Episode 15
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Welcome to the Create Thriving Families Podcast. I'm your host, Lisa Peterson. I'm a doctor of chiropractic and I've been in private practice for 20 years seeing mostly women, babies, and children. The Create Thriving Families Podcast is a place for us to have a conversation about how we can help our children become the healthiest, most vibrant and aligned version of themselves.
The full expression of who they came here to be. The quality of our lives and the quality of our relationships is dependent on the quality of our health, and I believe that the greatest gift any of us could give to our children is the best start possible when it comes to their own health. I can't wait to see where this journey takes us.
Let's get started.
Today I wanna talk about something that I see in my practice every single week, [00:01:00] and that is also I, in my opinion, one of the most misunderstood conditions in the first year of a baby's life. I wanna talk about Plagiocephaly or what a lot of people end up calling it Flathead syndrome. This is, this is a flattening of typically.
The back of the head, although it can happen anywhere in the cranium, sometimes it's on the right side, sometimes it's on the left side, and sometimes the baby has a flattening just directly in the middle of the back of the head. And the reason why I wanna do an episode on this is because the conversation that's currently happening around Plagiocephaly.
Is, it's usually around the way that it looks. And I understand that because the head shape is sort of the part that you can see, but the head shape is not actually what's most [00:02:00] important here. The shape of the, the head, , that's the alarm bell. , That's the, the symptom. Letting you know that there's something deeper.
Underneath. And there's a lot of really important information, uh, there underneath that alarm bell that I think that every single mother needs to have sort of laid out in kind of plain language. Whether you are pregnant right now, whether you are postpartum, and you're looking at your baby and you're wondering .
What you're seeing, or if somebody's maybe already told you that your, your baby has a flattening of their head and you're trying to figure out what to do about it. So that's where we're headed today. I wanna talk about what Plagiocephaly actually is, why we're seeing so much more of it than we used to.
What kind of risk factors start as early as some of them as early as pregnancy? [00:03:00] And what the research on Plagiocephaly tells us about the long-term picture, and most importantly, what we should be doing about it, both to prevent it and to help your baby if you can see that they're developing or have a flattening of the cranium.
This is one of those topics where I think that the more we know, the better equipped we are as parents to be the leaders in creating health for our families. So plagio definitely is kind of a complicated word. It's a Greek word. Plagio means slanted, and ke means head. So it's a slanted head. The way that we use it in more modern clinical terms, it just means that the head has.
Flattened the cranium has flattened asymmetrically most often on one side of the back of the skull. As I said before. There are two sort of [00:04:00] categories underneath Plagiocephaly that you should know about. They're very different from each other. The first one is called Craniosynostosis. This is when one of the seams of the skull, the sutures in the skull fuses too early.
It's a structural problem. It's pretty rare, and it almost always needs surgical and surgical evaluation. So this is not what most of the babies who are in my practice are dealing with. So we're gonna set that aside. And the second one, and that's the one that we're really talking about today, is called Def Reformational Plagiocephaly.
Sometimes it's called positional plagiocephaly. This one is different. This one is not about the bones fusing. Wrong it. This is about pressure. External pressure on a baby's soft growing skull during the months when the skull is at its most malleable. This is roughly the last few weeks of pregnancy and through the first [00:05:00] about six months of life and.
One thing that I think is important for mothers to understand is that a baby's skull is not like a hard helmet. It's a soft structure that's designed to deform and reshape, and that's actually a feature, not a defect. It's, it's how they're, you know, able to move through the birth canal. It's how the brain has room to grow at the speed that it needs to grow in that first year, but.
That same softness that is the cranium. It means that if a baby is spending hours and hours and day after day with the same part of their head pressed up against the same surface, the skull is going to respond to that pressure. It's going to flatten. Sometimes that flattening is on one side of the back of the skull, that's plagiocephaly asymmetric, and sometimes it's all the way across the entire back of [00:06:00] the head, and that's called brachycephaly.
In the medical literature, you'll see them usually lumped together as PPB, which just stands for positional, plagiocephaly and brachycephaly. So. Here's a number that usually surprises a lot of parents. Um, in one of the largest prospective studies that we have on plagiocephaly, which is out of New Zealand researchers followed 200 healthy full-term babies from birth.
