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"A British doctor claims to have created a new type of helmet that, in the event of an accident, can reduce the damaging effect of head rotation that often leads to brain injury.\nActing out of concern for his son, a keen motorcyclist, Dr Ken Phillips set out to design a helmet that replicated the head’s natural defenses. The skin’s ability to slip slightly over the skull normally moderates the sudden rotation of the head that typically leads to severe brain injuries even when the skull is protected from impact. Phillips’s design adds an artificial membrane to the exterior of a conventional helmet to mimic the slipping of human skin.\n“My son started the whole thing off,” said Phillips. “He told me that rotation was causing a lot of injuries that helmets didn’t protect against — and what was I going to do about it? As a doctor, I knew about head injuries but I had a bit of learning to do about helmet engineering.”\nAfter 15 years and £1m of research, the first range to employ the new Phillips Head Protection System (PHPS) has come to market — Lazer Superskin (lazerhelmets.com) helmets are available to buy for around $300. In tests conducted by the Louis Pasteur University in Strasbourg, the PHPS helmet was said to dissipate the effect of rotation during an impact by 60% compared with a top-end conventional helmet."

"The push to put babies to sleep on their back to reduce the risk of sudden death has led to an uptick in flat heads, but few cases need any intervention, according to the American Academy of Pediatrics.\nMost skull deformities in otherwise normal children resolve with just monitoring and counseling for the parents on positioning, a report from the AAP noted in the December issue of Pediatrics.\nOrthotic helmets to mold the head into shape should be considered only for severe cases of deformity or those that don't improve after 6 months of age, noted the writing committee, which was led by James Laughlin, MD, of Indiana University in Bloomington.\nSince the AAP started recommending putting infants on their back to sleep in 1992, the incidence of sudden infant death syndrome (SIDS) has fallen by more than half.\nBut positional skull deformity has risen drastically since then and now affects about 13% of healthy singleton babies, the report noted.\nParents often worry about it causing developmental delays, but there's no rigorous prospective evidence for a causal link, Laughlin's group pointed out.\nKeeping babies supine leads to some delay in early motor skill development related to upper body strength and rolling over, they acknowledged, but this resolves over time.\nClinicians should watch for skull deformity risk factors at birth, such as multiple births, large for gestational age, and breech or transverse position, and then screen for it at each well-child office visit up to age 1, the report recommended.\nParents can help prevent or resolve positional skull deformity by:\n- Placing the baby supine for 30 to 60 minutes of \"tummy time\" when the baby is awake and being watched\n- Alternating the position of the head when the baby goes to sleep each night\n- Periodically changing the direction the baby sleeps relative to active areas, such as the door to the room\n- Avoiding prolonged time spent in car safety seats and swings\nIn cases of torticollis, or \"wryneck,\" specific neck exercises should be done at each diaper change to stretch out the sternocleidomastoid and trapezius muscles.\nTwo to three months of these kinds of measures usually lead to improvement.\n\"There is currently no evidence that molding helmets work any better than positioning for infants with mild or moderate skull deformity,\" the AAP report emphasized.\nIn severe cases, helmets are best used from ages 4 months to a year.\nImaging studies are unnecessary for diagnosis of positional skull deformities in most cases, and can even be misleading, the authors noted.\nIn the interest of minimizing radiation exposure and possible need for sedation, imaging should be ordered by specialists rather than pediatricians or primary care physicians, and should typically be reserved for suspected craniosynostosis or cases requiring surgical intervention.\nSurgery is rarely needed, but may be indicated in severe refractory cases of positional skull deformity, the report noted. When it is needed, early surgery tends to take less invasive procedures.\nThe researchers declared that any conflicts of interest had been resolved through a process with the American Academy of Pediatrics Board of Directors.\nZalman S. Agus, MD Emeritus Professor\nUniversity of Pennsylvania School of Medicine and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner"

"For infants with congenital malformations of the ear, a treatment system called EarWell can gently reshape the ear—avoiding the pain and cost of later surgery, reports a study in the March issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS).\nBut treatment must begin early—preferably within the first three weeks after birth, according to the study by ASPS Member Surgeon H. Steve Byrd, MD, and colleagues of Pediatric Plastic Surgery Institute, Dallas. Dr. Byrd comments, \"The EarWell system is effective in eliminating or reducing the need for surgery in all but the most severe congenital ear malformations.\"\nNonsurgical Treatment Avoids Later Consequences of Infant Ear Malformations\nThe researchers review their experience with nonsurgical correction of congenital ear malformations in 175 infants. The EarWell system is a relatively simple technique for molding and reshaping the ear, taking advantage of the increased malleability of the ear cartilage in newborns. For best results, treatment should start within the first three weeks after birth, or correspondingly later in infants born prematurely.\nThe technique and length of EarWell treatment varies according to the type and severity of the infant's ear deformity. Dr. Byrd and colleagues present a classification system and technical details for plastic surgeons to follow in evaluating the best treatment for specific types of malformations.\nFor most infants in the study, both ears were treated, for a total of 303 ears. Ninety-eight percent of infants had relatively mild \"constricted\"-type ear deformities. EarWell treatment started at an average age of 12 days and continued for 37 days, including an average of six follow-up visits to the plastic surgeon's office.\nEarWell treatment was highly successful in correcting or reducing the severity of congenital ear malformations. Results were judged good to excellent in 97 percent of ears with one simple deformity and 88 percent with more complex \"mixed\" deformities. About 70 percent of ears with constricted malformations were graded as having no deformity after treatment.\nComplications consisted mainly of skin injuries that healed without further problems. In eight cases, treatment had to be stopped because of an allergic reaction to the adhesive tape used.\nWhile the EarWell system is not new, the report is the largest study of congenital ear malformations treated with this approach—including a standardized approach to treatment and assessment of the results. The results strongly support its use, especially in infants with deformities and less-severe malformations.\nBut lack of awareness of this nonsurgical alternative is a key limiting factor. \"The opportunity for early treatment can be hampered by a failure to convince pediatricians that the majority of misshapen newborn ears do not self-correct,\" Dr. Byrd and coauthors write. They also point out that EarWell is highly successful in the treatment of prominent ears—a condition that commonly goes unnoticed by parents and pediatricians, but is likely to get worse as the child grows.\n\"While we can operate on ears later in the patient's life, waiting not only increases the surgery's difficulty and expense, but may expose the child to teasing, bullying, and loss of self-esteem,\" comments Editor-in-Chief Rod J. Rohrich, MD, in a featured video on the Plastic and Reconstructive Surgery website. \"If your baby has any type of ear deformity, plastic surgeons can help with or without surgery. Discuss non-surgical, ear molding alternatives with your pediatrician, and consult with a board-certified plastic surgeon...the earlier the better!\"\nExplore further: Doctors nonsurgically correct infant ear deformities\nLily N. Daniali et al. Classification of Newborn Ear Malformations and their Treatment with the EarWell Infant Ear Correction System, Plastic and Reconstructive Surgery (2017). DOI: 10.1097/PRS.0000000000003150"

"There Is No Safer Football Helmet for Kids: Study\nResearchers compared high-tech helmets to standard gear for concussion protection\nThe concussion rate did not vary among players based on the type of helmet worn or the age of the helmet. The helmet brand also made no difference in the severity of concussions, which was measured by the number of days lost from play due to concussion.\n\"As long as the helmet their child is wearing is in good condition, is properly fit and is worn correctly, then the parent shouldn't feel bad if their child is not in a $400 or $500 helmet,\" Brooks said.\nPlayers with custom-fitted mouth guards actually suffered a higher concussion rate than those who used generic models.\nThe realities of both physics and human anatomy make it unlikely that any helmet could better reduce the chances of concussion, Brooks said.\n\"There's a lot of debate regarding whether you can create a helmet that could reduce concussion risk, given the structure of the skull,\" she said. \"The brain isn't attached to the skull. It's floating freely in spinal fluid. You can dissipate the force of something striking the skull, but you can't reduce the forces that make the brain bounce back and forth inside the skull following impact.\"\nBecause this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.\nDr. Margot Putukian, director of athletic medicine at Princeton University, said the new study adds further evidence to the questionable ability of helmets to prevent concussions.\n\"I think the companies are well-meaning and they are trying to develop technology that might reduce impact, but we're not seeing their efforts translate into a reduction in concussion,\" said Putukian, who was not involved with the study. \"There is risk in sports that can't be completely negated by equipment.\"\nCoaches and officials would have a better chance of reducing concussions if they limited contact during practice and taught athletes the proper technique for tackling, study author Brooks said.\n\"I personally don't have a problem with more emphasis on enforcing rules that limit contact with the head,\" she said. \"You shouldn't be leading with your head. You shouldn't be tackling with your head. We should be teaching kids that the head should not be the leading point of contact.\""

"Fetal conditions such as positional skull deformity, also known as plagiocephaly, have become more common since the advent of campaigns aimed toward reducing the risk of sudden infant death syndrome (SIDS) by laying newborns on their back before bed. A recent study out of the Netherlands has revealed that helmet therapy used to decrease an infant’s likelihood of developing a skull deformity has little to no effect on this condition.\n“Based on the effectiveness of helmet therapy, and the high prevalence of side-effects and high costs, we discourage the use of a helmet as a standard treatment for healthy infants with moderate to severe skull deformation,” authors of the study said in a statement.\nResearchers involved with the HEADS study included 84 full-term babies in good health who had begun to develop moderate to severe positional skull deformation. Infants were either affected by plagiocephaly, which causes misalignment of the ears and one side of the head to flatten, or brachycephaly, characterized by a bulge in the front of the skull and a flattened back of the head. Half of the babies were given no form of remedial therapy while the other half were fitted with specially designed helmet that they wore 23 hours a day for six months.\nAt the age of 2, the research team measured each child’s head and rated their parents’ satisfaction with their skull shape. Of the babies who participated in helmet therapy, 25.6 percent experienced a full recovery by the time they turned 2, compared to 22.5 percent of the babies who had no treatment at all. Parents whose babies wore a helmet reported an average satisfaction score of 4.6 out of 5, compared to 4.4 reported by parents of babies who received no treatment.\nNot only did helmet therapy have a similar effect on reducing a child’s risk for skull deformities compared to non-treatment, but parents of the infants that wore helmets reported certain side effects, including skin irritation, inability to cuddle with their child, odor, sweating, and pain. The fact that only a quarter of the babies included in this study experienced a full recovery shows that prevention methods require more attention. Around one in five infants develop a skull deformity due to lying in one position for an extended period of time.\n\"Parents would want to know whether treatment would result in improvements above and beyond what would be expected by doing nothing at all,” Professor Brent Collett from the University of Washington School of Medicine said in an accompanying editorial. \"It would be of interest to learn whether children with the most severe PPB (positional plagiocephaly and brachycephaly), who were excluded from this trial, show meaningful improvement. Additional work incorporating behavioral and public health strategies to promote 'tummy time' and similar positioning strategies should be explored.\"\nSource: van Wijk R, van Vlimmeren L, Groothuis-Oudshoorn C, et al. Helmet therapy in infants with positional skull deformation: randomised controlled trial. BMJ. 2014."

"You've probably heard that \"mother knows best,\" however, according to the American Academy of Pediatrics this might not be the case. In the past it was common for mothers to lay their babies down to sleep on their stomachs. However, AAP officials say this could contribute to Sudden Infant Death Syndrome, also known as SIDS or crib death, something that affects babies one-year-old and under.\nSince making the recommendation to lay babies on their backs in 1992, the number of SIDS deaths has dropped 40 percent.\nPediatrician, Dr. Lara Ross with the Family Medical Clinic in Meridian says although sleeping on the stomach is the most dangerous position, babies sleeping on their sides is not much better.\n\"The side sleeping would cause them to role on their belly which we know is more dangerous when it comes to SIDS.\"\nAlthough many questions remain about what causes SIDS, Dr. Ross says factors such as second hand smoke, and babies getting too hot are thought to also play a role. Other things that can pose a danger are big toys and thick comforters placed in cribs. All of these are items, which doctors say can obstruct breathing. To combat this:\n\"Really just put a light blanket or no blanket at all on the bed. If they do have a blanket it should be probably tucked on the end of the bed and the sides and probably just kind of below their waist.\"\nFor people who want to place their baby on his stomach, Dr. Ross suggest that you place you baby on his belly for 'tummy time' during the day while he is awake. By following these tips, doctors say you can greatly increase your chances of having a happy and healthy baby."

"After months of ensuring that your baby is put to sleep lying on their back, it can seem strange or even concerning that your baby starts wanting to sleep on their knees with their butts in the air. Once your baby can sit up and crawl, you might notice that they will fall asleep on their knees more often. You may even find them that way when you wake them up in the morning, even if you put them to bed on their backs. This position, called the frog position by some, is very common for a baby between the ages of six to twelve months, and your baby will probably stop sleeping this way when they learn to walk. But until then, you are probably wondering why do babies do this, and should you be concerned?\n1. Your baby sleeps this way because it’s comfortable.\nSleeping curled up on their knees with their butts in the air is comfortable and convenient for your baby. Just like some adults like to sleep curled up in a ball, so does your baby. This position might not look comfortable to you, but your baby disagrees. Once your baby starts sitting by themselves, they tend to fall asleep where they are. This means they might just let themselves tumble forward, curl up where they land, and take a nap. This napping position is also low effort, and when your baby finds themselves suddenly ready for a nap they don’t have to move much to fall asleep comfortably.\n2. This position reminds them of the womb.\nYour baby was positioned in the same way when they were in the womb. The womb was the most comfortable place that your baby has ever known. By sleeping in a frog position, they can replicate some of that comfort. Research suggests that this may be a contributing factor as to why some babies seem to rest more peacefully when they sleep in this position. However, some parents also report that their babies do not rest as well in this position. As in most things, your baby is unique, and what makes them most comfortable will vary.\n3. Babies that love to be cuddled might favor this position.\nIf your baby is a cuddle, they might prefer this position over others. A baby that loves to be cuddled up to their parent might find this position more comfortable than a baby that does not. If your baby prefers to be held or rocked by you rather than sitting by themselves, they might seek this position out themselves. This might have something to do with the feeling of having something pressed up against their stomach and legs that mimics the feeling of being pressed against their parent’s chest.\n4. This position allows your baby the most freedom of movement.\nYour baby likes the feeling of being able to move. Once your baby starts moving around on their own, they will like to have the freedom to move at a moment’s notice. When a baby is laid on their back, it takes them more effort to roll over so that they can sit up or crawl. If they are already in position on their knees, then they can get straight back to moving around when their nap is over!\n5. Sleeping in frog position is very common.\nMost babies go through a period when they prefer to sleep in a frog position. While not every child will choose to sleep in this position, it is not uncommon among babies between the age of six and twelve months or even older. While some parents might worry that this behavior is strange or might be a symptom of something wrong, your child is not strange for choosing to sleep in this position. This is a perfectly normal stage in their development that they will probably grow out of when they start walking.\n6. You shouldn’t worry too much.\nBabies sleeping in the frog position is relatively safe. Although the American Academy of Pediatrics (AAP) recommends that babies be put to sleep on their backs to avoid Sudden Infant Death Syndrome (SIDS) by the time your baby can roll over and crawl, they are fine to sleep in this position. Having the strength and motor skills to roll over and get their legs underneath them well enough to curl into this position indicates they also have the motor skills to roll back over if they need to.\n7. Don’t fight a losing battle.\nYour baby will put themselves into this position to sleep no matter what you do. For a baby that finds this position comfortable, no amount of you rolling them onto their back to sleep will stop them. Some parents have reported waking up multiple times a night to turn their baby onto their backs, but their baby always rolls back over. Suppose this is the position that your baby wants to sleep in, its best not to fight it. You might even be making their sleep worse by disturbing them so often to turn them over. As a parent, you know that you have to choose your battles, and this is one that you probably won’t win.\n8. Your baby has tight muscles\nYour newborn could not stretch for the 9 months you were making him. So, your baby’s muscles are still very tight from the pregnancy.\nUs adults have had time for our muscles to relax and loosen. For that reason, adults don’t sleep with their butt in the air. Give it some time and your baby could be sleeping in positions more similar to your own before you know it.\n9. Your baby is learning to crawl\nThe position of sleeping with your butt in the air is very similar to The crawling position. So your baby has a natural inclination for this position of crawling since it’s the next step toward walking. If your baby is sleeping in this position, it could be his body’s natural way of preparing him for this new exciting crawling journey.\n10. Is it dangerous for your baby to sleep with his butt in the air?\nIf your baby cannot turn over on their own, this can be very dangerous. However, once your little one is able to turn over independently, it becomes less necessary for you to worry although it’s not to say all concern should be thrown out the window.\nThis is an opportunity for your baby to master rolling over. Your baby needs to develop the ability to roll from belly to back and back to belly.\nIt’s important for you to allow your baby to do what feels comfortable and natural, but just observe this sleeping position with caution. Because it can present dangers while also leading the way to a very natural progression in regards to crawling, walking, etc.\n11. How to keep your baby safe while knee sleeping:\nFirst of all, you are a very good parent for taking the time to research the sleeping position. Since you’re such a good parent, you should be advised that there are additional ways for you to ensure your baby is getting a safe sleeping experience.\nThis sleeping position can lead to dangers, so as a great parent, check out this article on how to keep your baby safe while sleeping on knees or with their butt in the air.\nAll sleeping babies are precious, but a baby curled up to sleep on their knees with their little butt in the air is adorable. Rest assured that this position is both normal and safe and just enjoy this time admiring how cute they are when they just tumble over and curl up for a nap wherever they happen to be. After all, they’re going to wake up soon enough and be ready to get back to sitting up or crawling, and your moment of peace will be over.\nAnd as always, we highly recommend every single parent reads ways to keep your baby safe while sleeping in these positions."

"Tuesday, July 9th, 2013\nNearly half of two-month-old babies who were part of a recent study were found to have flat spots on their heads. Researchers at Mount Royal University in Calgary believe that the culprit could be the widespread use of devices like swings and seats that hold babies in static positions, and the practice–recommended as the safest way to protect against sudden infant death syndrome (SIDS)–of laying babies to sleep on their backs. More from NBC.com:\n“The reason why we want to catch this early is because if we see children with flattened heads, sometimes there are changes in their facial features,” says Aliyah Mawji, a registered nurse at the university who led the study.\nPediatricians and pediatric nurses have noticed a big increase in the number of babies with flat spots on their heads – a condition known as positional plagiocephaly (“oblique head” in Greek).\nMost experts say it’s due to advice to put babies to sleep on their backs – which in turn has slashed rates of sudden infant deaths syndrome or SIDS. But babies have big, heavy heads and weak little necks, which means their heads tend to roll to one side. Because their skulls are still soft, this can cause a flat spot….\n…So [Mawji] and colleagues did a survey in four Calgary clinics where parents bring their babies – each in a different type of neighborhood. They looked at 440 babies aged 7 to 12 weeks. “We found that 46.6 percent actually had some form of plagiocephaly,” Mawji says.\nA slight majority, 63 percent, had the flat spot on the right, and Mawji says that comes from the moment of birth.\n“This is actually due to the birthing process itself,” Mawji says. “The majority of infants come out in such a way that their head is turned to the right.” This is in part because the mother’s pelvic bone and spine don’t move – they’re hard bones – so the more flexible baby ends up squished and twisted.\nIf a baby doesn’t move around enough, this flat spot can become more permanent. And if no one does anything, and the skull hardens, it could become really permanent.\nMost of the cases Mawji saw were mild. And while she took care to get a range of family types into her study, she stresses that more research is needed to really show how common the issue is across the larger North American population. But her findings show it is probably more common than most people thought.\nExperts recommend parents make a concerted effort to move their babies regularly, still putting them to sleep on their backs, but encouraging them to alternate which side of their head is against the mattress, seat, or swing.\nImage: Sleeping baby, via ShutterstockAdd a Comment"

"Washington, Jul 9 (IANS): Nearly half of the newborns develop flat spots on their heads by the time they are two-month old due to sleeping on their backs to prevent sudden infant death syndrome, a new Canadian study has found.\nPublished in the US journal Paediatrics, the study investigated the occurrence of positional plagiocephaly, or flat spots on heads, in infants 7 -12 weeks of age who attend a two-month well-child clinic in Calgary, Alberta, Canada, Xinhua reported.\nResearchers from the Canadian Mount Royal University assessed 440 healthy full-term infants who had been born at more than 37 weeks of pregnancy.\nOf these infants, 205, or more than 46 per cent, were observed to have some form of flat spots on their heads. Of all infants with the condition, about 63 per cent had flattening on the right side and about 78 per cent had a mild form of the condition, they said.\n\"Since the 1992 recommendation from the American Academy of Pediatrics to have infants sleep on their backs, infant mortality from sudden infant death syndrome has declined dramatically,\" the researchers said in a statement. \"One consequence, however, has been an increase in positional plagiocephaly, or flat spots on infants' heads.\"\nAccording to the researchers, the high rate of head flattening indicates that parents should be educated early about how to prevent the condition from occurring.\nFlat spots, however, are generally harmless. The researchers said there is some indication that children with positional plagiocephaly have mild developmental delays, but that those typically disappear by 18 months.\nTreatment for the condition is usually simple and painless, often cured by repositioning the infants while they sleep, encouraging them to alternate their head position while sleeping on their backs.\nThe American Academy of Pediatrics does not recommend using any wedge pillows or other devices to keep babies in one position, and only kids with severe cases may need to wear a special orthotic helmet."

"Sleeping on back can make infant head flat\nPutting the baby to sleep on their heads significantly reduces the risk of sudden infant death syndrome (SIDS), but the practice increases their risk of developing plagiocephaly, a condition marked by flattened heads, researchers say.\nAccording to the findings of a new study, nearly half of the newborns develop flattened heads by the time they are two-month old because of sleeping face up.\nPlagiocephaly is a flat head syndrome that is characterized by a flat spot on the back of the head. The condition is usually caused by remaining static in a supine position for too long.\nFor the purpose of the study, researchers at the Canadian Mount Royal University looked at 440 healthy infants. All subjects were born full term i.e. after 37 weeks of pregnancy.\nOn two-month follow-up, the occurrence of positional plagiocephaly, or flat spots on heads, was significantly prevalent. Nearly 47 percent of the newborns had developed flat spots on their heads, researchers highlighted.\nOf all infants with the condition, 63 percent had developed flatness on their right side.\nFurthermore, almost 78 percent children with positional plagiocephaly developed mild developmental delays, but these delays usually disappeared by 18 months.\n“Since the 1992 recommendation from the American Academy of Pediatrics to have infants sleep on their backs, infant mortality from sudden infant death syndrome has declined dramatically,” the researchers said. “One consequence, however, has been an increase in positional plagiocephaly, or flat spots on infants’ heads.”\n“With the Back To Sleep (campaign) and the overuse of car seats, and people not holding their babies like they used to, we’ve sort of rediscovered this problem with infants’ head shapes”, said Dr. Lisa Stellwagen, neonatologist at the University of California.\nGenerally, the flat spots are harmless and the treatment is simple and painless. Re-positioning the infants while they sleep and encouraging them to alternate their head position frequently can be helpful, researchers recommended.\nHowever, using a wedge pillow or other devices that help keep babies in one position are not recommended. Moreover, the American Academy of Pediatrics suggests that only kids with severe plagiocephaly may need to wear a special orthotic helmet.\nThe findings of the study are published in the current issue of the journal Paediatrics."

