Treatment of Positional plagiocephaly

Treatment of positional plagiocephaly

Non-surgical.

If associated with torticollis, it should be treated with neck stretching exercises to include chin-to-shoulder and ear-to-shoulder maneuvers at each diaper change. 

The head shape can be treated with repositioning. Once the child hair grows, skin thickens, and skull remodels, any subtle differences usually are not visible. 

  • Move all toys, cribs, car seats so that the child does not lie on the flat side.
  • Child should not lie parellel to object of interest, but should be placed perpendicular off the flat side (33,48).
  • Tummy time

 Molding helmets normalize the head shape (45).

  • Positional/active counterpositioning and head molding helmets similarly improve the head shape (36).  Molding helmets will improve the abnormality quicker (33).  Helmets are better at treating posterior plagiocephaly than anterior plagiocephaly (45). Their use is dependent on physician and families concerns. 
  • Insurance companies are reluctant to pay for them and they have risen in cost. The author uses them for moderate to severe positional plagiocephaly that severely affects the face. It is best placed before the age by the age of 5-6 months. Best results are seen at the time of most rapid head growth before the age of 12 months.