And at six weeks of age, 16% of those babies already had measurable plagiocephaly, and by four months it was almost 20%. So one in five babies. By their second birthday, the majority of these babies had largely, uh, a cranial form that had come back to the normal range, but in that critical first half of the first year [00:07:00] of life.
This was happening to one out of every five babies in the developed world. So this is not a rare condition, and the reason that it's not rare is, in my opinion, the most important part of this whole conversation. So let's talk about why we're seeing so much of this, and if we go back to the old days for a second.
And by, by the old days, I don't mean back in the caves this time, which is what I've referred to as the old days in other podcasts, but let's go back about 30 years ago, because before about 1990 plagiocephaly was pretty uncommon and the numbers were nothing like what we, those of us who are seeing this in clinical practice, what we're seeing now.
In 1992, the American Academy of Pediatrics put out the recommendation for babies to be [00:08:00] put to sleep on their backs. They called it the back to sleep recommendation. And of course, I wanna say, you know very clearly that. The recommendation has had a huge impact on SIDS rates, sudden infant death syndrome rates, which dropped dramatically when people were, uh, informed and educated on having their babies sleep on their backs.
So of course, that's important. In my opinion, there is a difference between how babies sleep at night when you are also sleeping, and how they lay to sleep during the day when you're awake and right next to them. There are lots of babies who sleep on their stomachs up against their mother's chest during the day, and obviously they have their heads turned so that they can breathe.
And I also see lots of babies who, for one reason or another, have a hard time with. Reflux or neck pain or stiffness. And when they lay on their backs, [00:09:00] um, they have an increase in pain. And so they settle easier and they sleep better when they're on their sides. And I talk to all parents about how to let them, how to do this and how to let them nap safely on their sides when you are next to them and you yourself are awake.
But at nighttime, the safest has clearly been shown to be sleeping on their backs. The problem is that there was an unintended consequence that nobody was tracking in the original studies, and that consequence was that. Babies, were now spending almost every sleeping hour and a fair amount of their waking time as well on their backs, the same part of the skull, the same surface, hour after hour, night after night.
And in the 10 years that followed this recommendation in 1992, the rates of plagiocephaly went up five to six times. So a five to six fold [00:10:00] increase as a result. And that's not the entire story because over those same decades, there were a lot of, you know, we all added a lot of containers to modern babies' lives, car seats, car seats that they could be, you know, used as carriers clicked into strollers.
Um, and then, you know, sit in those same seats while you make dinner. Bouncers swings, rockers. The average modern baby in 2026 is spending a huge percentage of their, the hours that they're not sleeping in a hard or a semi hard surface that holds the back of their head against something, and that's a mechanical load on a soft skull, hour after hour.
And on top of that, we've dramatically reduced the amount of time babies are laying on their stomachs, tummy time. There are [00:11:00] babies in my practice in 2026 whose first real focused, significant experience of laying on their stomachs during the day doesn't happen until they're four or five or six months old.
And their cervical spines are weak and their visual systems haven't been challenged the way they need to be, and the back of their skulls have been under pressure for, at that point, close to half a year already. So. This is what I want every parent to hear in this because the rise in this condition plagiocephaly the flattening of the back of the head.
It's not, it's not about negligent parents. You're, you didn't cause this. This is a, this is a well-intentioned recommendation that, you know, altogether change the mechanical environment of the modern baby. The more technology and the more devices and the more things we have. [00:12:00] That we put babies in during the day, the more we restrict their movement and have them laying in static positions, often with the back of their head pushed up against something.
And so knowing that is the first important thing to, to know what to do about it. One thing that a lot of parents are never told is that PGI ly doesn't always start at birth. For a percentage of these babies, the conditions for plagiocephaly are being said in the third trimester in utero. And if you're pregnant right now and listening to this, this part is significant.
The risk factors that the research has consistently seen in terms of what can affect or increase your risk of plagiocephaly during pregnancy. The first one of those is uterine constraint. Anything that limits the space that your baby has to move and to shift and to [00:13:00] rotate during the last weeks of pregnancy increases the risk of a baby getting stuck in one position.
