to the parents/carers of children with plagiocephaly and brachycephaly is that “he/she will grow out of it”, “once she’s sitting it will get better”, “once he has hair you won’t notice it” or “it’s just an aesthetic issue”. The literature does not support these statements.

The standard treatment for these children is “watch and wait” and to perform ‘tummy time’. The tummy time is necessary for these children as it promotes motor development and learning however the watch and wait approach is not satisfactory.

Deformational Plagiocephaly

This is when the head is not a round shape.

This is a strain within the cranial dural system. It may result from pressure in utero, birth, early trauma (injury) or torticollis. It can be aggravated by positioning during sleep (sleeping on back). Flattening of the occiput is usually evident.

Causes:

In utero constraint- pressure in utero from multiple births, breech position, small or subluxated maternal pelvis. Premature infants may also be more susceptible to skull strains.

Birth- the most common causative factor. Cranial dural strains may occur at birth. The distortion may become more evident in the weeks following birth, often there is restricted movement and the head moulds to the sleeping head position.

Muscular strain (torticollis)- congenital or trauma induced torticollis resulting in shortening or tearing of the SCM muscle, causing the infants head to tilt towards and turn opposite the side of damage.

Back sleeping- aggravation of plagiocephaly may occur where a cranial dural strain exists by back sleeping.

The literature has shown that deformational plagiocephaly, plagiocephaly, facial asymmetry and torticollis are associated with developmental delays, in some cases. The developmental delays associated include visual, auditory, speech and milestones delays. The literature links are below:

"DP seems to be associated with early neurodevelopmental disadvantage, which is most evident in motor functions. After follow-up evaluations of this cohort at 18 and 36 months, we will assess the stability of this finding. These data do not necessarily imply that DP causes neurodevelopmental delay; they indicate only that DP is a marker of elevated risk for delays. Pediatricians should monitor closely the development of infants with this condition." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392083/

https://www.ncbi.nlm.nih.gov/pubmed/10654986

https://www.ncbi.nlm.nih.gov/pubmed/12140415

https://www.ncbi.nlm.nih.gov/pubmed/16404269

https://www.ncbi.nlm.nih.gov/pubmed/18344457

https://www.ncbi.nlm.nih.gov/pubmed/15956949

https://www.ncbi.nlm.nih.gov/pubmed/19816267

Support for Tummy Time with torticollis:

https://www.ncbi.nlm.nih.gov/pubmed/19191832


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