The Infant Skull, Brain and Development - Flattening and Misshaping Plagiocephaly

8/3/2019 The Infant Skull, Brain and Development - Flattening and Misshaping Plagiocephaly

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The Infant Skull, Brain and Development

Flattening and Misshaping(Plagiocephaly)

Newtown Community Chiropractic

Level 1, 241 King Street

Newtown, 2042

p: 02-9519-4729

[email protected]


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The Infant Skull, Brain and Development - Flattening and Misshaping (Plagiocephaly)

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THE NORMAL CRANIAL BONES

Pregnancy, the birth process, and early infancy, can have long-term effects on your childs health.

The sutures and fontanelles allow the bones of the cranium to overlap one another during the birth

process as they compress when entering the birth canal.

This process is called molding and the cranial bones should resume their normal shape within one

week of the birth.

The cranium will take on a rounded appearance in which the skull itself will be much larger in relation

to the facial structure.

The delicate nervous system in infancy is protected not by bone but by cartilage. The cranium itself at

this stage of development functions as membranous tissue in a constant state of flux.

It is constantly expanding and realigning to adapt to the extremely rapid growth of the brain during the

first 3 years of life.

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Shape of Skull

Temporary asymmetry is usual after birth and the shape should return to normal within 10 days.

Cesarean section infants usually have a more symmetrical cranial presentation due to lack of cranial

molding while passing down the birth canal. This is not necessarily a good thing and cranial

compression and molding techniques are usually called for.

Plagiocephaly the flattening or misshaping of the bones of the skull - is usually caused either by the

position of the baby in third trimester (with the head crammed against the pelvis) or through birth

trauma (forceps, suction or manual stress). It may be accompanied by torticollis (the head held to the

side).

Suspect plagiocephaly if:

There is any flattening or misshaping of the bones of the head or a bald spot The head is held to one side or rotated to one side or the baby prefers to turn the head to one

side

The shape of the face is asymmetrical When looking at the head from above, one ear appears further forward than the other

Having completed post-graduate studies in paediatrics, we have specific techniques for helping babies

fire up their brain. There are many things we can do, and specific advice we can give parents, to

increase brain function.

Every pregnant woman should be checked, to make sure she can have her ideal birth.

Every baby should be checked, to make sure it gets the best start to life.

Who do you know who has not been checked?


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ENCOURAGING BRAIN DEVELOPMENTAL

Pregnancy, the birth process, and early infancy, can have long-term effects on

your childs health.

Early brain development is key to your childs lifelong health and success. It is

an important pathway to lifelong learning, behavioural competence, positive

social relationships and health.

Your baby starts perceiving its environment in-utero:

Touch develops in the 8th week, then next taste and smell Balance develops just after the first trimester - this makes it crucial for

the pregnant woman to keep moving, so that the developing brain is

exposed to constant movement input

Early vision then develops, with baby opening its eyes in-utero Hearing develops near the end of the second trimester

For healthy development, the babys brain needs mum to be as healthy aspossible. The 5 things you need to do to be as healthy as possible in the

pregnancy:

1. Live a healthier nutritional lifestyle - provide your body with the rightnutrient building-blocks

2. Exercise more- movement is vital for your health and for your baby sgrowth

3. Be adjusted regularly, by a wellness family chiropractor4. Choose a wellness pregnancy provider - a doula or a midwife5. Be inspired and learn. Pregnancy and birth are not like anything youve

done before

At birth, your babys brain is small, compared to the rest of its body and

compared to how developed the brain will become. In fact, in your babys first

month of life, its brain increases its number of connections 30-fold! This huge

growth in brain-power is driven by your baby s experience of the world,

through movement and stimulation.

When the brain is not functioning at its optimum, we see:

a wired unsettled baby (crying; digestive, sleeping & feeding issues;overly sensitive)

coordination issues learning difficulties emotional issues

Having completed post-graduate studies in paediatrics, we have specifictechniques for helping babies fire up their brain. There are many things we

can do, and specific advise we can give parents, to increase brain function.

Every pregnant woman should be checked, to make sure she can have her

ideal birth.

Every baby should be checked, to make sure it gets the best start to life.



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DEVELOPMENTAL DELAY & PLAGIOCEPHALY

The birth process, and early infancy, can have long-term effects on your

childs health.