And that includes first time pregnancies where the uterus and the abdominal wall haven't been stretched before. It obviously includes twins or triplets, where space is being shared and is it's tight in there and it includes, you know, if there's a small pelvis or fibroids or an unusually shaped uterus.
If there's a low amount of amniotic fluid, any of those things can take away the room that your baby needs to move freely. The second, uh, risk factor is a breach or a transverse position. Babies who spend the last weeks of pregnancy with their head stuck into one corner of the uterus or jammed against the, the pelvis at an angle, they're arriving in the world with a head that's already been molded by external pressure.
You know, sometimes, in some cases for weeks [00:14:00] before they were born. The third one is a big one, and that is torticollis or um, a tightness or an imbalance in, usually when it's defined, they, they talk about a tightness or an imbalance of the the SCM muscles, which is sort of the big muscle that you can see in the neck that goes from behind the ear to the front of the clavicle.
It's the muscle that turns and tilts the head and. We as chiropractors, as you know, one of few professions who are examining the function of the bones of the spine. In this condition, we often see subluxations or lack of proper function or proper mobility that then impacts the nerve function and the muscle function, both in the top of the neck and the lower part of the neck, as well as often down between the shoulder blades.
And when the function of the spine is lacking proper, healthy [00:15:00] movement and the muscles on the front and the back of the neck or between the shoulder blades are, are being shortened on one side or tighter on one side, your baby has a really strong preferred direction. To look. They lie that way. They sleep that way.
They feed that way. They have their head turned more in one direction. Sometimes they're not at all able to turn their head in the opposite direction. Sometimes they can a little bit, but they prefer to lay more rotated into one side and the back of the skull on the side that they prefer to have their head towards.
Takes the load and the research tells us that. Limited passive neck rotation at birth is one of the strongest predictors we have for Plagiocephaly developing in the first six weeks of life. So this is not something to take lightly. This is something to really be looking for. It's a huge amount of babies who have this condition.
I see it every single week in my practice, [00:16:00] and a lot of parents are told to stretch and mobilize the muscles of the neck. Almost, you know, force the baby to turn their head or bend their head in the direction of restriction. But that's both incredibly painful as anyone who's ever had torticollis themselves knows full well.
And it does nothing to impact the function of the spinal segments that are locked into a malposition or of the neurology that has the muscles protecting and splinting to protect the area. It usually takes months of working on the muscles to see a change. And at that point, the back of the head on that side is almost always flat in my office.
It typically takes, I would say, somewhere from three to five adjustments, sometimes a more, sometimes less, to see a full improvement in torticollis. Obviously, depending on the age of the baby and how long they've had it before the parents come and see me. But working on the function of the [00:17:00] spinal segments is, in my opinion, by far, the fastest way to make a change in torticollis.
The fourth risk factor for plagiocephaly developing during pregnancy is, or, uh, just after birth, is assisted delivery. If you have vacuum extraction forceps, uh, prolonged second stage labor, traumatic birth in general is correlated with both torticollis and an asymmetric head shape. The cervical spine of a newborn obviously is very sensitive and.
The forces of a difficult delivery can leave a baby with sometimes small, sometimes subtle restrictions in their neck that the parent can't necessarily clearly see, but the baby's body will. Respond for weeks or months after the traction or the pull on their spine and their heads. It can cause swelling.
It can cause restriction in the spinal segments, and it can have a really [00:18:00] big impact on the nervous system as a whole, causing a lot of muscle tension and stiffness, and usually a whole host of other problems. And the fifth risk factor during pregnancy is prematurity. Premature babies have softer, more pliable skulls for longer periods of time, and a lot of times premature babies are spending time in the, uh, neonatal ICU, usually laying on hard surfaces.
So their risk obviously is significantly higher. So what does this mean for you? Practically, if you're pregnant right now, it means that the. The work of thinking about doing things that are preventing plagiocephaly should start before the birth. You should be thinking about moving daily, making you know, space to stretch and to move in for, for your baby, you should be moving in asymmetric ways.
