Have you ever felt like your little one's head is a little flat in the back? Or does it look a little wider than normal? It's normal for a mother or father to feel a little scared when they see something like this. But don't worry. Today we're going to talk about this condition (Brachycephaly).
What is brachycephaly? Is it dangerous?
Simply put, brachycephaly is when the back of your baby's head looks flat. This means the back of the skull may appear shorter and wider than normal. Sometimes you might think, "Oh, my baby's head looks a little weird."
This is actually a type of condition called (Positional Plagiocephaly), or "flat head syndrome." It's a common occurrence. The important thing is that it rarely causes long-term health problems or problems with the baby's development. In most cases, this condition gets better on its own, or can be corrected with simple management methods. So, don't worry unnecessarily, okay?
There are two main types of brachycephaly:
There are two types of this condition depending on the cause. Let's see what they are.
1. Positional Brachycephaly: This is the most common type. This condition can occur when your baby sleeps on their back for a long time, and stays that way for a long time when they are awake. We know that babies should always be put to sleep on their back to prevent Sudden Infant Death Syndrome (SIDS). It is a must. However, if babies keep their heads on the same side while they are awake, they can become flattened due to pressure on the back of their head.
2. Synostotic Brachycephaly: This is a little different. This condition is caused by a condition called ``Craniosynostosis.'' Simply put, the bones of the baby's skull fuse together before they should. This is a congenital condition, meaning it can be present at birth. This is a condition that requires some attention.
How do you know if a baby has Brachycephaly? What are the symptoms?
The main feature is that the back of the baby's head is flat. Sometimes the head may appear wider than it is long from front to back. You may look at your baby and think, "Oh, doesn't that look a little too wide?"
Another thing is that about nine out of ten babies with this condition will also have a condition called ``Torticollis''. This affects the baby's neck muscles. As a result, the baby's head may be twisted and tilted to one side. It may also be a little difficult for the baby to turn to the other side.
Why does this happen (Brachycephaly)? What are the causes?
The main reason for this is the constant pressure on the back of the baby's skull. A baby's skull is very soft, isn't it? And it's designed to be a little flexible. The reason for this is that the baby's brain needs room to grow. However, because of this softness, if constant pressure is placed on the same spot on the skull, the shape of the head can change.
Causes of Positional Brachycephaly
This type (Positional Brachycephaly) usually occurs within the first three months of a baby's life. There are several common causes that contribute to this:
- Prolonged face-up sleep: As mentioned earlier, if your baby is always face-up while sleeping and/or awake, the back of their head can become flat. But remember, to protect your baby from SIDS , you should definitely put your baby to sleep on their face-up.
- Problems before birth or during labor: Sometimes, if there is not enough room for the baby inside the mother's uterus, or if there is not enough amniotic fluid to protect the baby's head, this condition (Positional Brachycephaly) can occur before birth. Also, if the baby's birth takes too long, it can also be a cause.
Consider this: Premature babies, meaning babies born before their due date, are at higher risk of developing this condition (Positional Brachycephaly). This is because their skulls are softer than those of a normal baby. Also, it takes a while for their neck muscles to become strong enough to turn their heads from side to side.
Causes of Synostotic Brachycephaly (rapid fusion of skull bones)
This type of (Synostotic Brachycephaly) is caused by a condition called ``Bicoronal Synostosis'', which is a specific type of ``Craniosynostosis.`` Craniosynostosis`` is the premature fusion of the bones of a baby's skull. ``Bicoronal Synostosis`` affects the bones on either side of the baby's skull.
It is difficult to find a specific cause for most babies with craniosynostosis. Sometimes, it can be caused by a random genetic change (gene variation), or someone in the family may have the condition and pass it on.
In other cases, certain factors during pregnancy may increase the risk of a baby developing craniosynostosis. Some examples are:
- Some fertility drugs, for example `(Clomiphene (Clomid®))`.
- Thyroid disease in the mother during pregnancy.
- Premature birth.
What complications can occur if brachycephaly is not treated properly?
The main complication that can occur if positional brachycephaly is left untreated is aesthetic concerns. That is, the shape of the head looks slightly different. However, this type of brachycephaly rarely affects the baby's brain development. So there is nothing to worry about.
However, if the condition caused by the rapid fusion of the skull bones (Synostotic Brachycephaly) is not treated, or if the pressure inside the skull (`(Intracranial pressure)`) increases, the following can happen:
- Developmental delays in the baby
- Seizures, such as seizures
- Permanent head or facial deformities
Therefore, if you have Synostotic Brachycephaly, you should definitely seek medical attention immediately.