The most basic part of your babys brain - the brainstem - is responsible for

your babys function during pregnancy and immediately after birth. This part of

the brain controls your babys development, breathing, heart and digestion.

The brainstem can often be stressed by birth, even a vaginal birth, with the

tension and trauma of pulling on the babys head.

Plagiocephaly is the misshaping or deformation of the head, present from

birth. It may be the result of either the baby s head being stuck in the wrong

position in-utero, often for a long period of time in third trimester or as a result

of the birth process. Birth may cause the babys head to be constantly pushed

with every contraction against a part of mums pelvis or pubic bones, or

trauma is associated with forceps, suction and caesarian births. Either cause,

from constraint in utero or birth trauma, affects the shape of the babys

cranials (skull bones). Contrary to popular belief, the research shows that this

deformation does not work itself out and is not just aesthetic. Plagiocephaly

affects brain function and development and may result in decreased cognition

and coordination. Plagiocephaly is a significant public health issue, because

of the common misconceptions that it is an aesthetic misshaping that will

clear up by itself, whereas in reality the research shows that it actually affects

brain function.

Both brainstem tension from birth and plagiocephaly may cause the baby to

be unsettled. Research also shows that brainstem stress and plagiocephaly

can cause developmental delay, affecting cognition and coordination.

A wired or unsettled baby may have:

unexplained crying that may be high-pitched or not calm easily

digestive issues sleep difficulties feeding issues overly sensitive

Developmental delay may be noted by kids finding it hard to sit still, focus, cut

with scissors or use glue.

Growing brains need three things:

6. Oxygen: physical activity and healthy breathing are crucial7. Fuel: healthy nutrients are the building blocks8. Activation: the brain needs to have healthy input from the senses and

a good level of firing.As chiropractors, we check all of these things early on: how your baby is

breathing, that its nutrient requirements are met, and that the brain is

receiving the correct inputs from the senses and processing those, being

activated well.

Having completed post-graduate studies in paediatrics, we have specific

techniques for helping babies with brainstem tension, plagiocephaly or

developmental delay. There are many things we can do, and specific advise

we can give parents, to increase brain function.

References:

1. Yeargin-Allsopp, Murphy, Oakely & Sikes 19922. Drillien, Pickering & Drummond 1988, Glascoe & Shapiro 1999 3. Child Care in Practice. Vol 11:4 2005:415-432

About 17% of

children have

developmental

delay.1

Many are not

detected before

school entrance.2

Children withimmature physical

development

performed less

well on measures

of educational

achievement... 3


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PLAGIOCEPHALY (FLAT HEAD) INCREASED INCIDENCE OF THIS SIGNIFICANT

PUBLIC HEALTH ISSUE

Medical professionals have begun to notice an alarming rise in the incidence

of a skull deformity in infants called flat head syndrome. Plagiocephaly, the

medical term for this flattening of the skull, can occur as a result of consistent

pressure on a particular spot. It is a condition that can be permanent if not

cared for early on.

The increase in plagiocephaly is frequently blamed on the fact that babies are

now placed on their backs to sleep, in an attempt to prevent sudden infant

death syndrome (SIDS). If a babys head is always in the same position, the

pressure can deform the skull. There has been a dramatic increase in

plagiocephaly since the Back to Sleep campaign was launched to prevent

SIDS the rate of plagiocephaly rose 5 times in the first 5 years of the

campaign.1

However, back-sleeping is not the only factor. Extended periods of time spent

in a baby seat can also contribute to this condition, as can long periods in

strollers, swings, and other devices that put babies in a back-lying position.

Thomas R. Littlefield, M.S., is affiliated with an Arizona clinic that treats

plagiocephaly. In an article in the Journal of Prosthetics and Orthotics, he

notes that 28 percent of infants who attend the clinic spend 1.5 to 4 hours

daily in car seats or swings, and nearly 15 percent are in them for more than

four hours per day. Another 5 percent of infants are allowed to sleep in these

devices. Littlefield observes that cranial distortion resulting from overuse of

car seats and swings is more severe and complex than in children who

develop plagiocephaly from back-lying on a mattress. Consequently, herecommends reducing the time spent in car seats and swings, if possible.

Concern over plagiocephaly also led the American Academy of Pediatrics to

suggest in 2003 that infants should spend minimal time in car seats (when

not a passenger in a vehicle) or other seating that maintains supine

positioning.