You shouldn't be [00:19:00] spending hours and hours during late pregnancy sitting at a desk chair or in a reclined seated position because. It's affecting how much space your baby has to move in. I think you should also consider finding a chiropractor who is trained in caring for pregnant patients and who is.
Trained in pediatrics and who has a, has a good grasp of assessing pelvic alignment. And the goal is to give your baby the most generous amount of room possible to find an optimal position. And I wanna make a quick note here, because I have been in practice for 23 years, and I think in all of that time I have had two, maybe three patients total.
Ask me if I'm any good at taking care of whatever condition or problem that they have. And it both makes me laugh when I hear it because it's so rare for anyone to ask. And I'm impressed because I think it, it takes a lot [00:20:00] of, you know, seeming audacity. It's not, it's not audacity, but it seems that way maybe to ask someone who has a bunch of diplomas and accolades hanging on their wall if they're any good, but it's exactly what you should be asking.
You should ask whoever you're going to see if they have specific training in this area. Have you seen a lot of other patients with this condition? You know, et cetera, et cetera. And the truth is that for those of us who have been in the game for a while, you know, we always send a new patient who should actually be seeing one of our colleagues who's better at whatever they're there for than we are.
We are always sending them immediately to another chiropractor or another health professional. So we don't need to be asked to do that. But you as a patient or the mother of a patient, you can't know that and you should be asking. And any healthcare practitioner who gets offended by being asked if there are any good probably isn't.
You should probably go find someone [00:21:00] else. And so. Back to the point of things to be thinking of in late pregnancy and the early newborn phase. Make a plan before the baby arrives for the early postpartum. If your delivery is assisted, or if it's prolonged, or if your baby ends up in a non-optimal position, you wanna have a clear plan for getting your baby evaluated for cervical and cranial restrictions in the first few weeks of life.
Don't wait six months when the flat spot is already there. Do it in the first few weeks. The window for correcting the situation easily is, is there in those first few weeks of life. And this is preparation and being proactive. And anybody who's been a patient of mine or who has listened to other episodes of this podcast knows I'm not a huge fan of the wait and see method.
This knowledge is exactly the kind of thing that I want every mother to have in her [00:22:00] toolbox before her baby is born. Plagiocephaly has been treated in a lot of conventional, uh, medicine as primarily a cosmetic concern, and. The reassurance that most parents get is they're told some version of, you know, don't worry about it, and this will round itself out and we'll check and see at the next visit.
Or, um, if it's really severe, and maybe more so in some countries than others, there could be discussions about, you know, using a helmet for some of these babies who really have a, a big deformity. That doesn't happen as much where I live and practice, but. This reassurance of that things will work themselves out.
It doesn't really tell you what the research has been pointing to pretty consistently over the last, about decade or more. There is, [00:23:00] uh, there's a research team at Seattle Children's Research Institute and the University of Washington, and it's led by a clinical psychologist whose name is Dr. Matthew Spel and.
Him and a number of other researchers and their team did something that nobody else had done. They, they enrolled 472 babies and 235 of them had Def Reformational Plagiocephaly, and 237 of them. We're in a control group, a demographically controlled group. So same socioeconomic status, same age, same demographics.
The only difference being one group had plagiocephaly and one group didn't, and then they followed those babies forward prospectively, all the way from infancy through school age. So what did they find in their research? Well, at. Six months of age, they gave both groups of babies [00:24:00] something called the Bailey Scales of Infant and Toddler Development.
This is a very widely used standardized infant development test that's used all over the world, and the babies with Plagiocephaly scored lower. Then the matched controls on every scale, so cognitive language, motor, all of them. And the biggest gap was in motor function. The motor scores for the babies with Plagiocephaly was about one full standard deviation below the control group.
And in standardized test terms, this is a meaningful difference. This isn't a small fluctuation. It's a meaningful discrepancy between those two groups. And then they came back and they retested these same children at 18 months and again at 36 months. And this is, it gets really interesting as you look at the differences later on in these children.
