Nancy E. Reid
Objective: The incidence of positional plagiocephaly and brachycephaly has increased by 600% in the last thirty years, in large part due to the “Back to Sleep” campaign. Abnormal head shapes do not cause damage to the brain; however, there is a small-time frame in which to initiate treatment. This clinical review was completed to determine the treatment of plagiocephaly/brachycephaly, taking into consideration age and severity of head shape.
Methods: A literature search was conducted using PubMed and Google Scholar finding articles specifically regarding positional plagiocephaly/brachycephaly and treatment options. Out of the twenty articles analyzed, eleven were deemed appropriate for the review based on content.
Results: Based on the eleven articles identified, it was determined that the earlier treatment is initiated, the better the outcome in correcting head shape, as the growth of the baby's skull mainly occurs during the first year of life. Severe plagiocephaly benefited from cranial remolding while most infants with mild to moderate plagiocephaly benefited from conservative management, followed by helmet therapy if no demonstrable improvement.
Conclusion: Plagiocephaly/brachycephaly should be treated as soon as flatness is identified as early treatment with less severe head shape leads to better outcomes. In severe cases, helmet therapy should be initiated. Conservative management should be started first in mild and moderate cases followed by helmet therapy if no improvement is noted.
Scheeler LN. Abnormal Head Shapes: Best Treatment Options for Plagiocephaly/Brachycephaly. Lynchburg Journal of Medical Science. 2022; 4(4).
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