"Putting babies on their backs to sleep has sharply cut the rate of Sudden Infant Death Syndrome (SIDS), but it has also left nearly half of infants with a flattened head, a new Canadian study estimates.\nResearchers found that 47 percent of 440 2-month-olds having routine check-ups had what doctors call positional plagiocephaly — where the back or one side of the head has a flat spot. It develops when infants spend a lot of time with the head resting in the same position against a flat surface.\nFlat spots are a cosmetic issue — not a medical problem — experts stressed, and parents should keep putting their infants on their backs to sleep.\n\"It still is very important to put infants to sleep on their backs to prevent SIDS,\" said study author Aliyah Mawji, an assistant professor in the School of Nursing at Mount Royal University in Calgary, Alberta.\nThe Royal Children's Hosptial Melbourne shares the following tips on how to prevent flat spots developing on your babies head:\n- Sleep time: A baby must always be placed on their back to sleep to reduce the risk of SIDS (Sudden Infant Death Syndrome/Cot Death). However, it is important to vary the position of your baby's head by alternating its position between the left and right side each time they sleep.\n- Sleep position: Place your baby at alternate ends of the cot to sleep, or change the position of the cot in the room. Babies look at fixed objects like windows or wall murals. Changing their cot position will encourage them to look at different angles.\n- Play time: Place your baby on their tummy or side to play when awake. You can also change the position of toys that your baby likes to look at.\nYoung infants are susceptible to flat spots because the bones of the skull are not fused together — so that the head can get through the birth canal and the skull can accommodate a rapidly growing brain later.\nIn recent years, doctors have been seeing more and more cases of flat spots, which is thought to be related to the Back to Sleep campaign. For the past 20 years, experts have been advising parents to put infants on their backs to sleep, on a flat crib surface, to reduce the risk of SIDS.\nIn Australia SIDS rates have fallen by 83% since the beginning of the campaign.\nSo keep putting your baby on her back to sleep, said Dr. Roya Samuels, a pediatrician at Cohen Children's Medical Center in New Hyde Park, New York.\n\"Positional plagiocephaly is really a cosmetic issue,\" Samuels said. \"There's no evidence that it affects the brain.\"\nIn those cases, some doctors prescribe a corrective helmet that can help redirect the growth of the baby's head.\nSamuels said the most important thing is for parents to make routine visits to your local baby clinic or family GP so their baby's overall health and development — including changes in head shape and size — can be monitored.\nWhile plagiocephaly is cosmetic, Samuels noted that there is another, far rarer condition that causes a misshapen head, called craniosynostosis. In that disorder, the skull bones fuse prematurely, which can harm normal brain development. It usually requires surgery.\nFortunately, positional plagiocephaly is usually the culprit behind infants' flat spots, Samuels said.\nPlus, she pointed out, few people actually have perfectly symmetrical heads. \"Underneath our hair, most of us have lumps and bumps,\" she said."

"Most infants have flat spots on their heads, says study\nPutting babies on their backs to sleep has sharply cut the rate of Sudden Infant Death Syndrome (SIDS), but it has also left nearly half of the infants with a flattened head, a new Canadian study estimates.health and fitness Updated: Jul 10, 2013 00:57 IST\nPutting babies on their backs to sleep has sharply cut the rate of Sudden Infant Death Syndrome (SIDS), but it has also left nearly half of the infants with a flattened head, a new Canadian study estimates.\nResearchers found that 47 percent of 440 Two-month-olds having routine check-ups had what doctors call positional plagiocephaly -- where the back or one side of the head has a flat spot. It develops when infants spend a lot of time with the head resting in the same position against a flat surface.\nFlat spots are a cosmetic issue - not a medical problem - experts stressed, and parents should keep putting their infants on their backs to sleep.\n“It still is very important to put infants to sleep on their backs to prevent SIDS,” said study author Aliyah Mawji, an assistant professor in the School of Nursing at Mount Royal University in Calgary, Alberta.\nBut parents can do things to prevent or alleviate the flat spot, she said -- like making sure infants have “tummy time” when they are awake and under someone’s watchful eye.\nYoung infants are susceptible to flat spots because the bones of the skull are not fused together -- so that the head can get through the birth canal and the skull can accommodate a rapidly growing brain later.\nIn recent years, doctors have been seeing more and more cases of flat spots, which is thought to be related to the Back to Sleep campaign.\nFor the past 20 years, experts have been advising parents to put infants on their backs to sleep, on a flat crib surface, to reduce the risk of SIDS.\nThe campaign (now called Safe to Sleep) seems to have worked. In the United States, it’s credited with a 50 percent drop in SIDS, according to the U.S. National Institutes of Health.\nSo keep putting your baby on her back to sleep, said Dr. Roya Samuels, a pediatrician at Cohen Children’s Medical Center in New Hyde Park, New York.\n“Positional plagiocephaly is really a cosmetic issue,” Samuels said. “There’s no evidence that it affects the brain.”\nStill, she added, “parents can get concerned.” To help reshape a flat spot, Samuels said she tells parents to lay their baby on her back with the head facing right, on Mondays, Wednesdays and Fridays. On the other days, face the head to the left.\nIf your baby has a flat spot on one side of the head, Samuels said you can also place mobiles or other interesting visuals to the opposite side of the crib. That will encourage your baby to turn her head to the non-flattened side.\nMost of the babies in the current study had mild flat spots, and simple measures are enough to address that.\nFew people actually have perfectly symmetrical heads. “Underneath our hair, most of us have lumps and bumps,” Samuels said."

"New research gives parents a heads-up (on plagiocephaly)\nCollette Burjack, Mount Royal University July 2013\nParents are not getting the information they need to prevent flat spots on their infant’s head.\nThat is what Assistant Professor Aliyah Mawji RN PhD, found when she completed Canada’s first study on the number of infants with positional plagiocephaly — flat spots on either side of the back of the skull.\nBabies develop these flat spots by spending too much time in the same position, which puts pressure on one side of their head. For many infants, the flat spot is minor and may mend on its own or be hidden by hair. But others experience more severe forms of plagiocephaly, leading to misshapen heads and related facial distortions.\nMawji was shocked to discover that almost half of the infants in her study showed some type of positional plagiocephaly.\n“That’s a red flag that parents aren’t getting the message they could be preventing this,” she says.\n|Nearly 50 per cent of infants have flat spots on their heads|\nFlat spots have become more common in North America since the 1990s — an unintended consequence of the Back to Sleep campaign, which urges parents to place babies on their backs to prevent Sudden Infant Death Syndrome (SIDS).\n“Anecdotally, we’ve known that we’ve been seeing higher incidences of plagiocephaly since the success of that campaign,” explains Mawji. “It turned out we didn’t have a clear indication of just how big a problem this was.”\nAs part of her PhD research, Mawji partnered with the Head Shape Clinic at Alberta Children’s Hospital and Public Health, Alberta Health Services to examine 440 infants aged seven to 12 weeks from four community health centres across Calgary.\nShe found that 205 of the 440 infants had some degree of head flatness.\n“The majority of the cases were mild,” says Mawji. “That’s still a very high number. Close to 50 per cent.”\nAs babies age, their skulls harden and flat spots become more difficult to treat. If flat spots are not detected early enough, some infants may need to wear a cranial orthotic device — a helmet designed to reshape the infant’s skull.\n“It’s great that there’s a treatment, but it’s costly,” says Mawji. “It’s not covered by Alberta Health Care. And it can be uncomfortable for the infant. The helmet has to be worn 23 hours a day.\n“Why not just prevent it?”\n|Flat spots are easily preventable|\n“While it’s very important to continue putting your infant to sleep on his or her back, there are some really simple things you can do,” explains Mawji.\n“For example, alternate the side of your infant’s head that comes into contact with the mattress. An easy way to do this is to change the direction that you put the infant to sleep in the crib. Infants tend to turn their head towards the door, so if you change the direction they are laying each night, they won’t put pressure on the same side.”\nMawji also suggests limiting the amount of time an infant spends in car seats, bouncy chairs or other devices that put pressure on the skull.\n“Another thing you can do is when you’re feeding, don’t always hold your infant on the same side,” says Mawji.\n“And lots of tummy time. You can start putting a newborn on his or her tummy as early as one week. This helps infants to build neck, shoulder and arm strength, ultimately helping them to reach developmental milestones.”\nWhile Mawji is surprised by the number of babies she saw with plagiocephaly, she is hopeful her study will help parents become aware of these simple methods of prevention.\n“Some of the parents I spoke with knew their infant had a flat head,” says Mawji. “But they didn’t know what to do to prevent it.”\n|For Mawji, prevention has always been key|\nMawji began her career working as pediatric nurse at the Peter Lougheed Centre. There, she quickly became frustrated by the number of preventable illnesses she saw.\n“You’d have children coming in with asthma whose parents smoked in the home,” she says. “Or you’d see cases where you’d suspect abuse in the home. It’s those types of things that get you thinking, Well, maybe I can make an impact on a different level.”\nShe went on to spend some time working in neonatal intensive care nursing, but soon realized there was still something missing.\n“I thought, No, this is not where I am meant to be. I’m interested in prevention. So I decided to pursue a master’s degree in public health.”\nAfter receiving her masters from the University of Alberta, Mawji was offered the opportunity to work in global health. Her new position allowed her to travel to resource-poor countries and work on various community health programs.\nIt was during a trip to northern Pakistan that Mawji noticed something that would mark a turning point in her career.\n“I saw a whole bunch of people with flat heads. So I started asking, Have you heard of the Back to Sleep campaign? and they’d look at me like I was crazy,” Mawji laughs. “So then I had to ask the blunt question: Well, why does everyone have a flat head?”\n“And the answer I got was, Because it’s beautiful. We value flat heads.”\nMawji learned this community would rub the back of a baby’s head with a stone to shape the skull. When she returned to Canada to complete her PhD after two years abroad, she decided to further explore this unusual custom.\n“Originally, I wanted to study head flattening as a cultural practice,” she says. “I couldn’t return to Pakistan because it was politically unstable. So my supervisor, Dr. Ardene Robinson Vollman, suggested I look at Canada.”\nMawji quickly discovered that little research had been done on positional plagiocephaly — despite anecdotal evidence that it was on the rise.\n“Talking to nurses and doctors everyone said, Oh, yes, we’re seeing more of this in our clinic,” remembers Mawji. “But we didn’t have a clear sense of how big a problem this was at the population level.”\n|More research is still needed|\nNow that her study has exposed the extent of the problem, Mawji says there is still much work to be done including examining long-term effects.\nSo far, research indicates that flat spots do not affect a baby’s motor or cognitive skills. While some studies show that infants with flat spots are slower to reach developmental milestones, these differences usually disappear by eighteen months.\nWhile this is good news for parents already dealing with infants with flat spots, Mawji stresses that more research is needed to fully understand the consequences of this condition.\nMawji also worries that some children may be at risk for bullying because of their unusual features — particularly those children who suffer from more extreme forms of plagiocephaly.\nIn the meantime, Mawji says that the health system needs to be doing a much better job of informing parents and caregivers on how to prevent flat spots.\n“At the hospital new parents are focused on establishing feeding and making sure mom and baby are healthy, so this isn’t necessarily high on their list of priorities,” explains Mawji. “Prevention methods — which are very simple to do — are often not taught until parents come to the two-month immunization clinic, and by then the infants have already developed flat spots on their heads.\n“We need to find an avenue to disseminate the information much earlier.”\n|Getting the message out|\nMawji’s groundbreaking study, published in Pediatrics, has already been the focus of national and international attention.\n“I didn’t think I would receive that much attention, to be honest,” Mawji laughs. “I’ve given about ten interviews so far, and I’ve received emails from people around the world.”\nMawji’s story has been covered by the CBC, the Globe and Mail, NBC News, the Huffington Post, and other major media outlets.\nFor Mawji, this coverage means that more parents are getting the information they need. “But when we’re talking about health promotion and providing parents with some sense of control, there are very easy strategies parents can implement at home to help support the health of their infant,” says Mawji.\nMawji is also looking forward to incorporating her research into the classroom. After teaching at the University of Calgary for five years, she was pleased to join Mount Royal University School of Nursing in Jan. 2012.\n“I really welcome the opportunity to pull together my teaching and my scholarship,” she says.\n“I think this is a great way for us to role model to our students how we can find solutions to some of the issues we’re seeing in nursing. It’s how we bridge theory into practice.”\nSource Mount Royal University\nThe incidence of positional plagiocephaly: a cohort study, Mawji A, Vollman AR, Hatfield J, McNeil DA, Sauvé R. Pediatrics. 2013 Aug;132(2):298-304. doi: 10.1542/peds.2012-3438. Epub 2013 Jul 8.\nClinical classification of positional plagiocephaly, Argenta L, David L, Thompson J. J Craniofac Surg. 2004 May;15(3):368-72. Erratum in: J Craniofac Surg. 2004 Jul;15(4):705.\nCharacteristics of infants with positional abnormal head shapes and their physiotherapy service at an Australian community health facility, Leung A, Watter P, Gavranich J. Pediatric Health, Medicine and Therapeutics. 16 July 2014 Volume 2014:5 Pages 83—92. https://doi.org/10.2147/PHMT.S61989. Full text\nImpact of Parent Practices of Infant Positioning on Head Orientation Profile and Development of Positional Plagiocephaly in Healthy Term Infants, Leung A, Mandrusiak A, Watter P, Gavranich J, Johnston LM. Phys Occup Ther Pediatr. 2018 Feb;38(1):1-14. doi: 10.1080/01942638.2017.1287811. Epub 2017 Apr 4.\nPreventing “Flat-headed” Babies: A Commentary on “Impact of Parent Practices of Infant Positioning on Head Orientation Profile and Development of Positional Plagiocephaly in Healthy Term Infants,” Williams E. Phys Occup Ther Pediatr. 2018 Feb;38(1):15-17. doi: 10.1080/01942638.2018.1405661. Full text\nClinical assessment of head orientation profile development and its relationship with positional plagiocephaly in healthy term infants – A prospective study, Leung AYF, Mandrusiak A, Watter P, Gavranich J, Johnston LM. Early Hum Dev. 2016 May;96:31-38. doi: 10.1016/j.earlhumdev.2016.03.001. Epub 2016 Mar 28.\nPositional plagiocephaly is associated with sternocleidomastoid muscle activation in healthy term infants, Leung A, Mandrusiak A, Watter P, Gavranich J, Johnston L. Childs Nerv Syst. 2017 Apr;33(4):617-624. doi: 10.1007/s00381-017-3351-z. Epub 2017 Feb 24.\nFlat spots found on back of 46% of newborns’ heads CBC\nFlat-head syndrome linked to delayed motor skills The Globe and Mail"

"Physiotherapy for Positional Plagiocephaly\nDo you find your infant has their head tilted to one side frequently? Or, have you found a flat spot on the side or back of their head?\nIf so, your child may have positional plagiocephaly, potentially caused by a condition called torticollis in which the muscles of the neck are bent or twisted to one side. The good news is that a few simple physiotherapy exercises a day can correct the issue.\nLearn how positional plagiocephaly develops and what you can do to alleviate the condition.\nWhat is Plagiocephaly?\nPlagiocephaly is more commonly known as “flat head syndrome”. As its name suggests, it occurs when a young infant’s head is flat on one side. There are many causes of plagiocephaly, including genetics, birth trauma, and being laid on their back for long periods of time. Torticollis may also cause plagiocephaly and in this case physiotherapy is the first treatment recommended to correct the problem.\nWhat is Torticollis?\nCongenital muscular torticollis is a condition that affects the muscles in an infant’s neck, causing them to be unbalanced or uncomfortable to move. There may be a benign tumor in one of your child’s neck muscles (specifically, the sternocleidomastoid muscle), or the muscles on one side of the neck may be shorter than the other.\nWhatever the cause, torticollis makes it difficult for your child to turn their head in one direction. As a result, they may spend a lot of time with one side of their head on the ground. This side may become flat, or develop positional plagiocephaly.\nHow Can Physiotherapy Treat Torticollis and Positional Plagiocephaly?\nTorticollis, and the positional plagiocephaly it causes, can be treated by physiotherapy. In fact, it is the first line of treatment. If your child’s condition does not respond to physiotherapy, they may need minor surgery to lengthen the shortened neck muscle. However, with early and frequent physiotherapy, your child can avoid surgery.\nThis type of physiotherapy is simple. As the caregiver of the child, you will simply massage your child’s neck and move their head a few times per day. A physiotherapist will instruct you on how to massage their neck and how to move their head.\nThese movements will gently stretch your child’s muscles to lengthen the short side. Or, you may use massage to work out the begin tumor, which is more like a knot in the muscle than a normal tumor.\nYour infant may find these movements and massages to be uncomfortable at first. You should always work gently, and remember that your child will improve with time. Eventually, you should start to see your child’s head tilt subside and see them use the full range of motion in their neck.\nAlso, to target the positional plagiocephaly, it may be necessary to re-position your child during the day, or reorient their crib or seats so that they have to move their head in a new direction to see you or their toys. In order to reduce the chance of sudden infant death syndrome (SIDS), you should still position your child on their back to sleep.\nIf your child’s torticollis and positional plagiocephaly does not improve at six months of age, they may need new treatments. So, your first step should be to reach out to us at Meadowlands Physiotherapy to start early intervention with your child’s condition."

"Physiotherapy for Positional Plagiocephaly\nDo you find your infant has their head tilted to one side frequently? Or, have you found a flat spot on the side or back of their head?\nIf so, your child may have positional plagiocephaly, potentially caused by a condition called torticollis in which the muscles of the neck are bent or twisted to one side. The good news is that a few simple physiotherapy exercises a day can correct the issue.\nLearn how positional plagiocephaly develops and what you can do to alleviate the condition.\nWhat is Plagiocephaly?\nPlagiocephaly is more commonly known as “flat head syndrome”. As its name suggests, it occurs when a young infant’s head is flat on one side. There are many causes of plagiocephaly, including genetics, birth trauma, and being laid on their back for long periods of time. Torticollis may also cause plagiocephaly and in this case physiotherapy is the first treatment recommended to correct the problem.\nWhat is Torticollis?\nCongenital muscular torticollis is a condition that affects the muscles in an infant’s neck, causing them to be unbalanced or uncomfortable to move. There may be a benign tumor in one of your child’s neck muscles (specifically, the sternocleidomastoid muscle), or the muscles on one side of the neck may be shorter than the other.\nWhatever the cause, torticollis makes it difficult for your child to turn their head in one direction. As a result, they may spend a lot of time with one side of their head on the ground. This side may become flat, or develop positional plagiocephaly.\nHow Can Physiotherapy Treat Torticollis and Positional Plagiocephaly?\nTorticollis, and the positional plagiocephaly it causes, can be treated by physiotherapy. In fact, it is the first line of treatment. If your child’s condition does not respond to physiotherapy, they may need minor surgery to lengthen the shortened neck muscle. However, with early and frequent physiotherapy, your child can avoid surgery.\nThis type of physiotherapy is simple. As the caregiver of the child, you will simply massage your child’s neck and move their head a few times per day. A physiotherapist will instruct you on how to massage their neck and how to move their head.\nThese movements will gently stretch your child’s muscles to lengthen the short side. Or, you may use massage to work out the begin tumor, which is more like a knot in the muscle than a normal tumor.\nYour infant may find these movements and massages to be uncomfortable at first. You should always work gently, and remember that your child will improve with time. Eventually, you should start to see your child’s head tilt subside and see them use the full range of motion in their neck.\nAlso, to target the positional plagiocephaly, it may be necessary to re-position your child during the day, or reorient their crib or seats so that they have to move their head in a new direction to see you or their toys. In order to reduce the chance of sudden infant death syndrome (SIDS), you should still position your child on their back to sleep.\nIf your child’s torticollis and positional plagiocephaly does not improve at six months of age, they may need new treatments. So, your first step should be to reach out to us at Meadowlands Physiotherapy to start early intervention with your child’s condition."

"It’s not uncommon for babies to be diagnosed with both plagiocephaly and torticollis. The relationship between plagiocephaly and torticollis is slightly unusual as causality can go in either direction. In other words, sometimes plagiocephaly can cause torticollis and sometimes it’s the other way round. Keep reading for a more in-depth explanation of the relationship between plagiocephaly and torticollis!\nWhat is Plagiocephaly and Torticollis?\nPlagiocephaly is the most common form of flat head syndrome and presents itself as an asymmetrical head shape, with one side of the head usually being more flat than the other side. Torticollis is a condition characterised by a head tilt to one side as a result of a shortened neck muscle. A true torticollis is the result of a small knot in the muscle fibres of one of the neck muscles, known as the sternocleidomastoid muscle (above image). This small knot of muscle fibres has a scary name, a sterncleidomastoid tumour, but this only means that the doctor can feel a lump of knotty tissues that can be eased out with stretches and manipulation.\nHow Does Torticollis Affect Plagiocephaly?\nBabies with torticollis have limitations in neck movement from left to right, which further contributes to the tendency of keeping the head to one side. Many babies born with torticollis can therefore develop plagiocephaly as a result of this condition, as their head will spend more time in a more comfortable position.\nOn the other hand, babies with severe plagiocephaly will often require extra energy to turn the head to the side to which they are less accustomed to. In order to avoid discomfort, they keep the head turned to the same side as much as possible, resulting in a functional shortening of the muscles on one side of the neck. This is known as functional torticollis as there is no lump of knotty fibres in the muscles.\nTreatment for Torticollis and Plagiocephaly\nIn the early stages, the best treatment for torticollis is to gradually encourage an increase in neck movement. To do this, regularly ease the head gently from one side to the other, only going as far as is comfortable for your baby. To help, make this into a game and you can encourage your baby to turn to the affected side by placing toys on that side. You can also encourage movement by feeding from alternating sides. For more tips, head over to our guide for 5 exercises that improve torticollis.\nThese techniques will help to loosen and extend your baby’s tightened neck muscle and will result in an increase in neck mobility. You will also find that physiotherapy or osteopathy from a paediatric specialist will help to improve range of movement in the neck and help with core strength and midline stability. Take a look at our previous post for more information on how physiotherapy can help torticollis.\nTo help prevent and improve both torticollis and plagiocephaly, repositioning techniques can enable your baby to improve their strength and prevent one area of the head from being leaned on continuously. Encourage your baby to play on their front during supervised tummy time, use a carry sling, and balance your baby on your knee without allowing them to rest their head on you.\nIf these techniques have failed to make a difference in the head shape by the time your baby is around five months old, it is important that you consult a specialist as soon as possible in order to avoid permanent deformation. Technology in Motion provides the unique TiMband treatment in its clinics across the UK. They have corrected thousands of babies’ head shapes to date. Call 0113 218 8030 for more information, and an expert will be happy to answer your questions."

