What is Plagiocephaly and how to prevent it

Plagiocephaly and Brachycephaly, also known as flat head syndrome, are conditions characterized by an asymmetrical distortion of the skull (flattening of one side of the skull in the case of plagiocephaly or of the back of the head in the case of brachycephaly). Frequently, flat head syndrome is the consequence of subluxation of the cervical which prevents good mobility of the head. This subluxation is not always detected. 

A baby’s skull is very delicate and can deform very quickly if the baby is lying on a hard surface for a prolonged time, in the same position. Since professionals have recommend sleeping a baby on his/her back and on a firm mattress many babies develop this syndrome (or if they spend too much time in a carrycot, a car seat or a rigid bouncer). In all cases, if your child has plagiocephaly, it is important to contact a pediatrician or physiotherapist for advice.

For a baby with no health issues, the main causes of flat head are:

• extended use of infant car seat
• extended use of playmat (with baby lying on the back)
• extended use of baby bouncer (always choose a bouncer which is not stiff but soft at baby’s head level).

2. Prevention and recommendations

Some children will automatically place their head on the same side if their attention is attracted by a sound (e.g. Television) or drawn towards a fixed source of light, it is therefore important to vary the position of your baby's cot, so that baby does not continually turn his head to the same side.

A Baby should be stimulated during the day when he/she is out of their cot, through interactive games. A baby always placed on the same side could develop plagiocephaly.

When your baby is not sleeping, carry him in a wrap as much as possible (at home and outdoors when out for a walk) so that his head avoids contact with a flat, rigid surface until the bones have fused.

Recommended positions for a baby having developed flat head syndrome:

• Tummy position: for short periods of time, place your baby on his tummy with a baby wedge under his arms at chest level. This favours both baby’s muscle development and his interaction with family members without the baby’s head encountering a hard surface.
• 3 / 4 Position: When your baby takes naps during the day, place him in a 3/4 lateral position and alternate this position from left to right, from one nap to the next. 

Regularly changing your baby's position and carrying him in a baby wrap carrier are the best prevention methods of flat head syndrome.

3. Cocoonababy and plagiocephaly

The Cocoonababy is the result of several years’ careful observation in a medical environment, and specifically in the neonatal services of the Hôpital Nord in Marseille. More than 160 maternities use it daily in France. Convinced of the well-being and comfort that the Cocoonababy provides to newborns, Hôpital Saint-Joseph in Marseille (France) - 1st maternity in the PACA region (Provence Alpes Côte d'Azur) with 3600 births per year - replaced all crib mattresses by the Coconababy.

By its shape and the nature of the materials used, the Cocoonababy does not hold the baby's head in place but on the contrary promotes and facilitates the head movement and considerably limits the deformations of the head, which would be worse on a flat cot mattress. However, it is important to note that Cocoonababy helps reduce the risk of flat head syndrome, but it does not prevent it. It is therefore important to still follow the recommendations below when using the Cocoonababy.

4. Some tips when using the Cocoonababy

Some babies automatically place their head on a preferred side. This habit is often already present in the mother’s womb. Should this be the case, parents should place their baby in the cocoon so that he or she can turn his or her head alternately right and left. To encourage this, the Cocoonababy should be regularly turned the other way in the cot and parents should talk to their baby from the opposite side to the one he/she is facing to encourage him/her to turn his head away from a preferred side. 

Do not use any extra linen/cotton fabric sheets or towels over the Cocoonababy below baby’s head. Any additional layer added above the Cocoonababy's fitted sheet will cancel the benefit of the delicate contact top foam of Cocoonababy.

Change your baby’s position during day naps: remove the cotton fitted sheet covering the Cocoonababy® and place the bottom of the baby's right leg under the wedge so that baby sleeps on the right side (as shown in the picture below). Then do the opposite for the afternoon nap, placing your baby on the left side. Always use the tummy band to ensure that your baby remains safely in this side position. During day naps, make sure that the baby's position remains the same. Your baby can sleep directly on the zipped protective cover, (made in Perlam fabric, it is soft to the touch, hygienic and totally waterproof). Check regularly on your baby when in this position.

At nighttime however (when the baby sleeps unattended), he/she must lie flat on his/her back in the Cocoonababy®, with the Tummy band correctly in place.

For more on plagiocephaly, visit Raising Children.