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Deformational plagiocephaly, or flattening of the head, is an increasingly common condition in infants since the “Back to Sleep” program was initiated to help combat SIDS. Children do tend to grow out of deformational plagiocephaly as they become more mobile, with incidence reported at high as 47% of infants 7-12 weeks old (Mawji et al., 2013) and dropping to less than 5% at 2 years old (Hutchison et al., 2004).

Contrary to popular belief, however, plagiocephaly is not simply a cosmetic issue – multiple studies have demonstrated evidence of developmental delay across the ages of children with an infantile history of plagiocephaly, including language, fine motor, gross motor, and auditory and visual processing. They also had a significantly higher rate of needing special help in school.  (Hutchsion et al., 2009)

Stellwagen et al., (2008) demonstrated a very high incidence of abnormal neck range of motion in infants with plagiocephaly. Lelic et al., (2016) found altered afferentation and cortical activity to be associated with neck dysfunction. Haavik & Murphy (2012) have demonstrated that improved cervical spine function can improve proprioceptive input to the brain.  Haavik has published multiple studies demonstrating the impact of chiropractic care on brain function.  A study demonstrating how chiropractic care affects brain function in infants and children still remains to be done.

A chiropractic study (Davies, 2002) demonstrated significant improvements in plagiocephaly after just one adjustment. Further research is needed to understand the direct benefit of chiropractic care on the resolution of plagiocephaly, and developmental outcomes.

All infants (and children) with plagiocephaly should be checked by a suitably trained chiropractor for neck function to optimise growth and development. Should patients be interested in contributing to research in this area, please visit the website for the Australian College of Chiropractic Paediatrics: http://accp.asn.au/research/.

 

References:

  • Davies, N.J. (2002). Chiropractic management of deformational plagiocephaly in infants: an alternative to device-dependant therapy. Chiropractic Journal of Australia, 32(2), 52-55.
  • Haavik, H. & Murphy, B. (2012). The role of spinal manipulationin addressing disordered sensorimotor integration and altered motor control. Journal of Electromyography and Kinesiology, 22(5), 768-776.
  • Mawji A., Vollman A.R., Hatfield J., McNeil D., & Sauve R. (2013). The incidence of positional plagiocephaly: a cohort study. Pediatrics, 132(2), 298-304.
  • Hutchison, B.L., Hutchison, L.A., Thompson, J.M., & Mitchell, E.A. (2004). Plagiocephaly and brachycephaly in the first two years of life: a prospective cohort study. Pediatrics, 114, 970-980.
  • Hutchison, B.L., Stewart, A.,W., & Mitchell, E.A. (2009). Characteristics, head shap measurements and developmental delay in 287 consecutive infants attending a plagiocephaly clinic. Acta Paediatrica, 98, 1494-1499.
  • Lelic, D., Niazi, I.K., Holt, K., Jochumsen, M., Dremstrup, K., Yielder, P., … Haavik, H. (2016). Manipulation of dysfunctional spinal joints affects sensiromotor integration in the prefrontal cortex: a brain source localization study. Neural Plasticity, 1-9.
  • Stellwagen, L., Hubbard, E., Chambers, C., & Lyons Jones, K. (2008). Torticollis, facial asymmetry and plagiocephaly in normal newborns. Archives of Disease in Childhood, 93, 827-831.