"What is Plagiocephaly\nWhat Is Plagiocephaly?\nPlagiocephaly is flattening of the side of the back of the skull caused by a baby lying for too long on its back with the head turned slightly to the side. Before birth, plagiocephaly can occur in the womb if the mother’s amniotic sac does not contain enough fluid, or if there are multiple fetuses, such as twins. It also is often associated with premature birth, as premature babies often lack strength in their necks to move the head into different positions when they are lying down. When the head is left in one position too long, the soft skull deforms and flattens where it is in contact with the mattress or whatever surface on which the baby is lying.\nPlagiocephaly is more common in male babies than female babies, and more commonly occurs on the right side of the back of the skull. Babies who have torticollis, painful muscle tightness in the neck that forces the head to stay rotated to one side, are particularly susceptible to developing plagiocephaly.\nSigns and Symptoms\nThe signs of plagiocephaly, brachycephaly, and scaphocephaly are the visible flattening of the skull on the side of the back of the head, the back of the head, or the side of the head, respectively.\nHow Is It Diagnosed?\nParents may be the first to notice that the baby's skull is becoming flattened on the back or on 1 side. They may also notice that the baby keeps the head tilted to 1 side because of muscle tightness.\nCAUTION: If you see these problems, seek medical help immediately!\nYour physician will evaluate your baby's head to determine the cause and extent of skull flattening. Your physician may refer your baby to a physical therapist for treatment.\nYour physical therapist will conduct a thorough evaluation that includes taking the baby's health history. The physical therapist also will ask you detailed questions about how the baby is handled and the baby's activity level each day, and gently test for signs and symptoms of common plagiocephaly, brachycephaly, and scaphocephaly problems, such as:\nFlattened skull. The back or the side of the head is abnormally flat.\nTorticollis. The baby has difficulty turning the head to 1 side, or keeping the neck and head straight due to muscle tightness on 1 side of the neck.\nFacial asymmetry. The sides of the baby's face may appear unequal as a result of the skull deformity and flatness.\nYour physical therapist will examine:\nThe shape of the skull and face.\nThe baby’s muscle development.\nThe baby’s neck, trunk, arm, and leg movement.\nHow your baby holds the head and neck.\nHow your baby moves the head, body, and limbs.\nHow well your baby can lift the head and limbs when lying on the tummy.\nHow well your baby can roll over, crawl, and change body positions.\nHow well your baby can track objects with the eyes.\nYour physical therapist will likely also test for problems that can possibly occur in babies with severe plagiocephaly, brachycephaly, and scaphocephaly, such as:\nDelayed muscle development. The baby may not be able to roll, sit up, crawl, or lift the head or reach out with the arms when on the tummy in a way expected for the baby’s age.\nSensory problems. The baby may show a delay in the development of vision or hearing skills. The baby may have depth-perception problems, and problems tracking moving objects with the eyes.\nDelayed cognitive development. The baby may have delayed development of certain thinking and language skills.\nYour physical therapist will likely collaborate with a physician or other health care provider to make a final diagnosis. Further tests may be necessary to confirm the diagnosis, and to rule out other problems.\nIf your physician notices signs of plagiocephaly, brachycephaly, or scaphocephaly before you do, the physician may refer your baby to a pediatric physical therapist for evaluation and treatment.\nHow Can a Physical Therapist Help?\nBased on the findings during the examination, your physical therapist will develop and implement a treatment plan to address your baby's specific needs.\nPhysical therapy for any skull deformations should be started early, often prior to the baby being 3 months old. A physical therapist can help a child who is older regain strength and well-being. Your physical therapist will help improve your baby's:\nSkull shape. Your physical therapist will help your baby achieve and stay in certain positions that will give the skull a chance to become more normally rounded. Physical therapists teach parents this “repositioning therapy,” so it can be done at home. Repositioning therapy is the first line of home treatment. Your physical therapist will teach you how to reposition your baby in ways to aid in developing more normal movements, strength, and skull shape. This therapy usually consists of increased floor time and “tummy time,” and increased times of sitting upright.\nParents are encouraged to hold their baby more, and to perform other activities to encourage movement. Recent guidelines recommend tummy time 3 times a day, with constant adult supervision. Your physical therapist will design a safe program to gently treat your baby's particular symptoms.\nBased on each child's condition, the baby's pediatrician may prescribe an orthotic device, such as a remolding helmet, to gently redirect the growth of the baby’s skull.\nCAUTION: Babies should not sleep in carriers or strollers at night unless instructed by a pediatrician.\nMotion. Your physical therapist can help loosen any tight neck muscles your baby may have by using specific stretching motions, positions, and hands-on techniques called \"manual therapy.\" These techniques gently help the tight muscles relax, which allows the baby to regain more movement in the neck.\nStrength. Your physical therapist can work on specific skills your baby needs to develop. The therapist may use toys, games, and songs to encourage your baby to learn new movements and strengthen underdeveloped muscles. The program will progress to match the growing skills and strength of your baby.\nYour physical therapist can help improve your own:\nKnowledge. Your physical therapist can educate you about the causes of the flattened skull, and teach you healthier ways to position, feed, and provide safe nap and play times for your baby.\nPreventive skills. You'll learn how to safely place your baby on the tummy (eg, on the floor or in a playpen) after every feeding, nap, diaper change, and whenever the baby is awake and alert. Holding the baby for feedings, rather than feeding the baby in a carrier or stroller, allows the baby to look around, which improves neck and eye movement. A playpen is a good way to allow the baby to be active and safe while giving the parent some time to get chores done, without confining the baby to a container. Changing the position of toys and mobiles in the crib encourages babies to turn their heads in different directions."

"Torticollis is a common condition that occurs when one of the muscles in your baby’s neck is tight or weak making it difficult to turn the head to one side or causes the head to tilt or pull to one side.\nSigns of Torticollis\n- Flat spot developing on the back or one side of your baby’s head (also called plagiocephaly).\n- Preference for your baby to keep his/her head turned to one side or ability to turn head farther in one direction than the other.\n- Inability to maintain or bring head to midline or hold head in line with their trunk.\n- Difficulty feeding from both breasts (if breastfed) or prefers one breast over the other.\nCommon questions about Toticollis\nQ: Can I wait and see if the flat spot gets better?\nA: While waiting to see is always an option. It may not always be the best option and it is heavily encouraged to have your baby’s flat spot evaluated by a physical therapist so see if there is a reason why the flat spot is developing and if there are any exercise and positioning activities that can be performed with your baby to help. If left untreated can lead to positional plagiocephaly.\nQ: What is midline and why does it matter if my baby can bring his/her head to midline?\nA: Midline head position is when the head is aligned with the trunk with eyes facing forward and no rotation or tilt of the head. Think of an imaginary line down the middle of your baby’s body from top of head all the way to between their feet. Finding midline with the head is key to developing midline skills throughout the rest of the body, including bringing hands to midline and then crossing midline. Crossing midline is an important part of development and promotes the ability to use both sides of the body together in a smoot and coordinated manner to reach, crawl, roll, sit, etc.\nQ: How is breastfeeding related to Torticollis?\nA: During breastfeeding your baby needs to turn his/her head to both directions in order to switch breasts. If there is tightness or weakness in your baby’s neck that is limited turning his/her head to one side, then the breast that requires them to turn in that direction may be more challenging to nurse from, leading to your baby not wanting to latch or nurse from that breast.\nGoals of physical therapy with Torticollis\n-Regain full neck mobility and strength\n-Symmetrical use of both sides of the body\n-Symmetrical movement/transitions to both sides of the body (ie. rolls to both sides, transitions in/out of sitting over both sides)\n– Article written by: Anne Ferguson PT, MPT"

"Below are some frequently asked questions about plagiocephaly. If your questions are not answered here, please contact The National Association for Plagiocephaly for more information.\nTap a topic\nWhat's the difference between plagiocephaly and craniosynostosis?\nPlagiocephaly is the flattening of a baby’s head, either on one side or the back of the head. Plagiocephaly can develop in utero or, more commonly, from lying in the same position for too long (positional plagiocephaly). It is not life threatening and has not been shown to affect brain development.\nCraniosynostosis is a serious birth defect where the joints between a baby’s skull close prematurely, before the brain is fully formed. It can affect brain development and treatment usually involves surgery.\nWhat is torticollis? Do all plagio-babies have torticollis?\nTorticollis (also called “wry neck”, literally “twisted neck”) is a condition where a baby’s head is tilted to one side. The baby may also have difficulty turning his or her head.\nNot all babies with plagiocephaly also have torticollis – but it’s not uncommon to see the two together. Plagio-babies may favor one side of their head, which shortens or tightens the sternocleidomastoid (SCM) muscle, limits their range of motion and causes the head to turn or tilt to one side.\nTorticollis can also be caused by placement in utero, lack of space in utero (often present with large baby, small mother, or multiples) or trauma during the birth process.\nHow can I tell if my baby has plagiocephaly?\nA visual screening will alert you to whether your baby has plagiocephaly. Usually the flattening becomes noticeable by about 6-8 weeks of age.\nSigns to look for include a flattened appearance on the back of the baby’s head (brachycephaly) or on the sides, resulting in an elongated appearance (scaphocephaly). Other signs include:\n- the baby’s forehead may be more prominent on one side\n- one ear may be pushed more forward than the other\n- one eye may appear larger than the other\n- one cheek may appear fuller than the other\n- the baby’s nose may appear pushed to one side\n- the baby’s head may be tilted to one side or the baby has difficulty turning his/her head (possibly resulting from torticollis).\nGenerally your child’s pediatrician can diagnose plagiocephaly by a thorough examination, without an x-ray or CT scan.\nIs plagiocephaly painful?\nPlagiocephaly is not painful, nor is the treatment of it. It is most “painful” on the parents, emotionally speaking. Fortunately, if it is addressed early, the child will have no memory of the experience.\nWill plagiocephaly affect my child's development?\nPlagiocephaly has no known effect on a child’s brain development. It does affect the shape of the head as the skull forms, and if accompanied by torticollis can affect the child’s ability to move properly. But with prompt treatment, these issues can be resolved rather quickly.\nSome research indicates possible vision and jaw alignment issues with untreated plagiocephaly, but for the most part it is widely accepted to be cosmetic in nature.\nIs treatment required, or can my baby's head round out on its own?\nVery mild cases of plagiocephaly may resolve on their own, but for moderate to severe cases, treatment is recommended.\nTreatments include repositioning and physical therapy exercises, and for more advanced cases, helmet therapy may be advised.\nIn any event, as soon as you notice that your baby’s head may be misshapen, contact your child’s pediatrician for an examination and proper diagnosis.\nWhat could happen to my baby if her plagiocephaly is left untreated?\nIf left untreated, your baby’s condition may worsen, and by the time her skull is fully formed and sealed, it will be too late to correct the flattened appearance.\nThere is some evidence that vision and jaw alignment issues could result from a misshapen head. But even if the long-term effects are purely cosmetic, consider the effect on the child’s self-esteem. Many adults with untreated plagiocephaly have reported on the suffering they endured because of their deformed head shape.\nWhat is repositioning?\nRepositioning is a technique aimed at keeping your baby’s head off the flat spot and on the areas of your baby’s head that “stick out.”\nRolled towels, special pillows and sleep positioners may be recommended by your child’s physician to elevate the flattened side away from external forces that contribute to flattening such as the floor, crib mattress, car seat, baby swing, etc.\nAsk your doctor for a timeline of when to seek other treatments such as helmet therapy. Repositioning does not always work, especially if the baby is a bit older and treatment was delayed, or the plagiocephaly is severe enough to warrant a more “aggressive” treatment.\n(Note: Though we used the term “aggressive,” helmet therapy is not invasive or painful in any way. It is extremely gentle and causes no pain or discomfort to the child).\nHow long will helmet therapy take?\nIt depends. Helmet therapy can range anywhere from a few months to a year or more.\nThe general rule is, the sooner the plagiocephaly is diagnosed and treated, the faster correction will result. The younger the child, the more malleable their skull is and therefore receptive to re-formation.\nHow much does treatment cost? Will insurance cover it?\nCosts of helmet therapy depend upon several factors including how much treatment your baby needs, where your baby receives treatment, and what “brand” of helmet you choose. Helmets are generally priced at around $3,000-4,000. [in the USA]\n☞ Note Jaymee Stocks' comments are mainly about insurers in the United States. “Insurance companies can be very stubborn. Call and ask your provider if this is something they cover. If they give you a flat-out “no,” ask them to check under ‘durable medical equipment.’ If they still say no, prepare yourself for a fight. It may take some time, and you might consider starting treatment before approval, if you have an older child. On your part, it may take several appeals and hours of research, but these fights have been won over and over in the past.” If your insurance company does not cover the cost of your child’s helmet, apply for a grant from The Halo Project!\n☞ Helmet therapy in Alberta is not covered by Alberta Health. Check with your private or corporate health insurance provider about coverage.\nWhat type of doctor should we see?\nYour baby’s pediatrician should be able to diagnose him or her with a thorough examination. After a diagnosis of plagiocephaly, the doctor may refer you to a specialist such as a neurosurgeon, neurologist, or craniofacial plastic surgeon.\nLook for a specialist who has experience with infants.\nMy baby's a year old. Is it too late to seek treatment?\nIt is probably not too late, although your baby’s skull growth has definitely slowed down by now.\nSome helmet manufacturers will “band” babies up to 24 months old; however, treatment within the first year is found to be most effective.\nThe earlier the diagnosis and treatment, the better your chances of success!\nMy baby's helmet has an odor. What can I do?\nIt is normal for your baby’s head to perspire, especially during the first few weeks as they adjust to wearing the helmet.\nTake off the helmet only during the prescribed time, and wash your baby’s head using shampoo. Then clean the helmet using whatever cleaning agent the manufacturer recommends. Then, if possible, place the helmet in direct sunlight for the remainder of the “off time.” This helps to reduce odor and reduce any yellowing appearance.\nHow do I handle people staring at my baby in public?\nPeople will stare because they are curious. If you’re up for it, take advantage of the opportunity to spread awareness about plagiocephaly. Either way, keep a smile on your face and either ignore the stares or answer questions respectfully.\nHelmets can be decorated to virtually anything you can imagine to either answer the question (some say “fixin’ my melon” – watermelon theme; or “fixin’ my flat” – car theme) or make the helmet appear less medical.\nAfter helmet therapy, could my baby's plagiocephaly return?\nThere is less than a 1% chance that a child’s head will revert back to its pre-treatment shape. By the time treatment is completed, the baby’s skull bones have typically hardened and fused together, greatly reducing the chance of regression."

"About plagiocephaly or flat head\nPlagiocephaly is an uneven or asymmetrical head shape – a ‘flat head’. It can also be a flattened spot on the back or side of a baby’s head. Plagiocephaly can be mild, moderate or severe.\nBabies are often born with misshapen heads. This can be caused by the head’s position in the uterus during pregnancy, or it can happen because of the squashy passage down the birth canal.\nAlso, newborn skull bones are soft, thin and flexible. This means that the heads of newborn babies can change shape easily. So plagiocephaly sometimes happens when babies lie with their heads in the same position for a long time.\nIn some babies, more severe plagiocephaly can be caused by tight neck muscles (congenital muscular torticollis), which means babies have a strong preference for turning their heads to one side.\nLater in infancy, some babies with severe plagiocephaly might have a delay in the development of gross motor skills.\nThe proper medical name for this type of plagiocephaly is deformational plagiocephaly.\nThere’s another type of plagiocephaly called synostotic plagiocephaly or craniosynostosis. This article is only about deformational plagiocephaly.\nSigns and symptoms of plagiocephaly\nYour baby might have an uneven head shape, a flat head or flattened sections at the back or side of their head. Your baby’s ears might look uneven, and their forehead might be more prominent compared to the rest of their head.\nMedical help: when to get it for children with plagiocephaly or flat head\n- a strangely shaped head or a flat spot, which hasn’t gone back to a typical shape by about 2 months of age\n- a strong preference for turning their head to one side\n- difficulty turning their head left or right.\nTreatment of plagiocephaly or flat head\nOften, mild plagiocephaly doesn’t need treatment. It’s likely to fix itself as your baby grows.\nThis is because your baby’s head shape will naturally change as their head grows and their gross motor skills develop. When your baby starts to spend less time on their back and more time on their tummy or sitting up, there’ll be less pressure on the back of their head.\n- repositioning your baby so they avoid lying on the flat head spot when awake\n- doing gentle exercises and stretches with your baby to improve their neck movements\n- encouraging motor skills like rolling, reaching and turning\n- giving your baby tummy time and time on their side when they’re awake\n- carrying your baby in certain ways – your health professionals will advise you.\nFor severe plagiocephaly, your specialist might recommend that your child wears a specially fitted helmet, which takes the pressure off the flat spot and allows your child’s head shape to change as their head grows.\nPreventing plagiocephaly or flat head\nThere are several things you can do to prevent your baby from developing plagiocephaly:\n- Try to alternate your baby’s head position between right and left when they’re sleeping on their back.\n- When using the change table or cot, alternate the end where you put your baby’s head.\n- When your baby is awake, give them tummy time or time on their side during supervised play.\n- Play with your baby from the side they like least – for example, when you talk, sing or shake a rattle, or put toys near your baby. This will encourage your baby to turn their head to that side.\nPutting your baby on their back for sleep is the safest sleeping position. Putting your baby to sleep on their stomach or side increases the risk of sudden unexpected death in infancy (SUDI)."

"Many factors can be associated with cranial asymmetries. Some occur before birth because of limited space in the uterus. These can occur with multiple births, first born, breech births and male babies. Some asymmetries also occur during or after births. They can happen after long labors or from poor muscle tone, spine abnormalities, neck muscle tightness and positioning. Long periods of time in one position can also misshape an infant's head.\nWhat is plagiocephaly?\nPositional plagiocephaly is a disorder in which the back or one side of an infant's head is flattened, often with little hair growing in that area. It's most often the result of babies spending a lot of time lying on their backs or often being in a position where the head is resting against a flat surface (such as in cribs, strollers, swings and playpens). Learn more about plagiocephaly.\nWhat is brachycephaly?\nBrachycephaly is symmetrical flattening on the back of the head. This causes the head to look very wide above the ears and short from front to back. From the side, the back of the head looks taller than the front.\nWhat is brachycephaly with asymmetry?\nThis is a head shape that has both brachycephaly and plagiocephaly.\nWhat is scaphocephaly?\nScaphocephaly is a head that is shaped long front to back and very narrow from side to side.\nWhat is torticollis?\nTorticollis is a tightening of the neck muscles on one side of the neck. It causes the head to tip toward the affected side and rotate toward the opposite side. This preferred positioning of the neck can lead to an asymmetry of the head. If the child has torticollis, physical therapy may be recommended for further monitoring and instruction. Learn more about torticollis.\nWhat is craniosynostosis?\nCraniosynostosis is a premature union of the bones of the skull. If this happens before the child reaches full brain growth, it can cause an abnormal head shape. Doctors use physical examination and sometimes CT scans to tell the difference between craniosynostosis and plagiocephaly. If a child has craniosynostosis, Boston Bands are not used until after surgery.\nThe Boston Band uses a 3-D scan of the infant's head to ensure a custom fit. The band is made from a unique closed cell foam layering technique covered by a lightweight plastic shell. This allows the orthotist to remove layers when necessary as the child grows. The design of the band insures contact with the bulging areas of the child's head, leaving the flat areas free to grow. This enables the child to lie in any position he/she wants.\nThe Boston Band is typically recommended for children who are 3-18 months old and have any type of cranial asymmetry that has failed to improve with conservative measures, such as repositioning and/or using the Plagio Cradle.\nHow long the child may need to wear the Boston Band depends on how flat the head is and the amount of growth remaining. Children typically wear the Boston Band 23 hours a day for four months. Based on the child's age and head shape, the orthotist will outline a treatment plan specific to the child.\nA general course of treatment for the Boston Band involves:\nCustom helmet designs\nYou and your child can select from a wide range of artwork to create your very own theme for a cranial helmet. Many of these designs are patterns that can cover the entire helmet, while some are made to be placed on specific areas.\nThe Plagio Cradle was developed by Gary Rogers, M.D. and James Miller, CPO, at the Children's Hospital of Boston. This product is for preventing or treating early signs of plagiocephaly, not brachycephaly or scaphocephaly.\nThe Plagio Cradle is typically recommended for children who are 0-3 months old and must be discontinued immediately when the child exhibits signs of being able to roll over.\nA general course of treatment for the Plagio Cradle involves:\nThe American Academy of Pediatrics recommends placing sleeping infants on their backs to prevent the risk of sudden infant death syndrome (SIDS).\nBecause an infant's skull is flexible, he/she runs the risk of flattening his/her skull when against any surface. Doctors recommend alternating positions of the infant to evenly distribute the pressure of gravity on the growing skull. When parents observe flattening on the head, they should encourage a position where the flat spot is not touching. Supervised tummy time during the day is also important. A child should spend half of his/her waking time on his/her stomach.\nRepositioning is considered conservative treatment of cranial asymmetry for a child less than 6 months old. If repositioning does not improve the shape of the child's head after two months, a doctor may recommend a Boston Band.\nParents should plan on an hour for their first appointment. During this appointment, the orthotist will give the parent information about repositioning techniques, plagiocephaly, Plagio Cradle and Boston Band protocols. A general history will be taken, as well as detailed measurements and a 3-D scan.\nCost and benefits of using our cranial helmets:\nTo make a referral to one of our Cook Children's Home Health locations, call 800-747-8242. A representative will assist you.\nToll free - 800-747-8242\nAustin - 512-832-6254\nIrving - 214-596-9508\nFort Worth - 682-885-6294\nCopyright 2017 Cook Children's Home Health\nDurable medical equipment\nMeet our team\nEducation and safety\nState and government\nServicios de asistencia linguistica | Sprachunterstützungsdienst | Services de soutien linguistique | 语言支持服务 | Mga Serbisyo ng Suporta para sa Wika | 言語サポートサービス | 언어 지원 서비스 | Các Dịch vụ Hỗ trợ Ngôn ngữ | भाषा सहायता सेवाहरू | भाषा संबंधी सहायता सेवाएं | ભાષાકીય સહાયતા સેવાઓ | Услуги лингвистического обеспечения | خدمات دعم اللغة | خدمات پشتیبانی از زبان | خدمات برائے لسانی معاونت"

"What is plagiocephaly (baby head shape flattening)?\nPlagiocephaly is a fancy term for flat head syndrome. There are actually 2 types: plagiocephaly (where one side of the head is flatter than the other, commonly associated with torticollis), and brachycephaly (flat head across the whole back of the skull). Babies are susceptible to changes in the shape of their head when they are first born as the bones of the skull are soft and have not fused yet.\nRead more on Dr. Dina’s Blog – Strange baby Head Shape\nWhy does Plagiocephaly happen?\nIn 1992, the American Academy of Pediatrics introduced the “Back to Sleep” campaign to reduce the risk of SIDS. What is SIDS? Sudden Infant Death Syndrome. While this program has dramatically reduced the risk of SIDS, plagiocephaly and brachycephaly dramatically increased. Babies spend more time on their backs, and tend to be less comfortable on their stomachs. Asymmetries in head shape can also be a result of the baby’s position in the womb or birth canal.\nWhat is torticollis?\nTorticollis is an imbalance in muscle strength and range of motion, causing one side of the neck to be tight. This leads to a preference for looking to one side and a head tilt.\nRead more on Torticollis And Plagiocephaly – Achieving The Best Baby Head Shape\nWhy does it happen?\nMost cases of torticollis are congenital, meaning that the baby was born with it and is likely a result of position in the womb. Other causes can be mild trauma during delivery, or positioning in the first few weeks of life. Most often parents don’t notice that everything is on one side of the baby’s world (toys, mobile, turning to look at mom and dad, etc.) and the preference to look to one side causes a strength imbalance.\nWhat can I do?\nTorticollis Treatment and Prevention\nThe best way to ensure that your child doesn’t develop torticollis is to first take a survey of their environment.\nFor example, do they always have to look to the same side to see you from their bassinet/crib? Are all the interesting toys always on one side? Does their big brother or sister sit on that same side all the time?\nTry changing the surroundings to encourage your baby to look the other way. This can mean alternating which end of the crib their head is facing, having family members sit on opposite sides to encourage baby to look to the non preferred side, and placing all toys to the non preferred side.\nIf the preference doesn’t appear to improve, ask for a consult with a pediatric physiotherapist who can instruct simple stretching and strengthening exercises to help with the muscle imbalance.\nPreventing and treating Plagiocephaly?\nEncouraging tummy time and decreasing time spent on the back when awake is the best way to prevent the head from flattening.\nWhen baby is awake, encourage tummy time right away by having them lie on your chest, or use a rolled up towel underneath their underarms and chest. Doing tummy time on an incline (such as an angled cushion) can also make it easier by decreasing the amount that baby has to fight gravity to lift his or her head. Other positions to try while baby is awake are side lying (supported by rolled up blankets if necessary, with supervision), wearing baby in a carrier, or supported sitting. If you are concerned about the shape of your child’s head, speak to a pediatric physiotherapist for specific recommendations based on your child’s needs. In rare cases a plagiocephaly helmet may be recommended by your doctor."