How does a doctor diagnose brachycephaly?
The first thing your baby's pediatrician will do is examine your baby carefully. They will want to know if this is a positional condition or a synostotic condition caused by the bones of the skull fusing together too quickly.
The doctor will carefully feel the baby's head, looking for any hard edges where the bones of the skull meet, and for any abnormally soft areas.
Generally, if the head has hard edges, it is more likely to be the (Synostotic) type. If there are no hard edges, and the head is just flat, it is more likely to be the (Positional) type.
Most of the time, a physical exam like this can diagnose the condition (Positional Brachycephaly). However, if your doctor is in doubt, they may order imaging tests.
If your baby has symptoms of the condition (Synostotic Brachycephaly), you will definitely need imaging tests to confirm it. This may include one or more of the following:
- Skull X-ray
- A CT scan of the head
- An ultrasound or MRI (especially if there is a suspicion of a condition such as hydrocephalus, i.e. fluid accumulation in the brain)
How is Brachycephaly treated?
Treatment for brachycephaly depends on the type and can range from changing the baby's position to surgery.
Treatment for Positional Brachycephaly
For many babies with this condition (Positional Brachycephaly), the condition improves spontaneously over time, as the baby's skull develops and they begin to roll over and squirm.
In the meantime, your pediatrician will teach you how to reposition your baby's head. This can help reduce pressure on the back of your baby's head while they sleep and throughout the day. For example, your doctor may tell you to do things like:
- Tummy time: This strengthens the baby's neck muscles and reduces pressure on the back of the head. Do this for short periods of time, several times a day.
- Placing the baby in different positions: sometimes in a reclining chair, sometimes in a sling, sometimes on a flat surface.
- Switching sides when breastfeeding and holding your baby: Don't always hold your baby on the same side, switch sides.
- Reduce the amount of time your baby spends on hard, flat surfaces, such as in a car seat or stroller: If possible, use a sling or front-facing carrier.
Remember one very important thing: The safest way for your baby to sleep, both during the day and at night, is to put him or her on his or her back. Don't change that.
There are other treatments:
- Massage therapy: Your pediatrician can teach you how to gently massage your baby's head.
- Physical therapy for torticollis: If your baby has difficulty turning their head, you can do things like exercises that help relax and strengthen the neck muscles.
- Helmet therapy: In this, the baby is given a specially designed helmet to wear for several weeks. This helmet helps to reshape the baby's skull. However, pediatricians recommend this helmet therapy only for very severe cases.
Treatment of Synostotic Brachycephaly (a condition caused by the rapid fusion of the skull bones)
Surgery is an essential treatment for the condition (Synostotic Brachycephaly). It will not improve without surgery. This surgery is usually performed before the baby is one year old.
This skull surgery (`(Skull surgery)`) does the following:
- The baby's skull is being reshaped.
- Reduces increased pressure inside the skull (intracranial pressure).
- It allows the baby's brain to develop properly.
There are different types of skull surgery. Your surgeon will decide which surgery is best for your baby's specific condition. They will explain the pros and cons to you. So don't hold anything back and ask questions.
After surgery, the baby will likely need helmet therapy. He or she may need to wear a specially designed helmet for about a year after surgery.
When should I see my baby's doctor?
If you have any concerns about the shape of your baby's head, or if your baby is having difficulty turning their head, be sure to see a pediatrician. Also, if your baby has a seizure for the first time, take them to the hospital immediately.
Not only that, but be sure to take your baby to well-baby care appointments at regular intervals. That way, the doctor can regularly check the shape of your baby's head and overall development.
Can adults have brachycephaly?
Yes, adults can have brachycephaly. If the condition does not improve on its own during childhood, or if it is not completely cured with treatment, the flat head can persist into adulthood. This can cause self-esteem issues in some adults. If the back of the head is flat, it can be embarrassing.
If you are an adult and you are feeling stressed because of this condition, see your doctor or a mental health counselor . There are some treatments for this too.
Finally, something to consider.
When you think your baby has a problem, especially if it's something obvious like a flat head, it's normal to feel a little worried. Take a deep breath and calm down. The important thing to know is that brachycephaly is very common and often temporary. However, if you have any concerns about the shape of your baby's head or any other problem, it's best to see a doctor. The doctor can perform a simple examination of your baby's head and advise you on treatment options.
` Brachycephaly, Flat Head, Baby's Head, Scalp, Craniosynostosis, Positional Plagiocephaly, SIDS
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