The skull of a newborn is, as we know, malleable. The flexibility of the fontanelles is also an asset during childbirth because it facilitates the passage of the head. After birth, it then allows the brain to “grow” little by little.

There plagiocephaly is a deformation of the child’s skull characterized by a asymmetry giving the head an oblique shape: we commonly speak of ” flat head baby “, indicates the High Authority of Health (HAS) (source 1). This flattening of the back of the baby’s skull is quite common and develops in infants, for whom the skull is relatively flexible and grows particularly quickly.

We are talking about brachycephaly when the deformation at the back of the skull is symmetrical. It can also be accompanied by a significant enlargement of the skull, and an atypical growth in height.

A source of concern for parents, these positional cranial deformities are benign And usually disappear naturally around the age of two, assures the HAS.

A deformation of the skull may appear in the first months of life. It is becoming more and more frequent: it is estimated that approximately one in three children is affected.

Its main causes:

• Sleeping on the back : this position, which has been the one recommended for twenty years to prevent sudden infant death syndrome, can in fact promote the development of this malformation, especially if the child always rests his head on the same side when he is lying on a back to sleep. There is no question of calling into question the sleeping on the back. Laying your baby other than on his back increases the risk of unexpected death from suffocation or tipping onto his stomach. A position reaffirmed by HAS in March 2020;
• The positions in which baby is installed are not varied enough: this is the point of view defended by the Association of referral centers for unexpected infant death. Rather than sleeping on the back, we must wonder about the fact that the baby is too often “prevented from varying his postures”, for example when he is installed for a long time in seats normally provided for transport by car;
• Poor position of the fetus in utero : this congenital deformity normally resolves within weeks of birth, but in some cases it persists.

THE flat head syndrome may be aggravated by cervicodorsal torsion, called infant torticollis.

Whatever the origin, it is important to consult if your baby has a flat head, in order to determine the severity of this “anomaly”. In the vast majority of cases, cranial deformities disappear at the age of 2 years with appropriate care. A plagiocephalyif not corrected, may not go away in adulthood.

In recent years, a debate on sequelae other than aesthetic in severe plagiocephaly, emerged. “Many studies have questioned the incidence of an imbalance of the jaw with problem of occlusion, of a visual, auditory, or even postural disorder (scoliosis)”, explains Vincent Renard, chiropractor. Psychomotor effects were sought.

Faced with the increasing number of cases of plagiocephaly and the concern of parents, HAS recognized the flat head syndrome as a matter of public health and issued new recommendations in March 2020.

• In prevention, “if sleeping on the back remains the position to adopt when the infant sleeps, the rest of the time he must not be constantly immobilized to prevent him from resting his head always on the same side”, insists the HAS . THE head wedges, seat shells, anti-flat head cushions are also not recommended because they prevent the child from moving freely;
• It’s important to change your child’s positions when awake as much as possible. If you give him the bottle, alternate right arm and left arm. Same when you wear it. For his floor play activities, set him up on a mat with toys around him to encourage him to look to the side. Avoid game arches and mobiles that will fix his attention in a single place (source 2);
• Of the physio exercises to help the child turn to the correct side are generally offered;
• THE recourse to osteopathy is also highly recommended: using precise but gentle manipulations, the osteopath restores the shape of the skull and restores mobility to the child;
• As for the French association of chiropractic, it wishes to emphasize the contribution of this manual practice, which prevents and treats dysfunctions of the musculoskeletal system:

If there is no improvement in the cranial deformity after appropriate treatment, the doctor should refer the child as soon as possible to a center of competence or a reference center for craniofacial malformations (head and neck rare diseases health sector). A tight helmet (cranial orthosis) that allows the head to regain its shape can then be recommended.