"Babies can develop a flat spot on the back of their heads usually from sleeping in the same position too long alternating your babys sleep position and . Plagiocephaly is a flat spot on the back or side of a babys head it is caused by pressure on the bones of the skull before or after birth. What causes flattened areas on an infants head and what is it called learn more in this neurosurgeon edited guide to positional plagiocephaly. The most common form is positional plagiocephaly it occurs when a babys head develops a flat spot due to pressure on that area\nHow it works:\n1. Register Trial Account.\n2. Download The Books as you like ( Personal use )"

"Flat head syndrome is the name given to the condition when part of a baby’s head becomes flattened due to continued pressure on one spot.There are two types of flat head syndromes in babies.\nPlagiocephaly – This is a flattening on one side of a baby’s head.Its most common form is ‘positional plagiocephaly’, which happens when a baby’s head develops a flat area due to continued pressure on one side of their head. Babies are most vulnerable because their skull is soft and pliable when they’re born.\nBrachycephaly – This refers to the condition where a baby’s head is disproportionately wide compared to its depth.\nIt can happen when babies lie for long periods on their backs. This causes the whole of the back of their head to flatten, resulting in a much wider and shorter head.\nBrachycephaly is less common."

"Baby Flat Head Syndrome (Plagiocephaly / Brachycephaly)\nWhat is Flat Head Syndrome?\nBaby flat head syndrome (Plagiocephaly / Brachycephaly) is a condition that makes the back or side of a babys head look flattened. This can cause a misalignment of the ears and eyes as well as a distorted look to the skull. Although it is not known to cause medical problems later in life, flat head syndrome can have an impact on jaw and dental development early in life and may cause a child to be self-conscious during their early years of development.\nFlat head syndrome can occur in different forms:\nPlagiocephaly: a partial flattening on one side of the head.\nBrachycephaly: a flattening of the back of the head resulting in a wide appearance.\nWhat is it caused by?\nFlat head syndrome is caused by external pressure on the babys skull. There are a number of contributing factors including:\n- Constant positioning: Young babies spend a lot of time lying on their backs. This causes constant external pressure on the back of the skull.\n- Birth: Babies are often born with slightly misshapen heads during birth due to the pressure from the birthing canal.\n- Torticollis (Wryneck): Sometimes the muscles on one side of a babys neck can become tight or shortened causing babies to favour looking in one direction. This means they will also tend to sleep with their head in one position which can lead to plagiocephaly.\n- Infant seats: Infant car seats and carriers may cause regular external pressure on the back of the skull.\nCraniosynostosis is a more serious condition that may also cause a misshapen head. This condition is caused by premature closing of a babys skull sutures (internal rather than external factors). The rest of the skull can continue to grow while the affected area is prevented from growing. Surgery is the only way to correct Craniosynostosis.\nWho is at risk?\nBabies are most vulnerable to flat head syndrome (Plagiocephaly / Brachycephaly) in their first three months. During this time their skull bones are soft and can flatten if put under constant pressure.\nPremature babies are particularly prone to this condition because their skulls are softer than full-term babies.\nHow is it treated?\nFor information about flat head syndrome (Plagiocephaly / Brachycephaly) treatment and prevention visit our Treatments page.\nThe Mimos Baby Pillow can be of great help in the prevention and correction of plagiocephaly/Brachycephaly. It has a wide range of benefits and is becoming increasingly recommended by Paediatricians and Craniofacial Experts. For more information about the benefits click here."

"Well hello everyone! My name is Lisa and I am a paediatric physiotherapist. This is my first blog ever!!!! So I am a little bit nervous but also super excited to be able to share some of my knowledge and experiences with children and their development. I really hope what I share is of some benefit or interest to you.\nToday I am going to follow on from a talk about plagiocephaly posted late last year by Dr Katie Drewett (http://www.kids-health.guru/plagiocephaly/), and talk briefly about the way I manage positional plagiocephaly through physiotherapy.\nWhat is positional plagiocephaly?\nJust to recap from Dr Katie’s talk, positional plagiocephaly is one of a group of terms used to describe a positional asymmetry, “flat spot” or “odd” head shape caused by positioning. It is a flattening on one side of the head caused by spending long periods of time on one side compared to the other. Other “odd” or “flattened” head shapes I see in clinic include brachycephaly (flattening across the back of the head leading to a head shape that is very wide at the back compared to the front); and scaphocephaly (flattening on both sides of the head leading to a narrow head shape). Plagiocephaly is the most common presentation and is what I will refer to in this article, but the overall management principles can apply to all “flat spots” caused by positioning.\nWhat causes positional plagiocephaly?\nNewborn babies’ skulls are soft, thin and flexible and therefore prolonged pressure on one area can cause the individual bones of the skull to slide and move over one another causing flattening in that area. This flattening can be caused by prolonged pressure in utero (inside the uterus/during pregnancy), after birth from the baby not having opportunity to change position enough or from difficulties moving their head due to neck tightness or muscle weakness. A small percentage of head asymmetries can also be caused by an early fusion of the bones in one area which then causes the head to grow asymmetrically or out of proportion. This is known as “cranial synostosis” and often requires surgery. An assessment by a medical professional such as a paediatric physiotherapist, GP or Paediatrician can help determine this.\nWhat do paediatric physiotherapists do?\nAs a paediatric physiotherapist, my aim is to assess for developmental and or movement difficulties and provide activities to support development of weaknesses in these areas. When assessing an infant with an “odd” head shape or “flat spot”; I look for muscle tightness, weakness, motor and sensory difficulties to determine if the flattening is due to the position the head spends time in or early fusion, in which case I will refer onto a specialist for further assessment and management. I also assess the baby’s environment and opportunities for play and movement. This helps me to determine the appropriate method for management.\nHow do we manage “odd” head shapes or “flat spots”?\nMethods of management for positional head asymmetries include:\n- Positional/ exercise therapy\n- Cranial orthosis (helmet)\nPositional head asymmetries are graded by the severity of flattening plus associated facial asymmetries (differences in facial features between sides). This severity in conjunction with the age of the baby will determine the preferred method of management.\nIf your child has an asymmetrical head shape, your paediatric physio will grade the severity based on how bad the flattening is and if it has affected the appearance of the face. They will then decide on a plan of management based on this and the age of the baby.\nIn most cases, positional/ exercise therapy is the preferred method (as directed by your paediatric physio), unless the asymmetry is severe with associated facial asymmetries and/ or the infant is older (usually more than 6 months old). In which case a referral to an orthotist who specialises in cranial orthotic management is recommended.\nThere is a good amount of research that shows us that there is no significant difference in the overall outcome of using a cranial orthosis (helmet) compared to exercise therapy to treat positional plagiocephaly and helmet management is very expensive.\nResearch tells us that the asymmetry may resolve quicker with a helmet, however they can be expensive, and they need to be worn up to 23 hours day for an average of 12 weeks depending on the severity and age of the infant. Wearing a helmet can lead to other difficulties with sleep, irritability and minor motor delays due to the weight of the helmet. Infants must have good head control to be fitted with a helmet due to the moulding process and therefore infants are not considered for helmet therapy until at least 4 months of age. Even if helmet management is chosen, it is still recommended that infants also to do the required exercise therapy as they will usually have associated weakness, tightness of muscles or delays.\nMost positional asymmetries are noticed under 4 months of age. The most rapid period of brain growth in an infant is between 4 and 12 months of age and is therefore the period of time where most change in the head’s bony structure will also occur. Therefore, the goal of therapy is to develop the strength and motor control of the infant as soon as the “flat spot” is noticed, so that they can achieve independent movement to change position regularly such as rolling over and tummy time and therefore reduce the amount of prolonged pressure on their skull. It is also imperative to educate the carer about the importance of changing positions for play and minimising time in static positions such as lying in a pram and car capsule as these positions place pressure on the head and increase the risk of positional changes.\nThe only exception to this is sleep. SIDS guidelines state that infants must be slept on their backs to minimise the risk of SIDS. Due to this, health professionals will often recommend parents ensure they turn the infants head on different sides for each sleep. This is good, however, when an infant is still quite young and hasn’t developed neck control yet, their head will often fall back onto the ‘flat spot’ as gravity will force the weight of the head to fall to the flattest area. I also find recommending this as a main strategy can stress many parents out, as they worry that the infant is not keeping their head on the other side or are concerned about waking their baby up. It also causes some parents to look at other ways to keep the head on the other side by using pillows, towels and changing the position of their baby from their back which is NOT recommended by SIDS.\nSo rather than stress parents about sleep time, I prefer to work on the ‘active’ or ‘awake’ time. I teach parents exercises to use at nappy change time and when the baby is awake to develop strength in the neck and back muscles to develop motor skills so that they can in turn start to change their own position independently when awake and when asleep. Placing the infant in different and varied positions for play (side lie, back, tummy) can also help. And using a baby carrier for mobility rather than a pram also reduces the time that the baby is lying on their “flat spot”. Encouraging active movement helps to develop the balance system (vestibular system) which is very important for motor control. Infants with well-developed balance skills and who are provided with good amounts of vestibular input tend to develop motor skills earlier than their peers and are less likely to develop head asymmetries. The type of exercises and positions I teach parents is dependent on the location of the flattening, the cause of the flattening (I.e. weakness, tightness, prolonged positions in static positions) and the age of the infant.\nWhat do I do if I am concerned about my baby’s head shape?\nIf you have concerns about your infant’s head shape, would like further information or an assessment contact your GP, child health nurse, Paediatrician or paediatric physiotherapist.\nI hope you have found this intro to the management of positional plagiocephaly useful and I look forward to sharing information and tips on other child development topics with you.\nMy next topic will be on Developmental Coordination Disorder (DCD) so stay tuned for that.\nHave a great day!"

"Does Your Baby Have Plagiocephaly?\nHave you ever noticed that your child has an assymetrical head shape or flatness on the back of his or her head? Do you think that this is typical and that all children have a flat spot from sleeping on their backs? This is actually atypical, and may be diagnosed by a doctor as plagiocephaly. Although a diagnosis of plagiocephaly may be alarming, it is usually only an asthetic change, with no research to suggest that it has any effect on brain development.\nWhat is plagiocephaly?\nPlagiocephaly, also referred to as deformational or positional plagiocephaly, is a common condition characterized by a flat spot on your baby’s head. It is often associated with other asymmetries of the head and face, including:\n- Prominent or sloping forehead\n- One ear shifted forward\n- One cheek appearing fuller\n- One eye appearing smaller\nWhat causes plagiocephaly?\nPlagiocephaly is caused by prolonged or repeated pressure to one spot of your baby’s head. Babies are more at risk because the bones of their skull are soft and have not fully fused, making them more malleable than a fully developed skull. The following may put your baby at risk for plagiocephaly:\n- Position in utero: Babies may be born with plagiocephaly. It is more common in multiple births or babies who are breech, due to less space for the baby to move in the womb.\n- Prematurity: Babies born early typically have thinner skulls. Additionally, they may spend more time in one position if they require extra medical attention in the neonatal intensive care unit.\n- Back sleeping: Since the American Academy of Pediatrics introduced the Back to Sleep Campaign in 1992, the incidence of sudden infant death syndrome (SIDS) has decreased by 50 percent. But there has also been an increase in plagiocephaly due to the increased time babies spend on their backs.\n- Back positioning throughout the day: Babies who spend the majority of their days in devices such as swings, car seats and bouncy chairs are more likely to develop a flat spot on the back of their head.\n- Torticollis: Babies with torticollis have difficulty turning their heads to one side. This causes them to keep their heads turned to one side for prolonged periods of time, which may cause a positional plagiocephaly.\nIs plagiocephaly preventable?\nBecause plagiocephaly is most commonly caused by increased pressure to one area of the head, the best prevention is to make sure that your baby is in various positions throughout the day. It is imperative that babies be put down on their back to sleep, but while they are awake, the American Academy of Pediatrics recommends supervised tummy time. This, in addition to limited time in devices (swings, car seats and bouncer chairs), will alleviate pressure on the back of your baby’s head.\nIs plagiocephaly treatable?\nTreatment of plagiocephaly is usually noninvasive and may include:\n- Positioning: Your doctor or physical therapist may recommend different positioning techniques to remove the pressure from the flattened part of the baby’s head.\n- Stretching: If your baby has a preference to look to one side, your doctor or physical therapist may suggest specific stretches to help your baby move his or her head in all directions.\n- Customized helmets: – Your doctor or physical therapist may refer you to an orthotist who will make a customized helmet to alleviate pressure and mold the quickly growing skull.\nIf you are concerned that your baby may have plagiocephaly, always discuss it with your pediatrician before attempting any treatments on your own."

"What Is Plagiocephaly?\nDeformational plagiocephaly, also called “flat head syndrome,” is a condition in which a baby’s head has an uneven or irregular shape caused by external forces.\nFlat head syndrome is often associated with another condition called torticollis. Torticollis occurs when the muscle on the side of the neck gets shortened or tightened. Simple deformational plagiocephaly can often appear to be a more serious condition, such as craniosynostosis.\nWhat Causes Plagiocephaly?\nDeformational plagiocephaly can occur while a baby is still growing in the uterus. It can also develop after birth.\nCauses Before Birth\nBefore delivery, a baby drops into the mother’s pelvis. If it happens too early, the baby’s head might rest against a flat surface, where it can build pressure and cause flattening. Infants at greater risk for this occurrence include unusually large babies, breech babies and multiple birth babies.\nOther causes of deformational plagiocephaly before birth include:\n- Pressure inside a uterus that is either too small or crowded (in a multiple birth pregnancy).\n- Unusual fetal positioning inside the uterus.\n- A uterus that contains too little amniotic fluid.\nCauses After Birth\nAfter birth, deformational plagiocephaly can occur if a baby frequently lies in the same position. As the head begins to flatten, it naturally rests on that flat area, potentially worsening the problem.\nThe American Academy of Pediatrics (AAP) Task Force on Infant Positioning and Sudden Infant Death Syndrome (SIDS) recommends placing infants on their backs to sleep. This recommendation has led to a dramatic reduction in cases of SIDS. Gillette Children’s Specialty Healthcare fully supports this recommendation.\nHowever, since AAP introduced the “Back to Sleep” program in 1992, baby flat head syndrome has become more common because babies are spending more time on their backs, in one position. To help lower the risk of deformational plagiocephaly while also protecting against SIDS, our craniofacial team recommends frequent “tummy time” during waking hours and play to balance out positioning.\nPlagiocephaly and Prematurity\nBabies born early might be at greater risk for deformational plagiocephaly because their skull bones are softer than those of full-term babies. Additionally, premature babies often remain in a fixed position during their longer hospital stay, increasing the likelihood of a flat spot developing.\nPlagiocephaly and Torticollis\nBabies often develop plagiocephaly as a result of muscular torticollis, a condition in which a muscle on the side of the neck is short or tight. Torticollis can limit a baby’s ability to turn toward the affected shoulder, causing them to consistently hold their head in one position. Over time, this one-sided positioning can flatten one side of the head.\nPlagiocephaly Symptoms and Effects\nIf your baby has flat head syndrome, you might notice a flat spot on the back or side of the skull. That flatness gives the skull an uneven or irregular shape. Because the head naturally rests on the slightly flattened area, the condition can get worse if not treated.\nPlagiocephaly Diagnosis and Treatment\nInfants are typically diagnosed with deformational plagiocephaly between 4 and 8 months of age. If your baby develops the condition before birth, it is sometimes diagnosed earlier than 4 months.\nIf you or your pediatrician notices your child has an irregular head shape, the Gillette team of craniofacial experts can do a series of tests to form a diagnosis. By confirming a diagnosis of plagiocephaly we can rule out craniosynostosis, a more serious condition that requires surgery.\nSometimes plagiocephaly corrects itself. But it can also get worse if not treated. We can’t predict whether your child has the type of plagiocephaly that corrects itself. That’s why we guide families and caregivers in their decision to treat the condition with a custom-made baby helmet called the Gillette CranioCap® orthosis.\nBabies who have torticollis, a condition that sometimes accompanies plagiocephaly, might benefit from additional treatment options, including physical therapy. However, alternative therapies, such as chiropractic or other manual techniques, have not been shown to improve deformational plagiocephaly.\nIf your child has flat head syndrome, the Gillette team of specialists will work closely with you and your family to create the right plagiocephaly treatment plan for your child. Our experts can guide you through the services your child will need.\nYour child might receive care from specialists in the following areas related to diagnosing and treating deformational plagiocephaly:\nThe family-focused specialists at Gillette treat more than 1,000 children each year who have deformational plagiocephaly. Our experts can quickly distinguish deformational plagiocephaly from more serious conditions—such as craniosynostosis—to properly treat your child."

"Is this condition painful?\nNo, deformational plagiocephaly causes no symptoms.\nAre there different types deformational plagiocephaly?\nIn general, plagiocephaly can affect the forehead (anterior plagiocephaly) or the back of the head (posterior plagiocephaly). Posterior plagiocephaly is much more common because babies are usually positioned on their backs to sleep.\nLots of babies have slightly abnormal head shapes; how do I know when it is something to worry about?\nAbnormal head shapes in babies are quite common. In general, abnormal head shapes can be caused by either craniosynostosis (premature fusion of the cranial sutures), which is described elsewhere in this website, or by deformational plagiocephaly, which is much more common. Deformational plagiocephaly does not cause any increased pressure on the brain and is not associated with any danger to the neural development of the child. The most common form of deformational plagiocephaly is flattening of the back of the head (posterior plagiocephaly), caused by repetitive sleep positioning.\nIf your baby has an abnormal head shape, you should raise this concern with your pediatrician. Often the pediatrician will be able to distinguish whether your child has the much more common deformational plagiocephaly or the much less common craniosynostosis. If the pediatrician in unsure, then you should be referred to see a craniofacial surgeon, who can usually make the diagnosis by physical exam.\nWho gets deformational plagiocephaly?\nDeformational plagiocephaly can occur in any infant. Anterior plagiocephaly (flattening of the forehead) occurs most commonly on the left side, because the left occiput anterior position is the most common intra-uterine fetal head position. The heads of babies with anterior plagiocephaly often engage in the maternal pelvis rather early. Deformational plagiocephaly is also more common in multiple pregnancies, in which there is less space for the growing skull. Moreover, there may be molding of the skull that occurs from compressive forces during normal vaginal delivery.\nPost-natally, repetitive sleep positioning can cause deformational plagiocephaly. If the baby sleeps in the same position repeatedly, the skull will become flattened on the side on which the baby sleeps. In addition, some eye muscle imbalances cause infants to tilt their heads to achieve binocular vision, and this head tilt can also result in deformation from repetitive positioning. Similarly, torticollis (tightness of the sternocleidomastoid muscle in the neck) can cause a head tilt with the same result.\nWhat are the main issues related to deformational plagiocephaly?\nDeformational plagiocephaly is essentially a cosmetic deformity. There are no issues related to the growing brain or to intellectual ability. However, as noted above, there may be underlying causes of deformational plagiocephaly, such as ocular problems or torticollis that must be investigated and addressed. In severe cases, the deformity may become a source of psychosocial stress for the child as he or she grows.\nWhat is the treatment for babies with deformational plagiocephaly?\nMost babies can be treated with modification of their sleep positioning. The goal is to relieve pressure on the flat area of the head. By using positioning devices, such as foam wedges, and by changing the orientation of the child’s crib, pressure can be relieved and the shape of the skull will gradually correct itself. In infants with ocular problems, eye muscle surgery may be required to correct the head tilt. For infants with torticollis, usually a physical therapy program of stretching will correct the head tilt; in some cases, surgical release of the tight neck muscle is required.\nWhen it seems that these maneuvers are ineffective, molding helmet therapy can be used to treat deformational plagiocephaly. The baby is fitted for a helmet that gently reshapes the skull. The helmet is adjusted at regular intervals, and must be worn twenty-three hours per day for several months. Helmet therapy is most effective if it is instituted before approximately ten months of age.\nIn extremely rare cases of very severe deformities, surgical reconstruction of the deformed skull is performed.\nWhat sorts of specialists will be involved in my baby’s care?\nBabies with deformational plagiocephaly are seen primarily by the craniofacial surgeon and the neurosurgeon. When molding helmet therapy is used, the baby is seen frequently by the orthotist, who makes the helmet and modifies it as needed.\nThe STAR Scanner\nThe University of Missouri Center for Craniofacial Anomalies now has a STARscanner™ Laser Data Acquisition System in our clinic. This FDA-approved device allows us to quickly, safely, and easily perform a 3-D surface scan of a baby’s head shape. The 3-D information can then be viewed in multiple planes. The scanner uses an eye-safe laser, and the scan takes less than 2 seconds to complete. For infants with deformational plagiocephaly, the data obtained from the scan can be used to create the cranial molding helmet and to very exactly measure the improvement in head shape at each visit. For infants with craniosynostosis or other diagnoses that affect head shape or growth, the STARscanner allows us to accurately measure and track changes in head shape and growth to help make treatment decisions and to document the effect of treatment on the cranium. Having this technology in our clinic will enable our patients to see Dr. Muzaffar, have their scan, and see the orthotist who will be involved in the fabrication and adjustments of the helmet all in one place and at one visit."