The motor differences started to [00:25:00] narrow a lot of the babies who had plagiocephaly caught up in their motor milestones given some time. But the cognitive and the language differences became more pronounced so. By age three, kids with a history of plagiocephaly were scoring lower on cognition, on language, and on parent reported adoptive behavior.
So from motor discrepancies as a baby into cognitive and language discrepancies as a toddler. And when they did the school age follow up at around age seven or age eight, this is where the story starts to get even more nuanced because the kids who had been mildly affected as babies had pretty much caught up.
Their school age scores looked pretty similar to the controls, but the kids who had been moderately or severely affected as babies were still scoring [00:26:00] lower than controls on cognitive measures and on academic achievement. There was a clear dose response signal the more severe the plagiocephaly was in infancy, the larger the school age gap.
And that paper came out in the Journal of Pediatrics in 2019, and then in 2022, the same research team came out with another paper showing that those moderately and severely affected kids were also showing modestly elevated rates of behavioral and social functioning concerns through school age. So the kids who were moderately and severely affected by plagiocephaly.
We're also having a higher rate of behavioral and social functioning concerns when they were in their school age. And there's one part that I wanna make really clear, because the research team was very careful about how they worded this. And I wanna make sure that [00:27:00] I honor the wording. And Dr. Spout and his colleagues, they're not saying that the flatness of the head causes the developmental gap.
What they're saying in paper after paper is that plagiocephaly is a marker. It's a visible flag for an underlying neurodevelopmental pattern that was already there. The, the most likely explanation, the one that I find most clinically useful is that. Subtle early neuromotor weakness. Things like having poor head control, having asymmetric muscle tone, having retained primitive reflexes.
Having a baby who doesn't move spontaneously and symmetrically. That's what allows the head shape to flatten in the first place. And then that same neuromotor weakness is what predicts the larger motor, cognitive and language differences that we see later on when the children are [00:28:00] 3, 5, 7 years old. So the flatness of the cranium is not the, is not a disease, the flatness is a symptom.
And the actual issue underneath, if I can put it. In the simplest way that I know how is a nervous system that didn't have what it needed to organize itself during those first six months of life. And that's why I think it's really important to talk about this because if we look at plagiocephaly as a marker, then a baby with a flathead is not just a baby with an aesthetic problem.
The that's, that's a baby whose nervous system is asking for help. So. What does the standard of care actually look like for these kids? Uh, what do we do about it? I think if we look at it from an integrated, um, evidence informed standard of care, I think [00:29:00] there's four pieces that are important to look at.
And these are four things that I work with in my own practice, and they're consistent. With both the, the chiropractic pediatric literature, the things that include Dr. Claudia Re's textbook, Dr. Peter Fish's textbook, and Dr. Joyce Miller's research at Bournemouth University, as well as the sort of broader pediatric and physical therapy clinical guidelines.
So. The piece number one, when looking at what to do with these babies who have plagiocephaly is to assess the cervical spine and the cranial base. And this is, in my opinion, the most underappreciated piece of the entire standard of care. Every single baby with Plagiocephaly should have a careful hands-on evaluation of their cervical mobility, the movement, and the function of the cranial base and the soft tissues of the neck and the shoulders, because.
In my clinical experience and in the chiropractic literature, [00:30:00] the majority of these babies have some kind of cervical restriction or torticollis pattern that's driving this preferred head position. And if your baby can't turn their head equally to both sides, I mean you, there's no amount of rearranging furniture that's gonna fix that problem.
The baby has to be able to physically turn their head. And that's a joint mechanics and a neurologic problem. And this is exactly what chiropractic, pediatric care exists to answer. So piece number two in the standard of care is thinking about repositioning, you know, choosing a lot of different environments and having your baby laying on their stomach.
As much as possible. The research on this is very clear. Babies need a significant amount of time that they're awake during the day laying on their [00:31:00] stomachs from the very first weeks of life. The goal here is building cervical strength, you know, increasing vestibular input, which is balance and coordination of eye movements, visual challenges, the foundation of.
