Cranial Technologies

What is the difference between plagiocephaly and brachycephaly? These words and conditions sound similar, but each presents its own unique characteristics. Plagiocephaly and brachycephaly are two types of Flat Head Syndrome. While they can be addressed in many of the same ways, parents may notice a specific head shape and characteristics associated with each. Let's break it down and look at the differences between the two.

Plagiocephaly, often called Flat Head Syndrome, is a condition where a baby develops a misshapen area on the head. Plagiocephaly is common, 1 in 2 babies has some degree of plagiocephaly, and 1 in 4 babies falls in the moderate to severe range of flattening. Plagiocephaly can be identified by the head looking like a parallelogram from the top, with flattening to one side of the back of the head and flattening to the opposite side in the front of the head. There also may be ear and facial asymmetries. Parents should check early and often for signs of plagiocephaly, as early intervention is the best way to ensure the optimal outcome for your child.

Brachycephaly, similar to plagiocephaly, is when a baby develops a flat spot on the head. However, in brachycephalic head shapes, the flattening occurs symmetrically to the back of the skull. This flattening causes the head to become shorter and wider, leading to a flat back of the head. Alternatively to the skewing of facial features seen in plagiocephaly, infants with brachycephaly, present with an increased width-to-length ratio and increased posterior head height. With increased width to the head, facial features may seem disproportionately small in comparison.

The biggest difference between plagiocephaly and brachycephaly is where flattening is located. Babies with plagiocephaly have asymmetrical flattening to one side of the back of the head and flattening to the opposite side in the front of the head, which can include facial asymmetries. In comparison, babies with brachycephaly have flattening across the back of the head with increased width-to-length ratios and increased posterior head height. Untreated plagiocephaly and brachycephaly can result in noticeable facial asymmetry and disproportion of the head which is believed to be retained into adulthood.

Often plagiocephaly and brachycephaly go hand in hand. Many babies have a plagiocephaly-brachycephaly combo head shape, where the head is flattened on the back and also skewed to one side.

Physical therapy and helmet therapy are used to treat plagiocephaly and brachycephaly. Physical therapy is prescribed to treat neck tightness, positional preference, and developmental delay, which can influence head shapes. It is often used as a conservative measure before proceeding with helmet therapy. Physical therapy is most effective before four months old. Helmet therapy is often prescribed to babies with moderate to severe flat spots. Helmet therapy is very effective at treating flat spots, gently correcting the head shape through the use of a lightweight band. Helmets, like the DOC Band, are non-invasive and correct the baby's head shape without disrupting their daily routine.

Understanding the differences between plagiocephaly and brachycephaly helps caregivers understand the factors contributing to their baby’s head shape and the steps they can take to address it. Treatment options for both plagiocephaly and brachycephaly often include physical therapy, repositioning techniques, and in some cases, the use of a cranial helmet. Early intervention can make a significant difference in outcome, so be sure to discuss any concerns with your baby’s pediatrician. Cranial Technologies offers consultations with highly trained healthcare professionals at no cost to you, so you can fully understand your baby’s head shape, and make the most informed decision for your family.