"What causes Plagiocephaly?\nPlagiocephaly, one type of head flattening in babies, can either be acquired or congenital, which is when the baby is already born with the condition. The causes can be different depending on the type.\nCongenital plagiocephaly is rare, and according to diagnosispro.com, can be caused by either Curry-Jones syndrome or Faciocardiorenal (Eastman-Bixler) syndrome. Both conditions are very rare, and have several physical markers. Additionally, they can cause developmental, cognitive and motor delays. If your pediatrician suspects one of these conditions, make sure that your child receives the necessary care immediately.\nAcquired or Positional Plagiocephaly\nIn the majority of cases, plagiocephaly is acquired. There are different types of acquired plagiocephaly, with varying causes.\nThe four most common causes of acquired plagiocephaly are:\n- frequent pressure on one part of the skull,\n- muscular torticollis, and\n- a restrictive uterine environment.\nPremature babies can develop plagiocephaly when their soft skull bones pass through the birth canal. There is some suspicion that extended time on their backs in neonatal intensive care units increases the risk of plagiocephaly in premature infants.\nThe incidence of plagiocephaly in babies who were not premature is often associated with the SIDS Back to Sleep campaign. Babies who spend extended periods of time on their backs can develop the condition as a result of positioning. Infants who spend considerable time in car seats, swings, or bouncers (where the baby is lying on the back) are also at risk if their position is not frequently adjusted.\nAnother common cause of plagiocephaly is muscular torticollis – a condition in which one of the neck muscles is either tighter or shorter, which encourages a baby to keep their head in one position. Roughly 85% of babies diagnosed with plagiocephaly show evidence of muscular torticollis as well. A small uterus, where a developing fetus has little room for mobility can also put an infant at risk for plagiocephaly.\nIn plain English, individuals with acquired plagiocephaly have heads that are flattened in one area as a result of something applying pressure to the skull before the bones of the head fused together.\nKeep in mind that some babies are more prone to this condition, and there is absolutely no reason to feel guilty if your baby has been diagnosed with plagiocephaly!\nIf you would like updates on the latest news about flat head syndrome, advice from experts, and stories from other parents, as well as our free book about how to do tummy time and make it fun for your baby, please enter your email below. We promise not to make your information available to anyone else."

"What is Plagiocephaly /Baby Flat Head Syndrome?\nPositional Plagiocephaly is a condition that affects the skull, making the back or side of a baby’s head appear flattened. It may also involve bulging of the forehead, fullness of the cheek and ear misalignment on the same side as the flattening.\nThere are two types of the condition – Deformational – where the condition is caused by the birth process itself – and Positional – where it occurs post birth. Positional Plagiocephaly is more common.\nUnder the broad heading Positional Plagiocephaly there are three main types of asymmetrical head shape associated with the condition:\nA baby’s skull is made up of several ‘plates’ of bones which at birth are not tightly joined together. They are soft enough to be moulded by outside forces; this means their shape can be altered by pressure, just lying or sitting in the same position against a firm surface can cause flattening usually at the back of a baby’s head.\nIf you are concerned about the shape of your baby’s head, help and advice is at hand. You can get immediate and free advice from one of our experienced clinicians with our clinical plagiocephaly diagnosis form.\nPositional plagiocephaly can be caused by a number of factors involving positioning, such as extended time spent in a neonatal unit, the birth process, position in the womb and often the infant's preferred sleeping position. It can also be caused by a condition called torticollis.\nWhat is Torticollis?\nTorticollis is a condition in which a tight or shortened muscle in one side of the neck causes the head to tilt or turn to one side, resulting in the infant resting its head in the same position. In 2013, we analysed the data from all first appointments in our Kingston clinic and found that 20% of the babies examined had some kind of neck condition that was causing head immobility.\nHow Common is Positional Plagiocephaly?\nFrankly there does not seem to be much consensus on the incidence of Positional Plagiocephaly. The situation is not helped by the fact that the NHS does not measure head shapes either at birth or subsequently. Where head shapes are measured in other countries it is difficult to make comparisons because one is never certain that the same methodology is being used. Great Ormond Street Hospital for Children says: “Some reports estimate that Positional Plagiocephaly affects around half of all babies under a year old but to varying degrees.” GOSH’s summary is supported by a Canadian study published in 2013 which found that 46.6% of a sample of 440 infants at a two-month well child clinic had some form of Positional Plagiocephaly.\nSource: The incidence of Positional Plagiocephaly: A Cohort Study:Pediatrics peds. 2012-2009; published online July 8 2013"

"Treatment options for head flattening in infants – plagiocephaly, brachycephaly, and torticollis\nA diagnosis of Flat Head Syndrome can be confusing. Many new parents are unaware that the condition exists, and how it can be treated. We’ll go over some common treatment strategies for plagiocephaly and brachycephaly in this article, including repositioning, physical therapy, and the use of orthotics such as helmets and bands. Surgery isn’t recommended for positional cephalic disorders, and we’ll discuss why that is the case, as well.\nEarly treatment is critical\nThere is a standard pattern of treatment for positional cephalic disorders that most doctors will follow. Initially, repositioning or physical therapy may be suggested as mild techniques that can improve skull shape and development patterns. If your child has muscular torticollis, physical therapy is almost always recommended. The goal of physical therapy and repositioning is to encourage your child to strengthen the neck and back muscles necessary to lift and rotate its head voluntarily and to begin to sit up without assistance. This helps your baby reduce the amount of time that they spend on their backs, with pressure on their flat spot. Sitting and head rotation and lifting skills are often noted to coincide with an improvement in head shape even when no therapy or repositioning is used to encourage their development.\nIf your child’s skull shape does not improve in response to physical therapy or repositioning, the use of a helmet or band may be suggested. These orthotic devices can yield significant results within a few short months. They are, however, far more expensive than physical therapy. Regular trips to the doctor or orthotist are required, and there may be self-esteem issues later in life that result from orthotic use, although this is still a topic of debate. The technique is reserved for more severe cases of flat head syndrome or scaphocephaly, and parents are advised by both doctors and insurance companies to follow a treatment protocol of physical therapy, repositioning, and tummy time before resorting to helmet or band use. The treatment works by encouraging the skull to develop a normal shape by restricting growth in one area, and encouraging growth in other areas. Devices can be passive or active, although the actual difference between these two types is often considered negligible.\nOutcome and risks\nPositional cephalic disorders are a hot topic of research at present, and their long term consequences are poorly understood. Some doctors believe that the conditions are largely self-correcting, while others suggest that developmental delays and lifelong physical deformities may result from the failure to treat flat head syndrome early and correctly. This will depend of course on the severity of the condition.\nSome complications associated with the condition are motor skills delays, TMJ (dysfunction of the joint that connects the upper and lower jaw), sleep apnea, and physical deformation. The risks of failing to treat flat head syndrome are unknown.\nThat said, most milder cases of plagiocephaly and brachycephaly will improve to some degree on their own, and may be resolved entirely. Each case is different, and many factors are involved such as the severity of the condition and the age of the child.\nCan this be surgically corrected?\nSurgery is a poor option for flat head syndrome. Most doctors will agree that it is unnecessary and overly risky. In order to repair these deformities via surgical means, an expensive operation that places the child’s life in danger is required. The removal or re-sectioning of cranial bones is involved, and the lack of known lasting impacts makes surgery too much of a risk."

"Oral Health conditions\nIn the folk song “Dem Bones, ” every bone is connected to the next one in line. Here’s an interesting wrinkle on that idea: The gum bone, or at least problems with it, are connected to all sorts of health problems.\nGum disease—which begins when the sticky, bacteria-laden film known as plaque builds up around your teeth—is closely linked to premature birth, heart disease, diabetes, and other chronic health problems. Now, a report in the August issue of the American Journal of Preventive Medicine finds that treating gum disease (also called periodontal disease) can lead to better health — as evidenced by lower health care costs and fewer hospitalizations — among people with common health conditions.\nThe study looked at health and dental insurance records from nearly 339, 000 people, all of whom had periodontal disease and one of five conditions: type 2 diabetes, cardiovascular disease, cerebrovascular disease (usually a stroke), rheumatoid arthritis, or pregnancy. Researchers found that people with four of the five conditions (all except rheumatoid arthritis) who had at least one periodontal disease treatment had lower medical costs and fewer hospitalizations within four years of the treatment compared with people who weren’t treated.\nThe savings were especially striking — 74% lower — among pregnant women. The savings came from avoiding the costs associated with premature births, which has been linked to periodontal disease, and other complications. People with cardiovascular disease and diabetes who had their periodontitis treated had health-care costs that were between 20% and 40% lower.\n“This is a really solid finding and a testimony to what we’ve been preaching, ” says periodontist Dr. Alpdogan Kantarci of the Harvard-affiliated Forsyth Institute, a not-for-profit research organization focused on oral health. Daily tooth brushing and flossing can prevent and even reverse the earliest form of gum disease, called gingivitis, says Dr. Kantarci.\nLeft untreated, gingivitis can turn into periodontal disease. The gums pull back from the root of the tooth, creating a tiny pocket that gradually widens. Eventually, the infection and inflammation attack the tissue that holds the tooth to the jawbone, which can cause the tooth to loosen and possibly fall out.\nA dentist or hygienist can treat periodontal disease by cleaning the teeth above and below the gum line, a procedure known as scaling and root planning (SRP). They use manual scalers or ultrasound devices to scrape away hardened plaque (tartar). Most people only need local anesthesia, such as a shot of Novocain.\nThe common thread between gum disease and chronic health conditions is inflammation — the body’s natural response to an infection or injury. The build-up of inflammatory substances in the blood seems to worsen heart disease, diabetes, and other chronic conditions. Eliminating the gum infection may dampen that harmful response throughout the body.\nBottom line: As your dentist always tells you, brush and floss every day to keep your gums healthy. Be on the lookout for these signs of gum disease—especially if you’re pregnant or have a history of heart disease, stroke, or type 2 diabetes—and seek treatment.\nSigns of gum disease\nAny of these signs can be a clue that you have periodontal disease:\n- swollen, red, or tender gums\n- gums that bleed easily\n- pus between the teeth and gums\n- bad breath\n- buildup of hard brown deposits along the gum line\n- loose teeth or teeth that are moving apart"

"In 2014 the American Journal of Preventive Medicine did a study to see what impact periodontal therapy had on general health. What they found was staggering. By treating periodontal disease, you can save significant sums of money.\nPeriodontal disease has been closely linked to premature birth, heart disease, diabetes, and other chronic health problems. The study found that treating periodontal disease can help you achieve better health, which leads to fewer hospitalizations and lower health care costs.\nThe study looked at the health and dental insurance of 339,000 people that had periodontal disease in addition to one of five conditions; type 2 diabetes, cardiovascular disease, cerebrovascular disease, rheumatoid arthritis, and pregnancy.\nSubjects with four of the five conditions who had at least one periodontal disease treatment had lower medical costs and fewer hospitalizations within four years of treatment compared to people not treated.\nThe savings among pregnant women were 74 percent, which came from avoiding costs associated with premature births and other complications. Savings for those with cardiovascular disease or diabetes were anywhere from 20 percent to 40 percent.\nThe origin of periodontal disease is untreated gingivitis. The gums pull back from the root of the tooth and create tiny pockets that gradually widen. The body’s natural response to infection or injury is inflammation, which then attack the tissue that holds the tooth to the jawbone, which can cause the tooth to loosen and fall out.\nIt’s this inflammation that is the link between periodontal disease and chronic health conditions. Inflammatory substances build up in the blood, which worsens heart diseases, diabetes, and other chronic conditions. So by treating periodontal disease, you’re improving your chances against potentially fatal diseases.\nImproving your oral health doesn’t just help to prevent diseases of the mouth but can help prevent other conditions such as heart disease and diabetes. Studies now show that by treating periodontal disease, you can experience significant savings in medical costs. So if you suffering from periodontal disease, come in to see us and help improve health and finances."

"Corticosteroids' Effect on Fetal Lung Maturation (1972), by Sir Graham Collingwood Liggins and Ross Howie\nMetadataShow full item record\nIn a clinical trial from 1969 to 1972, Sir Graham Collingwood Liggins and Ross Howie showed that if doctors treat pregnant women with corticosteroids before those women deliver prematurely, then those women's infants have fewer cases of respiratory distress syndrome than do similarly premature infants of women not treated with corticosteroids. Prior to the study, premature infants born before 32 weeks of gestation often died of respiratory distress syndrome, or the inability to inflate immature lungs. Liggins and Howie, then both at the University of Auckland in Auckland, New Zealand, published their results in A Controlled Trial of Antepartum Glucorticoid Treatment for Prevention of the Respiratory Distress Syndrome in Premature Infants in 1972. The study built on experiments Liggins had earlier conducted with sheep. Liggins' corticosteroid experiments changed the way doctors treated pregnant women experiencing preterm labors, and they improved the life expectancy of prematurely born infants."

"The inflammatory shift of pregnancy\nDuring pregnancy, the female body must balance the act of protecting the fetus against harmful microorganisms and maintaining a tolerance to paternal antigens from the fetus, in order to prevent rejection. In a novel paper by researchers from Uppsala University, a large shift in inflammatory status of women in late pregnancy and around two months after delivery is revealed.\nThe SciLifeLab Clinical Biomarkers facility enabled 92 immune system-related markers to be measured with high sensitivity in blood samples from the 290 women who participated in the study. It was found that 41 markers decreased from late pregnancy to postpartum, while nine markers increased. Several of the top proteins that were higher in pregnancy than postpartum have anti-inflammatory and immune modulatory properties promoting pregnancy progress.\nThese results clearly reflect a tremendous change in the immune system, which can partially be explained by alterations in hormonal levels. With greater understanding of the inflammatory adjustments a pregnant body undergoes, advancement could be made in finding causes and treatment to pregnancy and postpartum complications, such as preeclampsia, preterm birth and perinatal depression. It may also offer new strategies for treating autoimmune disorders, which commonly go into remission during pregnancy, only to flare up again in after the baby is born.\nRead the full paper in Scientific Reports"

"Ka Hung Chan, Derrick Bennett, Kin Bong Hubert Lam and Zhengming Chen\nChronic liver diseases (CLD), such as liver cirrhosis and liver cancer, affect more than 800 million people worldwide, with a third of these living in China. Smoke from solid fuels (e.g. coal and wood) and tobacco contains high concentrations of thousands of toxic chemicals. When breathed in, these chemicals can reach and harm major internal organs, including the liver.\nThe Obstetrics and Periodontal Therapy (OPT) Study was an NIH-funded randomised controlled trial designed to evaluate whether periodontal treatment in pregnant women had any effect on preterm birth; its findings were published in 2006. The investigators randomly assigned about 800 women who had been pregnant for less than 16 weeks, and had periodontal disease, to one of two groups. One group received periodontal treatment during pregnancy, whereas the other group received treatment after pregnancy.\nAlthough the study found that treatment controlled periodontal infection and reduced the microorganism load, there was no difference in preterm birth rates between the two groups. The investigators concluded that treating periodontal disease during pregnancy did not affect the risk of preterm birth. However, they also found that there were more stillbirths in the group that received treatment after pregnancy, suggesting that periodontal treatment may improve survival of fetuses. The potential bias resulting from the intervention affecting both the outcome (in this case, preterm birth) and survival (in this case, stillbirth) was acknowledged as a limitation."

"Obesity during pregnancy could be a factor that increases a child’s risk of suffering from cerebral palsy. However, researchers in a recent study cautioned against assuming any cause-and-effect link between obesity and cerebral palsy.\nThe association between obesity and cerebral palsy was pointed out in a study that focused on one million Swedish children. These children were monitored over a period of eight years, and the researchers found that the cerebral palsy risk for these children was approximately two cases for every 1,000 babies. They also found that women who suffered from some of the most severe forms of obesity, were much more likely to have children who suffered from cerebral palsy. They also found that the incidence of cerebral palsy was high even in children who were born at full term.\nThe researchers insist that this only shows an association between a woman’s weight during her pregnancy and an increased risk of cerebral palsy, but does not confirm that maternal obesity gives rise to cerebral palsy.\nOverall, doctors do suggest that women maintain an ideal weight before pregnancy in order to reduce the risk of maternal complications. If you are trying to get pregnant, adopting a healthy lifestyle can increase your chances of conceiving as well as reducing risks related to childbirth. Adopting a healthy diet, exercising, and avoiding smoking and alcohol only help to have a safe and healthy pregnancy. However, do not attempt to lose weight, go on a diet or exercise, while you are pregnant without consulting your doctor.\nCerebral palsy is a condition that is characterized by different types of symptoms. A child who suffers from cerebral palsy may suffer from challenges and limitations that are very different from another child without cerebral palsy. Broadly, cerebral palsy refers to a set of neurological conditions that primarily affect a person’s movement, speech and other abilities. Symptoms of cerebral palsy are non-progressive, which means that the symptoms do not necessarily become worse over a period of time.\nIn fact, children with cerebral palsy can learn to manage these limitations, and cope with these challenges over time, via therapy and other techniques. Advancements in medical technology mean that patients with cerebral palsy are growing up to become more independent, and are able to successfully challenge their own limitations, and do well in academics, extra-curricular activities and other aspects of life.\nIf your child has been diagnosed with cerebral palsy, there are a number of steps that you can take to help him. Talk to your doctor about these. Most importantly, keep your stress levels under control, and get support. There are support groups and communities in your area that can give you tips on coping. With your child’s condition, you need all medical information, including doctor phone numbers, medical records, diagnostic test results, and other information ready at hand. Keep all of this well- organized.\nThe Indiana medical malpractice attorneys at Montross Miller Muller Mendelson & Kennedy, LLP provide legal representation to persons whose children have suffered cerebral palsy as a result of a childbirth injury. Contact them right away if you believe you might have a claim."

"Antibiotics in preterm labour linked to cerebral palsy in infants New research has linked the practice of giving antibiotics for some women vulnerable to premature birth to cerebral palsy and additional problems in infants. The researchers from the University of Leicester in the UK say their findings reaffirm that doctors shouldn’t make use of antibiotics for premature labour when the mother’s water is normally intact and there is absolutely no infection. Their study looked at women vulnerable to premature labour who had no signs of disease and the experts say the problem is not the antibiotics but rather the situation in which the antibiotics are provided. The analysis found 35 cases of cerebral palsy in 769 children of women without early broken waters who were given antibiotics.He spends hours every full day in his room performing them. Is there any redeeming educational worth to video games? Some seem like they may help him learn strategy. But I get worried that others may be too violent or numb his mind. – Scottie Some video games might improve kids’ hand-eye coordination and problem-solving skills. Video games that require kids to actually move or manipulate the overall game through their personal physical movement may also get sedentary children moving, though less than if they played outdoors or participated in sports actually. Others, though, don’t have such benefits, and violent video games have been shown to increase kids’ aggressive behavior."

"When a baby’s brain (‘cerebral’) is developing during pregnancy damage to the area of the brain that controls movement can occur. As the child develops it can be detected that the baby is not able to exhibit different movements properly (‘palsy’). The cause of this damage to the brain is yet unknown, however, it is found that babies born before the normal duration of pregnancy (‘preterm birth’), infection in the pregnant mother and mothers who smoke, indulge in alcohol or recreational drugs are more prone to bearing a child with cerebral palsy.\nSubmit a request for further information, a quotation or indicative cost. Your enquiry will be forwarded to up to 3 private healthcare providers. They will respond directly with further information.\nGet a quote for cerebral palsy treatment >"

"When a baby’s brain (‘cerebral’) is developing during pregnancy damage to the area of the brain that controls movement can occur. As the child develops it can be detected that the baby is not able to exhibit different movements properly (‘palsy’). The cause of this damage to the brain is yet unknown, however, it is found that babies born before the normal duration of pregnancy (‘preterm birth’), infection in the pregnant mother and mothers who smoke, indulge in alcohol or recreational drugs are more prone to bearing a child with cerebral palsy.\nSubmit a request for further information, a quotation or indicative cost. Your enquiry will be forwarded to up to 3 private healthcare providers. They will respond directly with further information.\nGet a quote for cerebral palsy treatment >"

"Cerebral palsy is one of the most common causes of neurological disability encountered in childhood. Today, with the prenatal and perinatal care being gradually improved, risky pregnancies can be followed closely. At the same time, with the development of newborn intensive care units, premature and low birth weight infants can survive. For this reason, the incidence of cerebral palsy has increased up to levels of 2–2.5 in 1000 live births over the recent years. In this case, early and accurate diagnosis of these children will increase the success of spasticity treatment. Spastic type is the most common type encountered among cerebral palsy subtypes (80%). As the main pathology in spasticity is the central nervous system, what can be achieved orthopedically is the treatment of spasticity in the musculoskeletal system. Orthopedically, what is attempted to achieve should be the optimization of quality of life and movement of the child with cerebral palsy. For this purpose, this disorder should be evaluated very well on patient basis, and orthopedic treatment should be determined as multidisciplinary treatment with physical therapy and pediatric neurology. In this sense, spasticity treatment starting at early childhood includes a broad range of treatments (botulinum toxin A applications, physical therapy) that can, in the future, be extended into soft tissue lengthening, and bone surgery. The goal should not be to solve problems one by one, but to fix the overall functions as general as possible, and to prevent permanent deformities. Spasticity requires a long-term treatment and functionability of the patient, and the treatment should attempt to improve the functions step by step."

"Cerebral palsy is the most common physical disability among children, with about two per 1000 live-born infants being diagnosed with the disorder. In most children with cerebral palsy, the disability is caused by damage to the immature brain during pregnancy or birth that results in problems with movement.\nDenmark and Norway have low income inequality and free access to education and offer high-quality antenatal care to pregnant women free of charge. Nevertheless, in our study recently published in the International Journal of Epidemiology, we found that the risk of having a child with cerebral palsy in these two countries varies by the parents’ educational level, and this educational gradient has been surprisingly stable over time.\nContinue reading “Lower risk of cerebral palsy in the child if the parents have higher education”\nAnwar T Merchant and Bryn E Davis\nThe Obstetrics and Periodontal Therapy (OPT) Study was an NIH-funded randomised controlled trial designed to evaluate whether periodontal treatment in pregnant women had any effect on preterm birth; its findings were published in 2006. The investigators randomly assigned about 800 women who had been pregnant for less than 16 weeks, and had periodontal disease, to one of two groups. One group received periodontal treatment during pregnancy, whereas the other group received treatment after pregnancy.\nAlthough the study found that treatment controlled periodontal infection and reduced the microorganism load, there was no difference in preterm birth rates between the two groups. The investigators concluded that treating periodontal disease during pregnancy did not affect the risk of preterm birth. However, they also found that there were more stillbirths in the group that received treatment after pregnancy, suggesting that periodontal treatment may improve survival of fetuses. The potential bias resulting from the intervention affecting both the outcome (in this case, preterm birth) and survival (in this case, stillbirth) was acknowledged as a limitation.\nContinue reading “Does correcting for bias caused by unequal survival in the treatment arms of a randomised controlled trial matter?”"

"by Jennifer Dunn, DPT\nPlagiocephaly, the flattening of one side of the head, is a relatively common condition in infants.\nPlagiocephaly is associated with uncontrollable factors such as multiple births, positioning in the womb, premature birth, and presence of torticollis, or a tightening of one side of the neck that causes the infant's head to be turned in one direction.\nPlagiocephaly and torticollis are also associated with controllable factors after birth such as positioning. Unaddressed plagiocephaly and torticollis can lead to permanent aesthetic changes such as head shape asymmetries, jaw malalignment, and ill-fitting head gear (hats, helmets) or glasses. Plagiocephaly and torticollis do not affect your infant's brain or typical development.\nFortunately, both plagiocephaly and torticollis are often successfully treated through physical therapy and variable positioning throughout the day. For a deeper look into plagiocephaly and treatment options, click here.\nIf you are concerned about your infant's head shape or positioning, a physical therapy evaluation may be appropriate. Call our office today to schedule an evaluation: 541-505-8180\nRead here for more information about our practice, industry news, tips for taking care of your body, and great recipes for healthy living."

