The Bulletin of the Institute for Family Health Care, King Hussein Foundation, today, Sunday, talks about flat head syndrome in children, which occurs when a flat spot appears behind or on the side of the head, and this condition may cause the child’s head to appear asymmetric.
The institute's bulletin explains the types of flat head syndrome, its signs, how to identify its infection, the causes that may lead to the occurrence of this condition, in addition to methods of treatment, and important tips that can be taken to reduce the risk of a child with it.
The bones of a baby's skull do not fully fuse and harden until several months after birth. Soft, flexible bones allow for easier passage through the birth canal and give the baby's brain ample room to grow.
These soft bones also mean that a baby's head can change shape. Flat head syndrome occurs when a flat spot appears on the back or side of a baby's head.
The condition can cause a baby's head to appear asymmetrical. One of the common causes of flat head syndrome is sleeping regularly or lying in the same position.
There are two types: postural plagiocephaly and congenital plagiocephaly:
Postural plagiocephaly: The most common type of flat head syndrome. According to the American Academy of Family Physicians, it affects up to 50 percent of children.
Congenital plagiocephaly: It is a rare birth defect. In children with this condition, the fibrous spaces between the bones of the skull close prematurely. This results in an abnormal head shape. This type of infection occurs in one of every 2,000 to 2,500 births.
How to recognize flat head syndrome:
It can take several months for signs of flat head syndrome to appear. Check for signs of infection during bath time when your baby's hair is wet and the shape of his head is more visible.
Signs to look for include:
A flattened area on the side or back of the head. Instead of the head being round, it may appear tilted in a particular area.
Ears that are not level, as flattening of the head can cause the ears to appear not parallel.
A bald spot in one area of the head.
Bony bumps on the skull.
Absence of soft areas or fontanelles (Fontanelle) on the head.
What causes flat head syndrome?
Congenital plagiocephaly is thought to occur by chance during fetal development. It can also run in families and is sometimes part of genetic disorders. According to a review published in the Indian Journal of Human Genetics, more than 180 syndromes can be associated, including Apert syndrome (a genetic disorder that causes fusion of the bones of the skull, hands, or feet and is characterized by malformations of the skull, face, teeth, and limbs) and Crouzon syndrome (Crozon syndrome is a disorder Hereditary, characterized by premature fusion of some bones of the skull).
There are several possible causes for the plagiocephaly position:
Sleeping position:
Putting your baby to sleep in the same position day after day, for example, on his back or with his head turned to the right or left, puts constant pressure on the same parts of the skull.
Babies are most at risk of developing a repetitive head posture in their first four months of life, before they can roll over on their own. It is always recommended to put your baby to sleep on his back to reduce the risk of sudden infant death (SIDS).
To reduce the risk of flat head syndrome, give your baby plenty of tummy time while he's awake. It is recommended to hold the baby for some time in your arms, rather than having him lie down for long periods of time.
Insufficient time spent on the stomach:
The risk of developing flat head syndrome increases the more time your baby spends on his back. Spending enough time on the tummy while he's awake can help reduce the risk of this condition. Your baby may cry when you put him on his tummy, but it is important to put him on his tummy several times a day.
When your baby is awake, place him on his tummy on a blanket or rug. Start with a few minutes per session, and a few sessions a day. As your child develops more muscle strength and neck control, you can increase the duration of the session.
Tummy time can also help your baby build the strength and muscles needed to roll over, crawl, sit up and eventually walk.
Multiple pregnancy:
When the uterine space is narrow, the risk of the baby's skull being compressed is greater than normal. This can lead to flat head syndrome.
Premature birth:
Babies born prematurely have softer bones than those born prematurely. They are also more likely to spend long periods in the hospital as they spend most of their time lying on their back. Flat head syndrome is more common in premature babies than in term babies.
Using forceps or aspirator during childbirth:
These tools put pressure on the skull and its flexible bones, which can lead to flat head syndrome.
Muscular torticollis:
This is a condition in which the neck muscles of an infant are stiff or unbalanced. It is often caused by a narrow uterus or being in a breech position.
How is flat head syndrome treated?
Treatment will depend on the severity of your child's condition and the cause. Treatment options include:
Counter-position therapy:
While it is important to always put your baby on his back to sleep to reduce the risk of SIDS, you should be careful to change his position from time to time. For example, if your baby prefers to sleep with his left cheek flat on the crib mattress, position his head so that he sleeps on his right cheek.
If your child has muscle torticollis, your doctor may recommend stretching exercises to increase the range of motion in his neck. Never attempt neck stretches without your doctor's approval and guidance.
Molding Helmet Therapy:
Mold helmet therapy involves having the child wear a helmet or a specially designed harness to help fix the skull into a symmetrical shape.
According to the American Association of Neurological Surgeons, the optimal age for helmet therapy is 3 to 6 months. Reshaping the skull with this treatment can take about 12 weeks.
Treatment with a cast helmet is usually reserved for those with moderate to severe cases of injury.
You'll need a prescription for a molding helmet, and your child will need to wear the helmet all the time, except while bathing. Helmets can irritate the skin and cause discomfort to your child. Nor is there conclusive evidence of the effectiveness of these devices.
Surgery:
Surgery is not usually needed in cases of postural flat head syndrome, but it is necessary in most cases of congenital injury when the sutures close and the bones fuse, so pressure in the skull needs to be released.
protection:
You won't be able to prevent all cases of infection, but there are some things you can do to reduce your child's risk:
Constantly change your baby's sleeping position (put his head to the left and the other to the right).
Give your baby supervised tummy time. Start with three to five minutes a session, two to three times a day, as soon as you bring your baby home from the hospital or within two days after birth. Apply up to 40 to 60 minutes on his stomach daily.
When you can, hold your baby upright instead of putting him in his crib, car seat or baby swing.
Change feeding positions. For example, if you bottle-feed your baby on your right arm, move him to your left arm, and so on.
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HEALTH UPDATE