Every single motor skill that comes after that is built during that time. And repositioning means that you are choosing pattern variation throughout the day for your baby. So you're alternating which side of the changing table their head is at and you're, which arm you carry them on. And. You know, changing sides when they're, when they're feeding, if you're feeding with a bottle, you still need to be changing sides and changing arms that you're holding them with so that they are having to rotate their head in different directions throughout, you know, for each of their feeds, holding them in different positions throughout the, throughout the day.
And the, the mechanical environment of modern day babies is really important [00:32:00] to think about because. As it stands today, it's very monotonous and repositioning is how we bring back variability that the developing nervous system really needs. I tell every single mother of a baby in my practice, babies need to be on the floor fighting for their lives as it often looks like for as much of the day as they possibly can, and they get frustrated and they get tired, and some days are easier to get them to comply than other days.
And I, of course, do not think you should leave a baby to cry on the floor, but I do think you can pause for a few seconds longer than your instincts are telling you to, and let them fight out the halfway roll or the toy that's just out of their reach or the, the pacifier that they flipped above their head and they can feel that it's there, but they can't manage to fully get ahold of it.
Give them some time and let them try. If you let them get a bit frustrated [00:33:00] and you don't come and save the day immediately, that frustration is the driving force that motivates babies into the next stage of motor skill. And it's really important that we as parents don't take away all of the opportunities for that frustration to drive them to the next stage of development.
Piece number three is pediatric chiropractic. When that's indicated, the evidence on conservative manual therapy for plagiocephaly and for torticollis is really encouraging. There was a 2020 synthesis of systematic reviews in the Journal of Chiropractic and Manual Therapies that found that manual therapy approaches stood out.
Among conservative interventions for producing the best results, Dr. Joyce Miller, who is at Bournemouth University, her research is part of that body of evidence and pediatric chiropractic care in someone who [00:34:00] has, is trained in that is really gentle. It's really low force. It's specifically aimed at restoring symmetric movement of the cervical spine in the cranial base and, and it's really the.
Um, one of the main drivers that allows sort of the rest of the standard of care to actually work. If you're working on repositioning your baby and having them lay on their stomach a lot during the day, but their neck isn't able to turn, you know, their head isn't able to turn to the right, how far you're gonna get with that is gonna be limited.
And I know that there's a lot of fear out there around chiropractic care for babies, and I think a lot of that comes with. Fundamentally misunderstanding what happens during a a, a visit to a pediatric chiropractor. What pediatric chiropractic actually is, it's not a smaller version of adult chiropractic.
The forces that are used are a fraction of an adult adjustment, and it's. It's often comparable to, [00:35:00] I say to my patients, the, the pressure you would use to push on your own eyeball or pushing on a ripe tomato, it's precise. It's gentle, and it's done by clinicians who are specifically trained in pediatrics post-graduate.
So asking around and finding a good pediatric chiropractor to assess your child if this is a situation that you're in. I think it's a really good idea. When it comes to, you know, every time you're reading literature about plagiocephaly, there's mention of helmet therapy. And first I wanna say that this is not a modality that's widely used where I have lived and practiced for the past 20 years Here in Norway.
It's, it's, um. Something that's hard for me to really have an opinion on because I, I, I don't think I've seen nearly any patients who've been had helmet therapy for plagiocephaly here. But one thing I wanna stress is that anything that [00:36:00] you're doing is, you know, something like that, that's looking to change the aesthetic of how the cranium is formed.
It's at least really important that the underlying motor pattern has been assessed and addressed. A helmet doesn't change torticollis, it doesn't build cervical strength. It shapes the skull while you're doing the other work. That actually makes a change in what the nervous system is doing. So if a helmet is something that's recommended for your baby, I think that's, that's a good time to ask what else you're planning to be doing alongside that to support the underlying motor pattern.
Um. So that it makes sense with all of the other parts, pieces of the puzzle that you're planning for assessing their cervical mobility and assessing, you know, how much time you're gonna have them laying on their stomach and the plan for any kinds of therapies that you're doing. This is a, a conversation that's, you know, integrating several ways of thinking and several [00:37:00] aspects, and I think it's really important for parents to feel empowered to have those conversations.