"Forums like BabyCenter reveal that many parents are concerned about a potential link between plagiocephaly and development delay. It seems that a number of children who have experienced plagiocephaly can also have other neurodevelopmental issues but with little research conducted in this area, a cause-and-effect relationship between plagiocephaly and neural development can be difficult for parents and healthcare professionals to establish.\nPlagiocephaly and Developmental Delay\nA 2010 study on the neurodevelopment of children with plagiocephaly sheds light on the possible relationship between plagiocephaly and development delay.\nMatthew L. Speltz and his team compared the neurodevelopment of six-month-old infants with and without deformational plagiocephaly. The incidence of developmental delays in affected children was significant, especially in terms of motor function. However, they also point out that motor, language and cognitive skills are closely interlinked in young infants, making it difficult to differentiate between the three with complete certainty. At best they found that there was a variance in motor skill development amongst infants with plagiocephaly.\nSo, there is an established link between neural development and head shape deformities, although more work needs to be done in order to define which the initiator of either condition is.\nIn 2010, Speltz and his team recommend that paediatricians pay close attention to the developmental rate of children with plagiocephaly.\nWhile research on the relationship between plagiocephaly and developmental delay is still limited at present and more rigorous investigation is needed to establish the cause of developmental delays in children who have deformational plagiocephaly, there are an increasing number of studies and research being conducted around the possible link.\nThe Relationship between Plagiocephaly and Neural Development\nA study which was undertaken by Robert Miller reported that 25 of the 63 children (39.7%) with persistent deformational plagiocephaly had received additional help during school including special education assistance, occupational therapy and speech therapy and just 7 of the 91 siblings (7.7%), serving as controls, required similar services (2). There are limitations which arise in this study, largely due to the very small focus group which is outlined by Miller himself who concludes, “there is a need for additional research on the long-term developmental problems in infants with deformational plagiocephaly” to establish a more definitive link between deformational plagiocephaly and developmental delay.\nSusan Orra reports a similar conclusion to the study in her recent evaluation of The Danger of Posterior Plagiocephaly and advises that “regardless of the cause, it is important to screen for posterior plagiocephaly early in infancy so that appropriate treatment can be implemented” (3).\nThe official journal of the American Nurses Association (ACA) also stresses the importance of receiving treatment for plagiocephaly in early infancy. Plagiocephaly treatment lessens the risks that are becoming emergent through cumulative research into the cause and effect relationship between deformational plagiocephaly and developmental delay.\nLaura Steinmann states, “It is a mistake to classify plagiocephaly as a low priority or minor cosmetic issue and not provide early treatment, because the opportunity to intervene occurs while an infant’s skull bones are still mouldable” (4). Furthermore, recognising plagiocephaly in the earliest stages of baby’s life is important to rule out more serious causative factors such as craniosynotosis.\nThe ideal age to start a treatment is 4 to 7 months, but we can start plagiocephaly treatment up to the age of 14 months. An earlier start in treatment gives fuller and quicker results because there is more opportunity for growth to bring about correction in head shape. For more information on how old is too old for flat head syndrome treatment, read our informative blog post which goes into further detail about the optimum age for treatment and what results you can expect.\nBrowse our website for more information on plagiocephaly and related conditions, including symptoms, diagnosis and treatment. Alternatively, call us on 0330 100 1800 or 0113 218 for expert help and advice, or to arrange an appointment with a plagiocephaly specialist.\n(1) Matthew L. Speltz, Brent R. Collett, Marni Stott-Miller, Jacqueline R. Starr, Carrie Heike, Antigone M. Wolfram-Aduan, Darcy King and Michael L. Cunningham. “Case-Control Study of Neurodevelopment in Deformational Plagiocephaly”. PEDIATRICS Volume 125, Number 3 (2010)\n(2) Miller, Robert I., and Sterling K. Clarren. “Long-term developmental outcomes in patients with deformational plagiocephaly.” Pediatrics 105.2 (2000): e26-e26.\n(3) Orra, Susan, et al. “The Danger of Posterior Plagiocephaly.” Eplasty 15 (2015).\n(4) Steinmann, Laura C. “Strictly Clinical.” (2016)."

"Mimos Baby Pillows – Prevention & Correction of Baby Flat Head Syndrome (Plagiocephaly)\nWhat is Plagiocephaly?\nDeformational Plagiocephaly is a condition characterised by a flat spot on the back or one side of an infants head caused by uneven pressure on the skull. This may be due to intra-uterine pressure, the birth process, extended time spent in a neonatal unit, or most often, the infant’s preferred sleeping position. Often a child who exhibits a reluctance to rotate their head to one side will develop this preferred sleeping position, which in turn can produce a flat spot on the skull. For example, when babies lie on their back for extended periods they can develop a flat spot where their head presses against the mattress.\nFor many years medical doctors have viewed plagiocephaly as only a cosmetic issue, confidently saying to parents that the head will naturally assume a more symmetrical shape as the child gets older. Unfortunately however, the research very strongly supports the fact that this does not happen, and that developmental delays are associated with plagiocephaly.\n‘Case-control study of neurodevelopment in deformational plagiocephaly’ was published in Pediatrics in 2010. The study assessed the neurodevelopment of infants with and without deformational plagiocephaly at an average age of six months and concluded: “Deformational plagiocephaly seems to be associated with early neurodevelopmental disadvantage, which is most evident in motor functions.” (1)\nA study published in Pediatrics in 2000, ‘Long-term developmental outcomes in patients with deformational plagiocephaly’ concluded: “Infants with deformational plagiocephaly comprise a high-risk group for developmental difficulties presenting as subtle problems of cerebral dysfunction during the school age years.” (2)\nA study published in 2009 ‘Are infants with torticollis at risk of a delay in early motor milestones compared with a control group of healthy infants?’ demonstrated that the congenital muscular torticollis group achieved early motor milestones significantly later than the control group. (3)\n1.Case-control study of neurodevelopment in deformational plagiocephaly. Speltz ML, Collett BR, Stott-Miller M, Starr JR, Heike C, Wolfram-Aduan AM, King D, Cunningham ML. Pediatrics. 2010 Mar;125(3):e537-42. Epub 2010 Feb 15.\n2.Pediatrics. 2000 Feb;105(2):E26. Long-term developmental outcomes in patients with deformational plagiocephaly. Miller RI, Clarren SK.\n3.Dev Med Child Neurol. 2009 Jul;51(7):545-50. Epub 2009 Jan 26. Are infants with torticollis at risk of a delay in early motor milestones compared with a control group of healthy infants? Ohman A, Nilsson S, Lagerkvist AL, Beckung E.\nAt Mt.Eliza Family Chiropractic, we stock Mimos Baby Pillows which help in the prevention and correction of baby flat head syndrome. The Mimos pillows we stock are specially designed in shape and reduces pressure by 400% and encourages the baby’s head to move in a healthy position for a comfortable sleep.\nUsing Mimos baby pillows is very easy. Simply place the back of your baby’s head on the pillow. The cavity in the pillow helps your baby’s head to grow in a natural shape while allowing them to still turn from side to side. For baby’s who experience flat head syndrome, Mimos pillows can provide both uninterrupted sleep for parents and their children as re-positioning during the night doesn’t need to occur any longer.\nWhat makes Mimos pillows the pillow of choice with flat head syndrome:\n- They are highly recommended by doctors and chiropractors.\n- Breathable and safe (anti-suffocation TUV certificate).\n- Effectively treats and prevents baby flat head syndrome\n- Comfortable, soft and compact\n- Allows 180˚ of head and neck movement.\n- Safe for direct contact with baby’s skin.\n- Hygienic and anti-allergic\n- Machine washable and quick drying.\nIf you have any concerns that your baby may be experiencing baby flat head syndrome, then please call Mt.Eliza Family Chiropractic and talk to one of our chiropractors about the options available to you to manage the condition, including the implementation of a Mimos Pillow. Our chiropractors can also give you advice and tips on your baby’s positioning during sleep or when laid down.\nPlease call 03 97876999 for more information."

"Adults need helmets for protection while babies need helmets for skull change. A good number of babies get some skull deformity, which requires a baby helmet for correction.\nSame way adults need helmets, babies need helmets too but they need it to adjust the shape of their skulls, maybe the baby has an illness. They could diagnose babies with positional plagiocephaly, or flat head syndrome.\nPositional Plagiocephaly, also known as Flat Head Syndrome, is when the baby lies a lot on his or her back, which causes and produces a flat head shape for the baby. When noticed at an early stage, it needs to be treated with immediate effect. Baby helmet therapy is one of the specialists methods used to correct flat head syndrome\nUsing helmets for babies is called “Helmet Molding Therapy”. The therapy is a means to help babies avoid funny shapes of skills, especially when it develops. Specialists always medically advised helmets in adjusting the skull tissues of the baby.\nAccording to statistics and research, 45% of children of about 7 to 12 weeks have Positional Skull Deformity (PSD). Even amongst the 45%, 3/4 of them have but mild cases in which they could be treated and corrected.\nThis case of Positional Skull Deformity began in 1992 after a “Back to sleep” campaign introduced by the American Academy of Pediatrics (AAP). This campaign introduced parents to putting their babies lay on their backs during bedtime to decrease sudden infant death.\nWhen babies are born, it is advisable to carry out cranial exams on them to see if there’s any deformity. If we found a deformity, the doctor needs to carry out another exam to see the type of cranial deformity. Maybe the child has Craniosynostosis, or the baby has Positional Skull Deformity and no parent will want to have confusion on such delicate matter.\nCranial helmets are helmets that specialists engineers specifically designed to adjust the baby’s skull and get it to get back in good shape. This helmet actually comes as a therapy from doctors for babies and it is a comfortable helmet not meant to hurt the baby.\nMany people could wonder why babies need cranial helmets. Yes, babies have a special type of helmet. These helmets treat Positional Skull Deformity. Not that babies use the helmets for sports no. They use it to shape their skulls.\nCranial helmets do not cause brain damage for your information. They made cranial helmets to treat flat head syndrome but also being comfortable to the baby. A lot of parents do not know that putting a little baby to sleep on his or her back is not really advisable.\nWhy so? This is also what causes Positional Skull deformity. You see young babies with flat heads and think it is normal while it is not. Babies at a gender age are not to be joked with because their bones are not yet strong, so anything can lead to a deformity with them.\nThese Cranial helmets mostly comprise a very strong outer shell with a foam lining on the inside. We always round the shapes of these helmets to shape the baby’s head to get its round shape back.\nCranial helmets actually are not for obligatory use. Statistics show that about 77% of plagiocephaly that have not yet reached a certain level in growth can be corrected even without the cranial helmet.\nCranial helmets vary in their price. The exact range cost for a good quality cranial helmet rangers from $1,300 to $3,000.\nThe act of arranging a baby’s skull without a cranial helmet is known as repositioning. We can do this because some parents fear these cranial helmets, so they prefer treating plagiocephaly without helmet since the baby’s bones are still soft so they can reshape it. The head can regain its shape\nWhy Parents Avoid Helmet Therapy\nThe subject of flat head syndrome and baby helmet therapy divided the medical community for long for a long time. Some parents look at flat head syndrome to be an issue that we can handle them with cosmetic methods while recommend specialist treatment (baby helmet therapy).\n- A lot of parents do not have the idea that cranial helmets exist to ease the treatment of the flat head syndrome.\n- Many parents see the cranial helmet therapy as a waste of money and time and feel that the baby’s head can gain back its shape on its own.\n- Many parents do not read so they have limited knowledge on plagiocephaly and so they treat the case as a mild case\n- Many parents may not be financially stable and do not have financial support, so they have no choice that find ways treating the child’s case without a helmet.\n- Other parents fear that the helmets may be uncomfortable for their kids and fear pain, so they avoid these helmets.\n- Parents feel the helmets can bring a little distance between themselves and their babies. They fear that if they hug their babies, they could apply more pressure on the baby so they avoid the helmets.\nBaby Cranial Helmets Design\nThere are several types of cranial helmets designs. The list can be long but to name a few we have: the Skull and Crossbones baby helmet, the magical narwhal baby helmet, the bow-utiful baby helmet, the football star baby helmet, the melon head baby helmet just to name these few and there many more.\nYou can choose any of the designs for your baby so it looks cute to them. There are many ideas you could use to design your baby’s helmet. It could be cartoons, stickers, bows and many more depending how inspired you are.\nThey designed these helmets in round shapes to make the baby’s skull take the round shape. According to research, a baby’s skull is supposed to be round if after delivery the baby has a funny shape of head, and then visit a Doctor.\nDoctors or specialists may not use baby cranial helmets for adjusting a baby’s skull. Cranial helmets can have some minor effects on the baby but they never alter in the natural growth of the baby’s head.\nOur specialists usually make these cranial baby helmets of a very strong shell on the outside and on the inside, they find a comfortable foam lining. We see this foam found on the inside to have a certain amount of pressure that shapes the baby’s head back to normal.\nBoy Cranial Helmet Designs\nWith the high rate of births in the world, the Plagiocephaly mostly affects the female babies more than the male babies.\nThey have specially designed helmets for either the male or female babies to fit and shape their heads. They confuse many people when trying to put on these helmets on their kids.\nThese Cranial helmets adjust the shapes of the baby’s heads and it also enables the male babies protect their heads. As a parent, you all know how your male babies could get rough sometimes, and these helmets help protect their head.\nHow to Wear Your Baby’s Cranial Helmet\nFirst, you put your hands on opposite ends of the helmet and pull open.\n- After that is done, try to adjust the ears of the baby to fit inside the ear holes and also that the forehead of the baby should be fully inside the helmet and the helmet reaching on the baby’s eyebrows.\n- Try to put on the helmet on your baby without applying pain.\n- Both of your baby’s ears need to be exposed and the helmet being closed behind the ears of the baby. .\n- They should position the back of the helmet at the bottom of the child’s head to avoid any rotation in the helmet.\n- We should balance the helmet on both ends, either on the front or the back.\n- If you feel the helmet, they did not wear the helmet properly; you do not need to be scared. Remove and try again until you wear it properly.\nBaby Helmet for Flat Head\nPretty sure you have come across babies wearing helmets, but have you ever wondered why? Babies wear these helmets to fix an abnormality in their head and it is mostly on babies with the flat head syndrome.\nThe flat head syndrome is a syndrome whereby babies’ skulls flatten at the back or at any side of the bay’s head, which deforms the baby’s head and bring stress to parents. They bought helmets in order to adjust to such abnormality.\nSpecialists introduced these helmets after a period in which they launched the “Back to sleep” campaign. After that period, a lot of babies began developing flat spots that called for medical intervention. Babies’ heads are very soft, so if we keep them in a position for a very long time, it affects the shape of the bay’s head.\nBabies normally have fast-growing tissues, so when you notice a flat head syndrome in a baby, we advise you to use the helmet immediately. With the helmet used, the baby’s head growths and shapes back how the helmet wants it to be shaped.\nWhy Babies Get Cranial Helmets?\nMany of you may have seen babies with helmets, but you do not know that these babies have skull abnormalities requiring the helmets. Babies wear these helmets when doctors diagnose them with some illnesses. These illnesses could be:\n- Positional Skull Deformity: This is a deformity that a lot of pressure can cause on the skull of the baby, especially if the baby spends a lot of time in a particular position.\n- Craniosynostosis: This is a deformity whereby the bony plates in the baby’s skull combine. The brain of a child with craniosynostosis grows but makes the skull of the baby come out abnormal. This deformity could either require surgery, which proceeds with a helmet therapy making the baby’s head and skull shape normally.\nThese two deformities are the principal cause of babies wearing helmets. Babies wearing helmets are not just seen as normal helmets, but are more undergoing helmet therapy. Something mostly known this as “Helmet Molding Therapy”.\nDo Helmets Cause Brain Damage To The Babies?\nA lot might wonder if these helmets cause brain damage to their kids, but the answer is NO, it does not cause brain damage. You may see the helmet to be strong and it will instead compress your baby’s head, but that is not the case.\nSpecialist engineers design these helmets are well and since designed for babies, they have a very comfortable foam lining. So the helmet which makes the baby’s head very comfortable and there is no pain perceived by the baby when on helmet therapy.\nWhat Age Can A Baby With The Deformity Start Wearing Cranial Helmet?\nNormally, doctors advised that infants with this deformity should start wearing the helmet at a tender age. That is so because the infant’s tissues are still soft so can easily adjust to normal. So it is preferable to a baby should wear the helmet within 4-6 months.\nAt that stage, it gently adjusts the baby’s skull and gives it its round shape back. If we bring the baby at around 8 months old, it might likely not adjust back to an early stage. It will take longer than normal to fix.\nHow Long Does It Take To Treat The Deformity?\nThe duration depends on when the baby began his or her treatment and we need to know that the way doctors or specialists treat one baby can differ from the way of another baby. Doctors can treat a baby fast and another can take a longer time.\nAn average period in which doctors can treat your baby is 3 months at least. Other babies could last longer than depending on what the baby needs. There are babies whom specialists can treat at 18 months, but theirs will take a lot more of time.\nIt is preferable to always visit your specialist so that they can carry an evaluation out on your baby to determine his or her progress. When you see the baby’s progress as a parent, you are happy. If you do not visit a specialist, the case might not be improving and you would not know, so always have appointments with your specialist.\nCan You Fix a Baby’s Flat Head Deformity without a Helmet?\nTruth be told, yes you can. They found such cases in approximately 77%. Specialists can adjust such, especially if the case is mild, and this case is called “Repositioning”. There are several ways to avoid helmets which are;\n- Try to always practice putting your baby to lie on their stomachs in the daytime. It helps to in strengthening the baby’s neck muscles.\n- Practice to regularly hold your baby, especially when they sleep. It helps with the amount of pressure applied on the baby’s head.\n- Try to regularize changing the head positioning of your baby from left to right and vice versa. Do that usually.\nWith this article, we have passed a lot of knowledge on to parents and even the future parents. Try practicing the methods as instructed and avoid making your babies have deformities.\nAs a DISCLAIMER, this article is just for informational purposes. Consult a specialist or a medical doctor with your baby for better treatment.\nskip to 11 American sports that require a helmet"

"By Cranial Technologies, Inc.\nOpen iTunes to buy and download apps.\nDo you have concerns about an infant’s head shape?\nDue to a combination of factors, the incidence of plagiocephaly, or a flat head, now occurs in nearly 1 in 10 infants.\nAlthough plagiocephaly does occur frequently, educating yourself and those around you is important for prevention and early detection.\nThis app is a tool for you to:\n• Learn more about the causes of plagiocephaly and ways to prevent it from worsening\n• View real examples of the three main types of abnormal head shapes (plagiocephaly, brachycephaly and brachycephaly with plagiocephaly)\n• the characteristics and symptoms of an abnormal head shape\n• Discover more about an infant’s head shape using the step-by-step Head Shape Analysis guide\n• Learn more about CranialTech’s plagiocephaly treatment process using the FDA-cleared DOC Band®\nAbout Cranial Technologies:\nCranial Technologies is the leading non-surgical treatment provider for deformational plagiocephaly and the only manufacturer of the FDA-cleared DOC Band® (Dynamic Orthotic Cranioplasty). Over the past 25 years, CranialTech has been committed to providing a superior product, service, and best possible outcome for every child with an abnormal head shape at locations throughout the U.S. and Spain.\nFind us online:\nDisclaimer: Please note that this application does not take the place of an official evaluation by a licensed medical professional.\nWhat's New in Version 1.1\n- Category: Medical\n- Updated: 25 June 2012\n- Version: 1.1\n- Size: 12.9 MB\n- Language: English\n- Developer: Cranial Technologies, Inc.\n- ©2012 Cranial Technologies, Inc.\nCompatibility: Requires iOS 4.2 or later. Compatible with iPhone, iPad, and iPod touch."

"Have you ever been out and about, noticed a baby sporting headgear, and wonder why babies have to wear helmets? No, it’s not a trendy fashion statement, and no, their parents aren’t being overly-cautious.This baby was most likely wearing a helmet as part of something called Helmet Molding Therapy — a fairly common treatment for babies who’ve developed flat spots on their head.\nAccording to BabyCenter, babies are born with soft skulls that haven’t fully hardened to allow for passage through the birth canal and for the rapid growth that takes place in their brain. Because of this, Kids Health notes that many babies develop a condition known as positional plagiocephaly, or flat head syndrome, in which their head becomes flattened on one side.\nThe Seattle Children’s Hospital notes that positional plagiocephaly can be caused by several things, such a premature birth or delayed development, but it is most often the result of the baby’s sleeping position. Most babies are laid on their backs to sleep (as recommended to reduce risk of SIDS), but the baby can often develop plagiocephaly if they aren’t turning their heads often during sleep.\nThough this isn’t a dangerous condition, and can usually be corrected either on its own or through the use of a helmet, there are several things parents can do to be proactive in reducing their child’s risk for flat head syndrome."

"MORE CHILDREN ARE BEING TREATED FOR FLATTENED HEADS, BUT SHOULD THEY BE? ELIZABETH TRACEY REPORTS\nPlagiocephaly is medicalese for ‘flat head,’ a condition increasingly common as more infants are put to sleep face up to reduce their risk of sudden infant death syndrome. Now a new study shows that more kids are also being treated for the condition than ever before. George Jallo, a neurosurgeon and plagiocephaly expert at Johns Hopkins, comments.\nJALLO: I don’t believe that there’s a true increase in the number of plagiocephaly cases that are reported in that article. What we may be seeing is that parents are more cognizant or pediatricians are more aware of the diagnosis of plagiocephaly. Years ago, parents noted it but didn’t make anything of it because it was the mild form. Now the parents are more educated they’re been looking at the Internet, they’re more aware that their child may have plagiocephaly. :30\nJallo says parents should recognize that a little knowledge can be dangerous, so consulting an expert before treating the condition is important. At Johns Hopkins, I’m Elizabeth Tracey."

