Agee noticed a flat spot on her baby girl Sarah’s head. A visit to the pediatrician confirmed it. Agee began to wake several times each night to check on Sarah head position.  Her head was always turned to the same side. Several times a night Agee turned Sarah’s head to the less preferable side. During the day Agee made sure to consciously shift the position of Sarah’s feeding chair from time to time so that Sarah would want to turn her neck in different directions as she looked for her Mom and at the various sights and sounds around her.  Since Sarah was bottle fed, her Mom realized that she generally bottle fed her on the same side each feeding. With breastfeeding sides are automatically shifted but with bottle feeding, the feeding side is usually dependent on the mother being right or left-handed. Agnes began diligently to change sides for each feeding. Each time Agee changed sides, Sarah would turn her head in a different angle. In Sarah’s case, she had both plagiocephaly flat head syndrome and torticollis twisted neck syndrome.

From 27 – 61% of those infants with torticollis also have plagiocephaly ( Congenital Muscular Torticollis). Other related facial inequalities can include a fuller cheek on one side and uneven ears and eyes. Since the baby’s neck directs its head, babies with torticollis often develop flat head syndrome. The reason the baby may develop flat head syndrome along with torticollis,  is because of the tightness of the neck muscles which causes the baby to keep the head in one position. The reverse can be true as well; if the baby favors one side of the head over the other, then the muscles can end up twisted and out of shape( Pregnancy, Baby and Toddler Health Information).

Many medical experts in the field of pediatrics will attest to the fact that torticollis and plagiocephaly are related. It is sometimes difficult to make an absolute judgment as to which came first, torticollis or plagiocephaly. Since it is the baby’s neck that conducts change in the head positioning, babies with torticollis will often develop plagiocephaly.  Reversely, if a baby favors the same side of its head consistently, the muscles can weaken on the other side.

There are theories as to the exact cause of torticollis after birth.  It may be caused by the infant spending too much time with its head turned in a particular direction. There are theories that plagiocephaly can cause this as well. The development of the baby in the early months of its life are crucial.  Torticollis can impact a baby’s vision, ability to eat properly, and motor skills both fine and gross. Example of distortion of development include decrease in head control, restricted reaching on the affected side, delayed sitting and walking, crawling imbalance, and other problems.

Parents and doctors will usually notice fairly early that the baby has restricted movement in the neck. For problems related to neck muscles, there are a variety of helpful therapies using stretching and positioning.  In positioning therapy, pressure is relieved by turning the head away from the flat side. It’s always best to get evaluated by a cranial therapy center near you and they will help determine the treatment if needed.

Treatment of plagiocephaly also often includes using a cranial helmet. A combined treatment of positioning and helmet use has been found to be more effective and faster than positioning alone.  An experienced, orthotist, (Orthotists are trained to work with medical supportive devices such as baby helmets) will custom make the helmet out of lightweight plastic and foam line.  The helmet contacts the good side of the head and does not touch the flatter side of the head, As the baby grows, the head will grow more symmetrical.  Baby cranial helmets are generally used from four to six month until eighteen months of age.

Front baby carriers and slings are effective tools to help alleviate pressure and causing your baby to move its body to different stances. It is recommended to change the positions of these carriers so the baby will look in different directions.  When good head control is secured, the baby can be positioned facing away from the parent in the carrier. Also, a good idea is to carry your child in your arms as often as possible.

There is a new baby pillow on the market which is getting many positive reviews on Amazon.  The Baby Love Memory Foam Pillow claims to round the baby’s head to prevent flattening.  This pillow supports the baby’s cheek on either side to make sure the baby doesn’t over stretch its neck.  According to these favorable reviews, this pillow has helped parents with babies where plagiocephaly and torticollis were present.

One mother wrote that her baby son had already started to develop torticollis and was getting a flat head. She claimed  that this pillow was so effective when used for laying her baby on his back and it allowed his head to be supported without restraint. Eventually his torticollis and flat head resolved themselves on their own without clinical  intervention.

Another mother wrote that her baby had a right-side flat spot and was developing torticollis.  She was trying to find a way to get her baby to sleep more on her left side. After buying and returning various pillows she finally found the Baby Love Pillow.  She claimed that this memory foam pillow was made of a different material (real patented antibacterial memory foam). Each time the mother checked her baby she noticed that the pillow really kept her baby’s head in a straightened position.

One more mother reviewed this pillow this way. She was already advised that her baby girl would need a helmet but they would not fit her with one until she was six months old.  She was started on physical therapy to help her neck and back muscles work quicker so she would start rolling off her back by herself. After six weeks of using the pillow, both she and her doctors have seen a noticeable difference in the baby’s  head shape. Her physical therapists were so sure that she would need a helmet at six months even with the recommended physical therapy. She will be six months shortly and her doctors are actually rethinking the need for the helmet. The manufacturer of Baby Love memory foam pillow advises parents to consult their individual pediatrician before using this pillow.  “We care about the health and wellbeing of all children and would not want harm to come to any child with any of our products.”

If you notice that your child may have signs of torticollis or flat head syndrome please make sure that it is seen by a competent pediatric orthopedist. Only one cranial center offer a free evaluation, which is the Cranial Therapy Center in Lakewood, NJ.

Some of the signs of torticollis and  plagiocephaly are:

1) Preference to turn his/her head to one side

2) Noticing in photos that his/her head is tilted to one side

3) Flattening on the back or side of the head

4) Your baby’s inclination to prefer breast or bottle feeding on one side

The earlier you start physical therapy, the less likely that that your child will need helmet therapy when it becomes six months old. Even trying the memory foam pillow at birth can be a good preventive measure. If you suspect that your baby has torticollis and/or plagiocephaly make sure to get your baby evaluated professionally to see if any problems do exist.  If your concerns are confirmed begin with re-positioning immediately. You can start be re-positioning your baby in the opposite direction that he or she tends to look at.  Tummy time is very important during waking hours and stretching therapy to loosen tight muscles is a must. Re-positioning your baby’s head during sleep (with special doctor approved pillows) can even out the pressure to his or her skull.  A medical evaluation can help enlighten you to proper re-positioning and tummy- time methods. Always remember early intervention is the key.