So again, um, if you're in the phase where you're listening to this, that you're, you're during pregnancy, I think it's really important. Like we said before, focus on moving daily. Make sure that you're creating an environment for your baby in utero where there's a lot of mobility and uh, you know, situations where that they can be, changing positions.
Find a good pregnancy and pediatric chiropractor in your area so you have someone that you can contact if you need them, and make a, make a plan before your baby arrives for, , what's, where is a place where you could take them to have them evaluated if you have questions, especially if you're delivery ends up being assisted or, or takes a really long time, and make a plan for ways that you can integrate.
Having a [00:38:00] lot of tummy time and having varied positions before the baby's here. It's really, you know, every single house here in Norway has hardwood floors. You have to have some kind of a, some kind of a mat or some kind of a place that you set up so that your baby can be laying on the floor because laying them on a cold hardwood floors, you're not gonna get them to stay there for very long.
You have to sort of set up the, your area so that it's conducive to having your baby be. On the floor as much as possible in the very beginning. So you have to think about some of those things. I think that, um. If your baby is in the first, three months of of life, look at the back of their head.
Look at their head from above. Watch which direction they turn their head to when they sleep, when they're feeding, when they're lying on their back. Look and see and try to notice if they have a strong preference. Some, a lot of babies that come to see me, they can, they can turn both ways, but they spend 75% of their time in one direction, and [00:39:00] those can be a little bit tricky to pick up sometimes because.
It's much easier if you have one who never turns their head from the midline to say the right side. But the ones who are able to turn their heads but have a preference for one of the sides, that can be a little, a little harder. You can look at things like if one of their ears is sitting, you know, farther forward than one of, than the other.
The earlier you see these things, the, the quicker you're able to intervene and the, the, the easier the path is forward. If your baby is between three months and six months and you can see that they have a flat spot in their cranium, this is the window. This is the time to get their cervical spine evaluated.
Be really diligent about having them on their tummies as much as possible. Think about varying the positions you hold them in and how they're laying on the changing table and the side that they're sleeping on when they're fa you know how, which way they're facing when they're [00:40:00] sleeping. Find a pediatric chiropractor or pediatric physical therapist, or a pediatric osteopath, somebody who can evaluate your baby for their spinal function and check their primitive reflexes and do a full detailed evaluation and also teach you about things that you can do in your home environment.
The published evidence is really clear that. Conservative care started early works, and if your baby's older than six months, it's important to know that your baby's nervous system is plastic, which means changeable. The window is not closed. It just requires a little bit more of a layered plan and maybe a little bit more time to be working that plan if the, if your baby's a little bit older.
The flat place that you can see on their head in almost every case is, you can think of it like a window into the nervous system that you can't actually see. And everything that we do, the cervical evaluation, the checking and following up [00:41:00] on primitive reflex integration, tummy time repositioning, all of this is with the goal to feed more input into the brain and.
And feed more be, you know, be working to improve the brain's, the vestibular function, the balance function, the strength of the cervical spine and the brain's ability to control and develop better movement and better control of the body, including the head and the neck. So that's the lens that I want you to think about out of this episode.
Plagiocephaly is not a cosmetic problem. It's a neurodevelopmental signal. And the standard of care in 2026 has to meet that signal with the the depth of the response that it deserves. So if this episode resonated with you, if it's something that you've been seeing with your own baby or in your own pregnancy, consider.
Following me on substack for more information like this, we [00:42:00] go, I go, I have articles and more information that goes more into depth in all of these issues and it's free to subscribe. So the link, I'll put the link for that in the show notes. If it's something that interests you in learning more about, it's the easiest way to make sure that.
You know, we can stay in conversation about this, a full reference list for every study and every clinician that I talked about during the episode is available in the show notes as a downloadable PDF, so that I'm citing all of my sources. And I think it's important if there's, you know, every mother who listens to this, if there's something that interests you, that you can read and research this for yourself and decide what it means for your family.
So. Thank you so much for being here. Thank you for listening, and I'll see you next time.
Thank you again for joining me today for this episode. I hope you found something valuable in the time we spent together, and I hope you'll join me again next week on the Create Thriving Families Podcast. Until then, be well.[00:43:00]
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