"The number of infants with a specific type of head deformity, in which the skull flattens out from repeated pressure to the same area, has increased exponentially over the past 20 years.\nWhile the condition, known as deformational plagiocephaly, is now common, there is no standard treatment for it, and some argue none is needed, saying the condition will get better on its own. Most experts recommend placing helmets on the heads of babies with severe DP cases.\nScientists note that the surge in cases coincides with a campaign by pediatricians to prevent sudden infant death syndrome by making sure babies didn't sleep on their stomachs. The Back to Sleep campaign, launched in 1992, initially urged parents to lay babies down on their side or back; the recommendation was later changed to back only.\n\"[The back to sleep campaign] has been very effective in reducing SIDS death, but it had the unanticipated outcome of creating molding of the skull, which was not seen as frequently before the recommendations were made,\" said Dr. John Persing, a professor of plastic surgery at Yale School of Medicine.\nThe risk of deformity comes from lying for long periods with one spot of the head pressed against the mattress.\nDeformational plagiocephaly is far from the only disease that lacks a standard of care, and in such situations, doctors \"wind up making decisions based on opinion,\" said Dr. Stephen Warren, a craniofacial surgeon at New York University Medical Center. \"And sometimes in medicine you have to do that, but anytime you make a decision based on opinions you'll have conflicting opinions.\"\nAdditional studies \"are the best way to make the best choices for the children we treat,\" said Warren, who published an article in the January issue of the Journal of Craniofacial Surgery, one of several in that issue to explore the topic. Warren's article discussed diagnosis and current treatments.\nDP is diagnosed in some 400,000 to 800,000 children in the United States each year. Experts stress the incidence rate could be drastically reduced if parents followed a few simple steps, such as alternating the baby's sleeping position from one night to the next.\nWhat is DP?\nDeformational plagiocephaly occurs when an infant keeps his or her head in the same position for a long period of time while lying down. Some infants are more prone than others to developing DP — for instance, infants who are born with torticollis or who develop it. These babies have a twisted neck that causes their head to tip to one side while the chin is turned to the other.\nNobody's head is perfectly spherical; we all have a little asymmetry to our skulls. When a child is suspected of having DP, the question is: How bad is the problem? There is currently no grading system to judge how severe a child's head deformity is, Warren said. Most doctors probably assess the patient visually and, based on their own experience, judge whether intervention is warranted.\nTo take away some of the subjectivity, Warren said, physicians should measure children's heads and note how the deformity changes over time. Then they can get a better idea of which cases will clear up on their own and which will require treatment.\n\"In order to objectify decision-making, you'd want to probably measure the severity of the problem,\" Warren said.\nDo helmets work?\nMost physicians agree that some babies with DP require helmets. But before the baby is about 3 to 6 months old, physicians and parents should first attempt to correct the problem with physical therapy. This involves exercises to accustom the baby to turning his or her head in different directions.\n\"Not every child who comes in with a flat head needs a helmet,\" said Dr. Lisa David, a professor of plastic and reconstructive surgery at Wake Forest University Baptist Medical Center in Winston-Salem, N.C.\nBut if, after the exercises, the condition has not improved, a helmet will prevent the baby from lying on the flattened spot and will create a space for the baby's head to grow.\nEarly in life, a baby's head is like putty, but as he or she approaches 1 year old, the bones become more brittle. So after about a year, helmets are not as effective, said Persing,of the Yale School of Medicine.\nSome physicians think DP can get better without any intervention. Persing said he was once among that group.\n\"I've seen enough children now [to know] that it doesn't remodel on its own, it needs some help in some cases,\" Persing said.\nBut to have conclusive evidence that helmets work, scientists need to run what is called a randomized controlled clinical trial. This trial would randomly assign some infants to wear helmets while others have no treatment, to see what the outcomes are. Ideally, physicians would use this type of evidence to help them make the best decisions for their patients, Warren said.\nSuch a study has never been conducted, and some think it never will be, because it would require that some infants not be treated.\n\"At this point, most people feel like the treatment is already known, we already know how to treat these children, and to not treat these children would be inappropriate,\" Wake Forest's David said.\nRight now, the head deformity is corrected to avoid social problems for the child later in life. If DP were found to cause neurological problems as well, that would be an entirely new reason to treat these children, Warren said.\nPersing said he is currently conducting a study to examine in detail whether DP leads to neurological impairments.\nExperts say DP can be avoided with two simple activities. Parents should still lay infants down on their backs, but when the babies are sleeping, parents should alternate which side of the head the baby will rest on for the night. For instance, if a baby falls asleep with his or her head facing to the right one night, parents should turn the head to the left the next night.\nIn addition, under strict supervision, babies can be placed on their stomachs every now and again. This avoids putting pressure on the skull and strengthens the baby's neck muscles, Persing said.\n\"Just with those two simple maneuvers, you will probably avoid deformational plagiocephaly,\" and the condition would once again be rare, as was in the days before the SIDS recommendations, Persing said.\nPass it on:The number of cases of deformational plagiocephaly has increased dramatically in recent years. Researchers differ in how they think it should best be treated, though most think helmets are warranted in some cases.\nFollow MyHealthNewsDaily staff writer Rachael Rettner on Twitter @RachaelRettner.\nThis story was provided by MyHealthNewsDaily, a sister site to LiveScience."

"06 Apr Proper Repositioning of a Baby’s Head Cures Flat Head Syndrome. Here’s Why:\nDuring the first few months of a baby’s life their head is relatively soft, unlike an adult head, which is nearly as hard as a rock. This softness certainly makes it easier for the baby to travel through mom’s birth canal. It also allows their head to expand to accommodate their rapidly growing brain. As they get older, their skulls begin to harden and soon begin to feel more like an adult or kid’s hard head. (Literally and figuratively!)\nThere is, of course, a downside to babies having soft skulls, namely that their heads often become misshapen. If you look closely, you will notice that about half of all babies today have some flattening of the back of their head. This occurs because many babies spends a lot of time resting a certain spot on their heads on a mattress, car seat, or stroller, or other device. Their head develop a flat spot, much like a water balloon lying on a sidewalk. The older they get the harder the flat spot is to correct because their head is firming up as they get older.\nFortunately, this effect also occurs in reverse. If the baby’s head is no longer allowed to rest against the firm surface then their head will ‘remodel’ and reacquire its beautiful round shape. This can be challenging, however, as babies tend to find a comfortable position and don’t want to change how they hold their head. So an effective repositioning aid plus good repositioning practice is important and effective in correcting this problem. The earlier the better as it’s much harder to correct the problem as the child gets older. Physical therapists are excellent at supporting your repositioning efforts.\nIf a child has a misshapen head after 6-months of age then it is often necessary for the child to wear and orthotic helmet to correct the problem. The corrective principle is the same; the pressure on the flat area is removed by the shape of the helmet so that the head can ‘remodel’ to its natural shape. In most cases the child will emerge from helmet therapy with a beautiful round head and not remember the experience.\nSo keep an eye on the shape of your baby’s head. It’s important, and completely within your power to identify and correct any head shape problems.\nDr. Jane Scott"

"The first question many parents ask after discovering their child has a flat head is ‘does flat head syndrome correct itself?’ There are many myths around flat head syndrome babies which can be confusing but it is important to know that some cases do self-correct, depending on several factors:\n- How old the baby is.\n- The severity of flat head syndrome or type of flattening.\n- How successful repositioning has been.\nIf you are concerned by the shape of your baby’s head, our blog post on classifying plagiocephaly can help you determine if they are showing symptoms of flat head syndrome. We recommend booking a free clinical assessment as there is currently no international standard system for plagiocephaly measurement, so diagnosis is typically based on observation measurements and clinical judgement.\nSelf-Correction through Repositioning\nMild cases of flat head syndrome tend to correct themselves naturally over the course of the early months of life. These cases include deformities that have occurred in the womb, during birth, or after the baby is born. After noticing flat head syndrome in their baby, parents are advised to begin repositioning techniques straight away to increase the chances of self-correction.\nProviding repositioning therapy is started early enough, mild flat head syndrome can usually be corrected before the bones in the skull harden and become less receptive to repositioning. In a study published in April 2015, repositioning alongside active physiotherapy achieved acceptable correction in 77.1 percent of cases who started treatment at an average age of 0-4 months.\nThere are, however, instances such as more severe deformities and older ages where repositioning techniques are unsuccessful. If repositioning hasn’t corrected your baby’s head shape, it is unlikely that the condition will correct by itself. At this stage, we recommend making an appointment with a specialist clinician for an assessment and advice regarding further treatment. Due to the short window of time a baby’s head is malleable, we strongly advise that repositioning techniques are put into action as soon as flat head syndrome is spotted, and that an appointment is made as soon as possible if the repositioning is not working.\nCorrection through Helmet Therapy\nIt is unlikely that repositioning techniques will help moderate to severe cases of flat head syndrome. If this is the case, we would advise seeing a clinician as soon as possible to classify the severity of your baby’s flat head syndrome and seek helmet therapy. Starting helmet treatment as early as possible gives your baby’s head the optimum amount of time to correct before the bones in the skull harden. In the previously mentioned study, 94.4 percent of babies who started in the helmet treated group achieved full correction, along with 96.1 percent of infants who transferred into the treated group from the repositioning group.\nThe best correction results can be achieved when treatment is started between 4 and 12 months, as the bones in the skull are still malleable. A good degree of correction can still be reached through treatment up to 14 months, but a severe condition may not fully improve if there is less time for the correction to occur.\nLeaving moderate or severe cases in the hope that the flat head will correct itself can lead to irreversible repercussions later in life, such as psychological factors, developmental problems, and a restriction of the number of activities in which a person can safely participate due to helmet fittings. If you are concerned about your baby and their head shape, our FAQs page is a great place to start.\nIf you believe your baby may be showing signs of flat head syndrome and would like to book a no-obligation appointment with one of our experienced and friendly clinicians, get in touch and we will be happy to help."

"Pin site infections are a common complication of external fixation that places a significant burden on the patient and healthcare system. Such infections increase the number of clinic visits required during a patient\\'s course of treatment, can result in the need for additional treatment including antibiotics and surgery, and most importantly can compromise patient outcomes should osteomyelitis or instability result from pin loosening or need for pin or complete construct removal. Factors that may influence the development of pin site infections include patient-specific risk factors, surgical technique, pin design characteristics, use of prophylactic antibiotics, and the post-operative pin care protocol including cleansing, dressing changes, and showering. Despite numerous studies that work to derive evidence-based recommendations for prevention of pin site infections, substantial controversy exists in regard to the optimal protocol. This review comprehensively evaluates the current literature to provide an overview of factors that may influence the incidence of pin site infections in patients undergoing treatment with external fixators, and concludes with a description of the preferred surgical and post-operative pin site protocols employed by the senior authors (ATF and SRR).\nThe definitive treatment of paediatric femoral diaphyseal fractures remains controversial. Modalities of treatment vary mostly according to age, with fracture pattern and site having a lesser impact. Current evidence is reflective of this variation with most evidence cited by the American Academy of Orthopedic Surgeons being level 4 or 5. The authors present a review of the most up-to-date evidence relating to the treatment of these fractures in each age group. In an attempt to clarify the current trends, we have produced an algorithm for decision-making based on the experience from our own tertiary referral level 1 major trauma centre.\nSubtrochanteric femoral fractures in children are uncommon and have received limited attention in the literature. Its treatment is controversial, and different options are available: traction, spica casting, internal fixation and external fixation. The aim of this study is to present our results with external fixation of subtrochanteric femoral fractures in children using Ilizarov frame. Between January 2012 and January 2014, 14 patients with closed subtrochanteric femoral fractures were treated in Cairo University School of Medicine Teaching Hospital. The average age at the time of injury was 6.4 years (range 3.8–11.5 years). Pathological fractures and fractures associated with neuromuscular diseases were excluded from this study. Two patients were multiply injured with abdominal injuries (as ruptured spleen). In all cases, a low profile Ilizarov frame was inserted using two half pins inserted proximally from greater to lesser trochanters parallel to the hip joint orientation line (line between tip of greater trochanter and femoral head centre) and secured to an arch, and another three half pins were inserted distally perpendicular to the femoral shaft and secured to an arch that was connected by three rods to the proximal arch. No post-operative spica was used. Average follow-up was 18 months (range 12–36 months). All fractures united with anatomical alignment within an average of 8 weeks (range 6–12 weeks). There were no deep infections and no significant limb length discrepancies. At the latest follow-up, no patient had any restriction of activities. External fixation with a low profile Ilizarov frame appears as a good treatment option for subtrochanteric femoral fractures in children.\nLevel of evidence: Level IV.\nHow to cite this article:\nMaini L, Kumar S, Batra S, Gupta R, Arora S. Evaluation of the muscle morphology of the obturator externus and piriformis as the predictors of avascular necrosis of the femoral head in acetabular fractures. 2016; 11 (2):105-111.\nAvascular necrosis (AVN) of femoral head is a recognised complication of fracture dislocation of the hip joint but is not studied frequently in relation to acetabulum fractures. The aim was to establish the relationship between obturator externus and piriformis muscle morphology in acetabulum fractures and potenital development of AVN of the femoral head. Twenty-five fractures were included in this prospective study and were subjected to radiological assessment and computed tomography of the pelvis. Magnetic resonance imaging (MRI) of the hip was performed to assess the morphology of obturator externus and piriformis, and findings were compared intraoperatively (in 15 cases). Serial radiographs were taken at monthly intervals to assess the development of avascular necrosis. The patients with no evidence of AVN on radiographs at 6 months had additional MRI scans to look for such changes. Three patients developed AVN of femoral head and two had complete tears of piriformis and/or obturator externus muscles on the pre-operative MRI with the findings confirmed intraoperatively (p = 0.013). None of the patients without changes of AVN at 6-month follow-up had complete tears of either or both muscles. Of these patients, there was one case each of T-type fracture, isolated posterior wall fracture with hip dislocation, and posterior wall with transverse fracture of the acetabulum. Complete tears of obturator externus and/or piriformis muscles are a strong predictor of future development of AVN of the femoral head.\nAn intramedullary device has some advantages over external fixation in callus distraction for bone defect reconstruction. There are difficulties controlling motorized intramedullary devices and monitoring the distraction rate which may lead to poor results. The aim of this study was to design a fully implantable and non-motorized simple distraction nail for the treatment of bone defects. The fully implantable device comprises a tube-in-tube system and a wire pulling mechanism for callus distraction. For the treatment of femoral bone defects, a traction wire, attached to the device at one end, is fixed to the tibial tubercle at its other end. Flexion of the knee joint over a predetermined angle generates a traction force on the wire triggering bone segment transport. This callus distraction system was implanted into the femur of four human cadavers (total 8 femora), and bone segment transport was conducted over 60-mm defects with radiographic monitoring. All bone segments were transported reliably to the docking site. From these preliminary results, we conclude that this callus distraction system offers an alternative to the current intramedullary systems for the treatment of bone defects.\nFemoral non-unions are difficult to treat even for the experienced orthopaedic trauma surgeon. If the non-union follows failure of modern stable internal fixation, the complexity of the management is further increased. We report two cases of stiff hypertrophic femoral non-unions after failed locking plate fixation that were successfully treated with a new hexapod circular external fixator. In addition to providing the necessary stability for functional rehabilitation and union, the hexapod circular fixator software allows gradual correction of deformities in order to restore the normal mechanical alignment of the limb.\nP. M. Stevens,\nChristian J. Gaffney,\nThe purpose is to describe the technique and report the results and complications of percutaneous femoral rotational osteotomy, secured with a trochanteric-entry, locked intramedullary rod, in adolescents with femoral anteversion. Our series comprised an IRB approved, retrospective, consecutive series of 85 osteotomies (57 patients), followed to implant removal. The average age at surgery was 13.3 years (range 8.8–18.3) with a female-to-male ratio of 2.8:1. The minimum follow-up was 2 years. Eighty-three osteotomies healed primarily. Two patients, subsequently found to have vitamin D deficiency, broke screws and developed nonunions; both healed after repeat reaming and rod exchange and vitamin supplementation. Preoperative symptoms, including in-toeing gait, tripping and anterior knee pain or patellar instability, were resolved consistently. We did not observe significant growth disturbance or osteonecrosis. We noted a 12.5 % incidence of broken interlocking screws; this did not affect the correction or outcome except for the two patients mentioned above. This prompted a switch from a standard screw (core diameter = 3 mm) to a threaded bolt (core diameter = 3.7 mm). These results have led this technique to replace the use of plates or blade plates for rotational osteotomies.\nLeonard C. Marais,\nTheo L. B. Le Roux\nPrevious classification systems of chronic osteomyelitis have failed to provide objective and pragmatic guidelines for selection of the appropriate treatment strategy. In this study, we assessed the short-term treatment outcome in adult patients with long-bone chronic osteomyelitis prospectively where a modified host classification system was integrated with treatment strategy selection through a novel management algorithm. Twenty-six of the 28 enrolled patients were available for follow-up at a minimum of 12 months. The median patient age of was 36.5 years (range 18–72 years). Fourteen patients (54 %) were managed palliatively, and 11 patients (42 %) were managed through the implementation of a curative treatment strategy. One patient required alternative treatment in the form of an amputation. The overall success rate was 96.2 % (95 % CI 80.4–99.9 %) at a minimum of 12-months follow-up. Remission was achieved in all [11/11] patients treated curatively (one-sided 95 % CI 73.5–100.0 %). Palliative treatment was successful in 92.9 % [13/14] of cases (95 % CI 66.1–99.9 %). In patients with lower limb involvement, there was a statistically significant improvement of 28.3 (95 % CI 21.0–35.7; SD 17.0) in the AAOS Lower Limb Outcomes Instrument score (p value < 0.001). The integrated approach proposed in this study appears a useful guideline to the management of chronic osteomyelitis of long bones in adult patients in the developing world. Further investigation is required to validate the approach, and additional development of the algorithm may be required in order to render it useful in other clinical environments."

"12 years old girl, a known case of Neurofibromatosis Type 1, presented with shortening and deformity of Left leg since birth. Her Xrays revealed Left Congenital Pseudarthrosis of Tibia. She had undergone six surgeries elsewhere but her pseudarthrosis had failed to heal.\nShe underwent surgery by our new comprehensive protocol for pseudarthrosis excision, fixation with rod and plate, and bone grafting.\nAt two years post-operative, the pseudarthrosis has healed and deformity is corrected.\nA one year old female child presents with antero-lateral bowing of Right tibia bone.\nThe lesion progressed to a frank fracture (CPT) by age 2 years.\nThe child was operated by our new comprehensive protocol.\nAt 2 years post-operative, the pseudarthrosis has solidly healed, deformity if fully corrected and child is fully functional.\nCongenital Pseudarthrosis of Tibia (CPT) is an extremely rare condition and occurs in 1 in 1,50,000 children. In 50% cases, CPT is associated with a genetic condition called Neurofibromatosis Type 1.\nIn this condition, the leg bone (tibia) is usually bowed at birth but progresses to frank fracture (pseudarthrosis) by age of 2 years.\nTreatment of CPT is always surgical. Traditional treatment methods were associated with significant difficulty in achieving union, and, multiple surgeries were often needed for achieving union.\nHowever, in recent years, we have been using a new treatment protocol with excellent success rate. The results of our technique have been peer-reviewed and published in the Indian Journal of Orthopaedics (see Reference below).\nVaidya Sandeep V, Aroojis A, Mehta R, Agashe MV, Dhawale A, Bansal AV, Sarathy K. Short Term Results of a New Comprehensive Protocol for the Management of Congenital Pseudarthrosis of the Tibia. Indian J Orthop. 2019 Nov-Dec;53(6):736-744. doi: 10.4103/ortho.IJOrtho_155_19. PMID: 31673175; PMCID: PMC6804390.\nThis article is contributed by Dr Sandeep Vaidya, Paediatric Orthopaedic Surgeon, Pinnacle Orthocentre Hospital, Thane. Dr Vaidya is also available for consultations at BJ Wadia Children’s Hospital, Mumbai; Ajit Scan Centre, Kalyan; and Ace Children’s Hospital, Dombivli. For more information, call 7028859555/ 8879970811/ (022)25419000/ 25429000 OR email email@example.com."

"Congenital Pseudarthrosis of the Tibia\nWhat is Congenital Pseudarthrosis of the Tibia (CPT)?\nCongenital pseudarthrosis of the tibia is a shin bone fracture in children that has not healed. It normally presents before a child turns two years old. Typically, the child gets a shin bone fracture that either happens spontaneously, or results from when the child experiences a minor trauma, and the fracture will not heal. It is a rare condition that occurs in 1 out of every 250,000 children.\nIt stems from the periosteum, a membrane that covers the bone, being abnormal and preventing proper bone healing. Since the bone has not healed correctly, it is unstable and there is mobility at the false joint which should be solid, stable bone. As a result, many patients have an unstable leg, making function difficult.\nHistorically, congenital pseudarthrosis of the tibia was known as an extremely challenging problem to treat, because it was very difficult to get the fractured bone to heal with techniques available at the time. Advances in medical treatment as well as surgical techniques have generated vast improvements in outcome. While refracture is a potential risk, current treatment protocols have minimized this once devastating complication.\nBasic science and surgical research have shown that the poor healing is due to the irregular periosteum, abnormally hyperactive osteoclasts (cells that remodel bone), and the mechanical challenge of stabilizing very small bone fragments in children. A multifaceted approach addresses each component of the problem individually.\nA secondary effect of CPT is limb length discrepancy, which must be factored in to the overall treatment plan to ensure an optimal reconstructive outcome.\nWho gets congenital pseudarthrosis of the tibia?\nCongenital pseudarthrosis of the tibia is often associated with neurofibromatosis (NF-1) which has many other serious potential manifestations. However, congenital pseudarthrosis of the tibia is also seen in fibrous dysplasia, osteofibrous dysplasia and cleidocranial dysostosis. A significant percentage remain without a known cause (“idiopathic”).\nHow is congenital pseudarthrosis of the tibia diagnosed?\nCongenital pseudarthrosis of the tibia is typically identified with X-rays and physical examination. Patients who are deemed high risk (e.g., patients with neurofibromatosis) may have screening X-rays performed in early childhood. In some cases, the first sign is a deformity in the leg or a fracture that occurred with minimal trauma.\nWhat will happen during a clinic visit for congenital pseudarthrosis of the tibia?\nThe doctor will evaluate the patient for neurofibromatosis, a genetic disorder that causes tumors to form on nerve tissue which occurs in 40-50% of patients. The doctor will also ask for a history of previous fractures and examine the leg to determine the range of motion of the false joint. X-rays will be taken to determine the quality of the bone, the condition of the joints, the amount of limb length discrepancy and the severity of any bone abnormalities.\nHow is congenital pseudarthrosis of the tibia treated?\nThe primary treatment goal of congenital pseudarthrosis of the tibia is to achieve union of the shin bone (tibia) and to maintain that union. Treatment also addresses the resulting limb length discrepancies and bone deformities. To treat congenital pseudarthrosis of the tibia, the International Center for Limb Lengthening has a combined multimodal, comprehensive treatment program that addresses both the biological and mechanical issues. Many doctors use various elements of our protocol, but we strongly believe that the combined multimodal approach is the most effective.\nWhat happens in surgery for congenital pseudarthrosis of the tibia?\n- Two to four weeks before surgery, the patient receives a bisphosphonate infusion from our endocrinologist. Bisphosphonates inhibit cells responsible for breaking down bone. It is used to prevent resorption (melting away) of bone graft and to improve local healing response. This can take place in Baltimore or for patients from further away, it can be done closer to home by a local endocrinologist.\n- In the operating room, the abnormal periosteum is removed from the tibia and fibula (both bones in the lower leg), and the pencil tip ends of the tibia and fibula are slightly trimmed to allow straightening of the leg with stable bone contact to optimize healing.\n- The tibia is stabilized with intramedullary rods (inside the canal of the bone), and the fibula is stabilized with wires. Newer intramedullary rods have allowed surgeons to avoid crossing and damaging the ankle joint during fixation of almost all cases.\n- Healthy periosteum and a bone graft are harvested from the pelvis usually on the same side as the tibia pseudarthrosis.\n- The healthy periosteum, bone graft, and bone morphogenic protein (BMP) are placed in between and around the tibia and fibula bones, generating a large cross-sectional surface area for optimal healing. BMP is a naturally occurring cell signaling molecule that drives bone formation. When used in CPT treatment, it helps increase bone formation in the early stages. This is an off-label use of BMP in the United States (not approved by the FDA for this use). While healing can occur without BMP, it is an important component of the International Center for Limb Lengthening’s multi-faceted approach.\n- In some cases, an external fixator is applied to the leg to provide rotational stability and to compress the bone ends while they knit. In most cases, an internal plate is used to control the newly realigned limb. In the past, external fixators were a necessity. The combination of the newer ankle-sparing intramedullary rods and improved internal plates gives surgeons another option to maintain improved ankle motion. Your doctor will assess which treatment is best for your child’s unique needs and circumstances.\n- Once healing has occurred (typically evident by 2 months, and strong by 3-4 months), activity restrictions are lifted, and children can return to normal activities. A plastic leg brace called an ankle foot orthosis (AFO) is worn on the leg under clothing for additional protection.\n- If an external fixator was used and healing of the tibia has been achieved, then the frame stays on for 3-4 months.\n- If a proximal lengthening is being performed at the same time, then the frame is in place for 4-6 months. In the external fixation device, the patient is allowed to bear weight as soon as they would like after surgery. After the frame is removed, a long leg cast is placed for 4 weeks. After 4 weeks, the cast is removed and a brace is used for 2-3 months or longer.\n- If a plate was used instead, the plate is removed 6-12 months after the initial surgery, while the rods remain inside to act as “rebar” to strengthen the newly healed leg and prevent refracture.\n- After either method is used, regular monitoring of the bone is required on an annual basis. The internal rod may needs to be swapped out every 3-4 years during childhood as the leg grows longer to keep providing protection against refracture.\nWhat happens after congenital pseudarthrosis of the tibia surgery?\nPatients return monthly to clinic for follow-up visits until the bone heals. Three or four months after surgery, another infusion of bisphosphonate is done to prevent the bone graft from resorbing. After the bone has healed, patients return annually for checkups. Even after solid healing, there is still a risk for additional fractures until adulthood. Bracing reduces the number and severity of these fractures. We have seen very successful results with this combined treatment at all ages. After skeletal maturity, the bone becomes more normal and does not have as much tendency to fracture again.\nAdditional surgery may be needed in the future for limb lengthening or to insert longer rods to accommodate growth. Ankle deviations are common and may require realignment surgery. While our success rate with the multimodal approach is very high, nothing is 100%. We have found that some children require a second surgery to achieve union or to treat a refracture.\nWhat is the “unbroken” congenital pseudarthrosis of the tibia?\nSome children with congenital pseudarthrosis of the tibia are born with the leg crooked, but not broken. In such cases, we recommend bracing to prevent fracture. However, if fracture does occur, then our standard multimodal protocol is followed. In some cases, we will electively cut the bone at one or two levels to correct severe deformities and prevent future fractures.\nWhy come to the International Center for Limb Lengthening for treatment of congenital pseudarthrosis of the tibia?\nLimb lengthening and deformity correction are complex processes. Your doctor at the International Center for Limb Lengthening will take the time to make sure you understand all of your options and then will customize your treatment to meet your specific needs. Our patients benefit from our team-centered approach with world-renowned pediatric and adult orthopedic surgeons and specialized physician assistants, nurses and physical therapists. We help patients with congenital pseudarthrosis of the tibia achieve their best possible result.\nVideo: Congenital Pseudarthrosis of the Tibia: CJ’s Story\nChat with a Doctor About Congenital Pseudarthrosis of the Tibia\nOur doctors hold free monthly chats on various subjects, including congenital pseudarthrosis of the tibia. Click here for more information."

