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Causes
Causes
Many risk factors are associated with the development of positional plagiocephaly. A few of the more common ones:
Restrictive Intrauterine Environment
One of the leading risk factors in the development of plagiocephaly is
a restrictive intrauterine environment. In this case, the infant does
not have room to move, or becomes stuck in one position. The constraint
may be caused by several sources: a very large or multiple number of fetuses
(twins,triplets..) small pelvis, small or malformed uterus, or if there
is an excess or lack of amniotic fluid. A breech orientation can lead
to an abnormal head shape when the infant's head becomes wedged under
the mother's ribs. Mothers of children with plagiocephaly often report
experiencing pain in the hip, from pressure of the fetus on the pelvic
wall.
Congenital Muscular Torticollis (Wryneck)
In CMT, one or more of the neck muscles develops a tightness, causing
the head to tilt and/or turn. This can result in plagiocephaly as the
tightness causes the head to be held in a single position. Torticollis
may be obvious or subtle.
Prematurity
Firmness of infant cranial bones increases nearly 5-10 fold during the
last ten weeks of pregnancy. Premature delivery makes the already soft
cranium susceptible to molding forces. Premature infants are also more
likely to be physically delayed, preventing normal movement of the head.
Preemies will often spend extended time in the Neonatal Intensive Care
Unit (NICU) on a respirator with the head in a fixed position. This can
result in a long and narrow head shape.
Back Sleeping
Prior to 1992, the risk factors associated with plagiocephaly were considered
to be a restrictive uterine environment and congenital muscular torticollis.
After the American Academy of Pediatrics (AAP) 1992 recommendation to
sleep infants only on their back to reduce the risk of SIDS, craniofacial
centers began to see a dramatic increase in plagiocephaly. By 1996, several
studies documented the relationship between back sleeping and plagiocephaly.
The AAP now recommends frequent rotation of a child's head, as well as
supervised tummy time.
Infant Car Seats, Carriers, Bouncy Seats and Swings
In recent years, it has been noticed that extended use of car seats, infant
swings and bouncy seats also contribute to plagiocephaly. In these devices,
the back of the head is against a rigid, unyielding surface, and the resulting
deformity can be severe, even causing 'cornering' or 'squaring' of the
head. While normal use is not a concern, extended use, especially allowing
infants to sleep in them, increases the risk of plagiocephaly.
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Disclaimer: The information contained in Cranial Technologies' website should not be used as a substitute for the medical advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances. If you have questions regarding treatment of an infant currently in the DOC Band®, clinicians at the center providing treatment should be contacted directly. For feedback or general questions about our website, please email the webmaster at wbmgr@cranialtech.com Website Last Revised: January 12 2007 Created: August 16 2002 ©1997-2008 Cranial Technologies Inc. All rights reserved. DOC, DOC Band and Dynamic Orthotic Cranioplasty are Trademarks of Cranial Technologies, Inc. U.S. Patents 5,094,229; 5,038,312; 5,951,503; 6,346,353.
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