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2 2 22 2When infants must be in a back-lying position, moving their heads occasionally can help reduce pressure and avoid

developing a flat spot. The simplest and most effective prevention, however, is to decrease the cumulative time an

infant spends on her back.

Plagiocephaly the flattening of the skull bones is not just aesthetic. Even though some parents may be advised

that it is only an aesthetic concern that is mostly covered up when the baby grows a full head of hair, recent

research shows that it also affects the brain and, in turn, the baby s functioning and health.

Suspect plagiocephaly if:

There is any flattening or misshaping of the bones of the head or a bald spot The head is held to one side or rotated to one side or the baby prefers to turn the head to one side The shape of the face is asymmetrical When looking at the head from above, one ear appears further forward than the other


1. Hummel et al. Advances in Neonatal Care. 2005


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PLAGIOCEPHALY: WHAT TO DO

Plagiocephaly, the flattening or misshaping of the cranials (bones of the skull) is not just an aesthetic

problem. This misconception, that it is purely aesthetic and not a concern, is a significant public health

issue.

Recent research shows that plagiocephaly is associated with early neurodevelopmental

disadvantage (developmental delay)1. As another research states, such developmental delays maynot be significant enough to be noticed until school, as it comprises developmental difficulties

presenting as subtle problems of cerebral dysfunction during the school-age years.2

The research shows that the possible dysfunctions associated with plagiocephaly may include motor

dysfunction3

(movement), hearing changes4, decreased mental and psychomotor

abilities

5, general

nervous system changes6, vision

7and middle ear infections

8.

The conclusion of recent research is that plagiocephaly compromises the brains function, affecting

cognition and coordination of the body, resulting in a host of decreased performance throughout the

body.

Chiropractic Care

The aim of care for a baby with plagiocephaly is not purely physical aesthetics. Theobjective is to improve neurological function, which will result in greater control of the brain

over the bodys functions. Restoring full neck movement increases the amount of visual

and auditory input to the brain, resulting in higher stimulation and functioning of the brain.

Chiropractic care includes information, advise and empowering the parents to take active

care. Visit to visit, chiropractic involves decreasing the tension in the body, so that

movement is freer and there is less stress on the system, as well as balancing the

movement in the cranial bones (the bones of the skull) so that the brain has more room to

develop symmetrically and reach its potential. Maintaining motion in the cranial bones

means that as the brain grows, the skull grows in symmetry.

As chiropractors, we check all of the warning signs early on: how your baby is breathing, that its

nutrient requirements are met, and that the brain is receiving the correct inputs from the senses andprocessing those, being activated well. We check for movement and position of the baby s skull bones,

for tension in the brainstem and for developmental milestones and primitive reflexes, to see that your

babys development is age-appropriate.

Home-care

When settling, pat the baby on the bottom, while holding bub vertically up on the shoulder Minimise light and sound input Wrap the baby to comfort in sleep Settle bub by holding your child in your hands while youre gently bouncing on a gym ball Use gentle deep pressure squeezing on the baby s arms and legs, to calm the baby Encourage a lot of tummy time (specific exercises are given by the chiropractor)


References

1. Case-Control Study of Neurodevelopment in Deformational Plagiocephaly. Speltz et al. Pediatrics 2010 Feb2. Long-term developmental outcomes in patients with deformational plagiocephaly. Miller et al. Pediatrics 2000

Feb

3. Are infants with torticollis at risk of a delay in early motor milestones compared with a control group ofhealthy infants? Ohman et al. Dev Med Child Neurol. 2009 Jul

4. Auditory ERPs reveal brain dysfunction in infants with plagiocephaly. Balan et al. J Craniofac Surg 2002 Jul.5. Neurodevelopmental delays in children with deformational plagiocephaly. Plast Reconstr Surg 2006 Jan.6. Neurologic findings in infants with deformational plagiocephaly. Fowler et al. J Child Neurol 2008 Jul.7. Visual field defects in deformational posterior plagiocephaly. Siatkoski et al. J AAPOS 2005 Jun8. Incidence of otitis media in children with deformational plagiocephaly. Puzycki et al. J Craniofac Surg 2009

Sep.

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The Infant Skull, Brain and Development - Flattening and Misshaping Plagiocephaly