"July 22, 2009\nNew Guideline For The Treatment Of Pediatric Diaphyseal Femur Fractures\nThe American Academy of Orthopaedic Surgeons'(AAOS) Board of Directors approved a new clinical practice guideline for the treatment of pediatric diaphyseal femur fractures. Diaphyseal (the shaft of a long bone) fracture of the femur (the bone in the thigh) is a very common childhood injury.\nThere are several accepted treatment options for femur fracture, a thighbone injury occurring in an average of 19 out of 100,000 kids each year. However, there has not previously been a thorough examination and recommendation outlining the evidence-based best practice recommendations. Therefore, this new guideline can help physicians in three ways, by:\n- Outlining the best-known practices depending on the age and size of the child;\n- Assuring the most thorough review of all evidence-based outcomes of treatment, by reviewing more than 42 years of published research; and\n- Highlighting what research work still needs to be done to better predict and navigate future care and research.\n- \"Our treatment recommendations include not just best practices, but a heightened level of attention to the child's social and emotional state as well. For instance, though casting and traction still is an effective treatment, when we believed it was a comparable medical option, this guideline outlined flexible nailing for an internal splint, which significantly reduced hospital stay time, thus getting the child back into her school, family and social routines,\" said Dr. Ernest L. Sink, an AAOS work group Vice Chair on this guideline and practicing pediatric orthopaedic surgeon from The Children's Hospital in Aurora, Colorado.\nThe pediatric diaphyseal femur fracture clinical practice guideline presents:\n- the results of a systematic review of published studies from 1966 to October 1, 2008, on the treatment of isolated diaphyseal femur fractures in children*;\n- 14 specific recommendations;\n- the results of the Academy's commitment to developing more evidence-based outcome methods and resulting guideline recommendations for its members and the orthopaedic surgery community; and\n- guidance for appropriately trained surgeons and all qualified physicians considering treatment of isolated diaphyseal femur fractures in children.\n- \"Treating a child's fractured femur is a very successful endeavor, with a high likelihood of good outcomes. If you are a parent, you can be relieved to know that thousands of hours of peer review went into the development of this guideline, and if you are a physician, you can trust that your peers have given these treatment options and outcomes the most comprehensive review.\" said Dr. Sink.\nIn addition to providing practice recommendations, the guideline also highlights gaps in the literature and areas that require future research. It also is intended to serve as an information resource for decision makers and developers of practice guidelines and recommendations.\nOn The Net:\nAmerican Academy of Orthopaedic Surgeons"

"A total hip replacement is one of the surgical procedures which provide greatest satisfaction among patients due to the significant improvement in the quality of life they experience.\nSo much so, that it has been defined by some authors as the surgery of the 20th Century. It is a procedure which consists in substituting the hip joint with an artificial joint or prosthesis.\nThe most common reason for surgical intervention is arthrosis, a disease caused by the wear-and-tear of the cartilage which leads to a malfunction of the joint. It is especially common in older people, older than 65, who live with pain and which can limit their day-to-day activities considerably.\nIn today’s context of continuous technological innovations and advances and facing the enormous pressure from manufacturers, the range of prosthesis available to orthopaedic surgeons is wider than ever. This situation demands that the prostheses used have supporting scientific evidence based on clinical studies or on data from arthroplasty registries.\nThe legislation which regulates the commercialisation of medical devices, such as prostheses, is more lax than that which regulates drugs which means that not the same type of studies are required for their approval and in consequence, neither is the scientific evidence. In fact, this precise legislation is undergoing a review at present and a new one on this matter will soon be made available.\nSeveral years ago, the prestigious journal BMJ (British Medical Journal) published an article in which it was highlighted that in the UK, 24% of hip prostheses used had no scientific evidence to demonstrate their clinical effectiveness.\nAs a consequence of that publication and applying the same methodology, at the Hospital Sant Rafael and in collaboration with the Catalan Arthroplasty Registry (RACat) of the Agency for Health Quality and Assessment of Catalonia (AQuAS), we embarked on the task of analysing what the scientific evidence was on hip prostheses used in public hospitals in Catalonia which had sent their data in to the RACat during the period 2005-2013.\nFollowing the analysis of the 18,816 acetabular or hip cups and 19,546 femoral stems (the main components of the hip prosthesis) collected in the registry, our first surprise was to observe that 123 different models of cups had been used and 138 different models of stems. In the group of participating hospitals in the RACat during the period of the study, it was seen that with many of these models less than 10 units in number of each had been used.\nAs these models only represent 1% of implants used, they were excluded from the study and in the end 74 models of hip cups and 75 models of femoral stems were studied.\nThe results of the analysis, either recently published or not yet published, now at a pre-publication stage, show that less than 50% of components used had the highest level of scientific evidence in accordance with the ODEP. This top level is achieved when there are studies having 10 years at least of monitoring with a number of prostheses evaluated exceeding 500 units.\nWhat also caught our attention was not finding any evidence for 18 hip cups or 16 femoral stems which represented, respectively, 13.56% and 9.53% of all implants carried out during this period.\nAll scientific studies show limitations and it is not always possible to offer exhaustive results. Aware of this, and of the fact that the data in our study are the results of a research project which might not be able to reflect what the reality of public hospitals in Catalonia is in absolute terms.\nWe do want to stress that the task of the orthopaedic surgeon needs to be more and more regulated by evidence based medicine and this is, precisely, one of main purposes of arthroplasty registers: to carry out studies like the one we have been able to do at Hospital Sant Rafael with the aim of improving the health care of people.\nPost written by Miquel Pons, Danieol Chaverri and Luis Lobo, Hospital Sant Rafael, Barcelona."

"Frequently Asked Questions\nBelow are some frequently asked questions about plagiocephaly. If your questions are not answered here, please contact us for more information!\nCraniosynostosis is a serious birth defect where the joints between a baby’s skull close prematurely, before the brain is fully formed. It can affect brain development and treatment usually involves surgery.\nNot all babies with plagiocephaly also have torticollis – but it’s not uncommon to see the two together. Plagiobabies may favor one side of their head, which shortens or tightens the sternocleidomastoid (SCM) muscle, limits their range of motion and causes the head to turn or tilt to one side.\nTorticollis can also be caused by placement in utero, lack of space in utero (often present with large baby, small mother, or multiples) or trauma during the birth process.\nSigns to look for include a flattened appearance on the back of the baby’s head (brachycephaly) or on the sides, resulting in an elongated appearance (scaphocephaly). Other signs include:\n- the baby’s forehead may be more prominent on one side\n- one ear may be pushed more forward than the other\n- one eye may appear larger than the other\n- one cheek may appear fuller than the other\n- the baby’s nose may appear pushed to one side\n- the baby’s head may be tilted to one side or the baby has difficulty turning his/her head (possibly resulting from torticollis).\nGenerally your child’s pediatrician can diagnose plagiocephaly by a thorough examination, without an x-ray or CT scan.\nSome research indicates possible vision and jaw alignment issues with untreated plagiocephaly, but for the most part it is widely accepted to be cosmetic in nature.\nTreatments include repositioning and physical therapy exercises, and for more advanced cases, helmet therapy may be advised.\nIn any event, as soon as you notice that your baby’s head may be misshapen, contact your child’s pediatrician for an examination and proper diagnosis.\nThere is some evidence that vision and jaw alignment issues could result from a misshapen head. But even if the long-term effects are purely cosmetic, consider the effect on the child’s self-esteem. Many adults with untreated plagiocephaly have reported on the suffering they endured because of their deformed head shape.\nRolled towels, special pillows and sleep positioners may be recommended by your child’s physician to elevate the flattened side away from external forces that contribute to flattening such as the floor, crib mattress, car seat, baby swing, etc.\nAsk your doctor for a timeline of when to seek other treatments such as helmet therapy. Repositioning does not always work, especially if the baby is a bit older and treatment was delayed, or the plagiocephaly is severe enough to warrant a more “aggressive” treatment.\n(Note: Though we used the term “aggressive,” helmet therapy is not invasive or painful in any way. It is extremely gentle and causes no pain or discomfort to the child.)\nThe general rule is, the sooner the plagiocephaly is diagnosed and treated, the faster correction will result. The younger the child, the more malleable their skull is and therefore receptive to re-formation.\nAccording to plagiosupport.org,\n“Insurance companies can be very stubborn. Call and ask your provider if this is something they cover. If they give you a flat-out “no”, ask them to check under ‘durable medical equipment’. If they still say no, prepare yourself for a fight. It may take some time, and you might consider starting treatment before approval, if you have an older child. On your part it may take several appeals and hours of research, but these fights have been won over and over in the past.”\nIf your insurance company does not cover the cost of your child’s helmet, apply for a grant from The Halo Project!\nLook for a specialist who has experience with infants.\nSome helmet manufacturers will “band” babies up to 24 months old; however, treatment within the first year is found to be most effective.\nThe earlier the diagnosis and treatment, the better your chances of success!\nTake off the helmet only during the prescribed time, and wash your baby’s head using shampoo. Then clean the helmet using whatever cleaning agent the manufacturer recommends. Then, if possible, place the helmet in direct sunlight for the remainder of the “off time”. This helps to reduce odor and reduce any yellowing appearance.\nHelmets can be decorated to virtually anything you can imagine to either answer the question (some say “fixin’ my melon” – watermelon theme; or “fixin’ my flat” – car theme) or make the helmet appear less medical."

"Many parents that contact us or visit us at our clinics often ask “what’s a normal head shape for a baby?” and “how can I tell if the flattening is plagiocephaly?”. Although we would always advise that you visit one of our leading orthotists for a professional diagnosis if you are concerned about your baby’s head shape, this blog post offers some key indicators for recognising plagiocephaly and the steps you can take to treat the condition.\nThere are many words used to describe a head shape and the word plagiocephaly describes a head shape which is flatter on one side at the back. This shape is often seen in combination with a wide head shape, known as brachycephaly.\nWhat is Plagiocephaly?\nThe skull is often viewed as two parts, the cranial base on which the brain sits, and the cranial vault which provides the protective covering around and over the brain. A baby’s skull is made up of a number of bone ‘plates’ which are connected by flexible ligaments known as sutures. The role of the sutures is to allow the skull to develop naturally alongside the normal brain growth of the child.\nThese sutures do retain some flexibility throughout childhood, however, as we get older, the bones fuse together and create a permanent head shape that will not change. In infancy, the sutures retain much more flexibility and are soft and malleable enough to be moulded into deformation from external pressure – causing flatness and abnormal head shapes in the upper part of the skull, the vault in babies. For more information on what is plagiocephaly please visit our website for a more detailed definition.\nWhat Causes Plagiocephaly?\nPlagiocephaly develops when the natural growth of a baby’s head meets some sort of pressure which inhibits that growth. This can either be prenatally in the mother’s womb, or because the baby’s head is exposed to a flat surface for an extended period of time. The key causes of plagiocephaly are:\nSleeping on the back: Babies who sleep on their backs for extended periods of time without alternating their position are at increased risk of plagiocephaly. However, since the very successful ‘Back to Sleep’ campaign which is promoted to all new parents, the number of babies who have died has dramatically reduced and we fully recommend all parents to place their baby on the back to sleep.\nMuscular torticollis: A congenital condition caused by shortening or tightening of one or more of the neck muscles. This causes the infant’s head to tilt and/or turn to favour one particular direction.\nPrematurity: The cranial bones of premature infants are very soft and malleable, especially as the bones typically strengthen in the final ten weeks of pregnancy. After birth, premature babies often spend an extended period of time in neonatal intensive care on their backs to recover.\nPre-birth moulding: A baby could be born with a flattening of the head due to early descent into the birth canal; multiple births causing ‘crowding’ within the uterus; a mother’s small maternal pelvis; the baby being in a prolonged breech position or small quantity of amniotic fluid giving little internal cushioning in the uterus.\nNoticing the indicators of plagiocephaly as early as you can ensures your baby can benefit from more successful plagiocephaly treatment. Although this list is not exhaustive, the key plagiocephaly symptoms to look out for are:\n- Flattening on one side or at the back of the head which causes noticeable asymmetry or a high dome at the back of the head.\n- Flattening at the back of the head, the flatness usually occurs higher up on the back of the head (particularly in cases of brachycephaly).\n- Uneven position of the ears as the ears and cheeks have been pushed forward on the flatter site of the head.\n- The eyes differ in size and position (one eye appears lower/smaller than the other). This can cause the brow to be pushed forward on the flatter side.\nPlagiocephaly Treatment: The Next Steps\nIf you are concerned about your baby’s head shape and need advice, the next step is to contact us for a free consultation to assess the severity of any head shape deformity that your baby may have.\nEvery plagiocephaly helmet is custom-made for your baby’s individual head shape using a safe photographic scan. Once we have taken the scan and the paperwork is completed, we send this to the manufacturer who quantifies and modifies the head shape using CAD (computer aided design) software.\nWith over 150 infants using a TiMband at any one time, you can be assured that whatever your baby’s head shape, we have the right knowledge and experience to correct it. We don’t stop head growth, instead the TiMband helmet creates defined limits for the direction of growth, gently and permanently correcting the shape of the head.\nYour baby’s TiMband is made of a semi soft closed cell foam liner and lightweight polythene co-polymer shell, which fits comfortably round the head. We have lots of fun and attractive helmet pattern transfers that you can choose from.\nAt the end of the treatment, we supply you with a USB with the before and after scans with software to allow you to see how your baby’s head shape has improved.\nIf you think your baby may have plagiocephaly, get in touch and book a free assessment with one of our leading clinical orthotists who will be able to advise you on the best form of treatment for your baby. For more information about what you can expect from an initial appointment, read our informative blog post on what happens at a plagiocephaly evaluation.\nTechnology in Motion has over 10 years’ experience providing helmet treatment for plagiocephaly and can provide you with specialist plagiocephaly advice and support. Call 0330 100 1800 or contact us via the enquiry form to book an appointment at one of our clinics."

"Because infants are born with a soft skull, they can become vulnerable to developing plagiocephaly. Also called “deformational plagiocephaly”, this condition is commonly referred to as “flat head syndrome”. Plagiocephaly is a condition where an infant’s head has an uneven or irregular shape caused by external factors. For some infants, plagiocephaly happens while in utero, caused by pressure on the skull. Infant plagiocephaly can also be caused by lying in the same position for too long, placing pressure on the skull causing a flat area on the back of the head.\nIn some cases, plagiocephaly will correct itself. But, if an infant naturally rests their head on a flattened area, the condition can worsen causing additional issues. Because we cannot predict whether or not this condition will correct itself, working closely with the team of trained professionals at Sovereign Rehabilitation is important to ensure your infant is getting the best care possible. Treatment includes repositional therapy where special exercises are used on the infant on a regular basis both with physical therapists and at home. Other treatment options are orthotic therapy, where a custom-fit helmet is used to assist with changing the head shape. Depending on your baby’s specific needs, our caring and professional physical therapists will work with you and your infant to develop the best care plan possible.\nCauses of Flat Head Syndrome\nFlat head syndrome can also be associated with another condition called torticollis. The professional team of highly trained physical therapists at Sovereign Rehabilitation is dedicated to helping your infant with the necessary treatment options to help relieve symptoms of deformational plagiocephaly. Other causes of flat head syndrome can include:\n- Womb position:\n- for infants who remain in one position in utero can be at risk for plagiocephaly\n- Multiple births:\n- limited space with multiples can cause plagiocephaly\n- Premature birth:\n- making them more susceptible to flat head syndrome\n- with this condition, babies have limited mobility causing their head to be in one position\n- while back-sleeping is recommended to reduce the risk of SIDS, frequent rotating of the head and supervised tummy-time can reduce your infants susceptibility to flat head syndrome\nContact Sovereign Rehabilitation today to schedule a consulting about Plagiocephaly."

"Plagiocephaly (Flat Head Syndrome)\nWhat is Plagiocephaly (Flat Head Syndrome)?\nPlagiocephaly (also known as “flat head syndrome”) is a congenital head shape problem that results from either coronal synostosis, or from deformation of the skull due to pressure on one side of the skull. It is characterized by a flat spot on the back or one side of the head. This deformation usually occurs because the child tends to sleep or position itself, predominantly on the one side. This causes a flat spot and may often affect the position of the ear and the face.\nSlight changes in your child’s skull shape are usually of no consequence and growth usually limits the number of visible irregularities. However, in severe circumstances, it may be appropriate to consider helmet therapy for your child to make sure the head forms as roundly as possible. Most people have a significant amount of skull shape asymmetry and we simply don’t notice that on a day-to-day basis. Therefore, it should not be assumed that any residual asymmetry your child may have as an infant will be noticeable as an adult.\nPlagiocephaly and Torticollis\nPlagiocephaly may also be associated with children who have torticollis – a shortening or stiffness in some of the neck muscles. This causes difficulty with turning the head and makes it more likely to have a flat spot. Treatments of physical therapy and surgery – as a last resort – are sometimes necessary to treat torticollis and improve the underlying condition. Other treatments for your child would simply include positioning techniques to cause your child to sleep in a different position."

"While deformational plagiocephaly\noften resolves with repositioning and tummy time, it is reassuring to know that such impressive technology is available for those little heads that don't remodel on their own.\n(DP), a frequently occurring pediatric condition, is characterised by changes in skull shape in the absence of craniosynostosis.\nThe Linthorpe couple said they spotted the tot's misshapen skull - medically known as deformational plagiocephaly\n- at an early stage.\nBrandon, aged nine months, has a condition called deformational plagiocephaly\n, commonly known as flat-head syndrome.\nThe condition that Lucy suffers from is called Flat Head Syndrome, known medically as positional or deformational plagiocephaly\nSTAR Cranial Center of Excellence practitioners offer an unparalleled level of expertise, with the successful treatment of thousands of infants with deformational plagiocephaly\nand other head shape abnormalities.\nWashington, Mar 11 (ANI): Researchers from Hasbro Children's Hospital and Children's Hospital Boston have identified risk factors for the severity of asymmetrical head shapes, known as deformational plagiocephaly\n(DP), or more commonly as flat head syndrome."

"Chinese Randomized Trial Looks at How Useful 3D Printed Models Actually Are in Treating Bone Fractures\nChinese researchers are examining how 3D printed models can improve treatment of fractures. Chunhui Chen, Leyi Cai, Wenhao Zheng, Jianshun Wang, Xiaoshan Guo, and Hua Chen of the Department of Orthopaedics at The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University in Zhejiang explain their findings in ‘The efficacy of using 3D printing models in the treatment of fractures: a randomised clinical trial.’\nWe have followed cases previously where 3D printing has been used in creating prosthetics, fabricating arm casts to aid in mending broken bones, and making implants to heal injuries, but in this study the researchers evaluated the technology in terms of its ability to make improvements in pre-operative planning for breaks so serious that they require surgery. 48 patients suffering from distal radius fractures (one of the most common type of upper body injuries) participated in the study, with a 3D model made of each break.\nThe researchers then noted the following: operative time, amount of blood loss, and frequency of intraoperative fluoroscopy. Both surgeons and patients were given the opportunity to fill out questionnaires and offer input regarding the study at the end (among surgeons, the mean score for ‘usefulness of the 3D prototype for communication with patients’ was 9.1 ± 0.8 and that for ‘overall usefulness of 3D printing models’ was 6.7 ± 1.4.)\nThe scientists saw a need for this research project due to a high number of distal radius fractures and associated complications.\n“Some authors have reported that the use of 3D printing models in the treatment of fractures has beneficial effects. Thus, we assumed that 3D printing models could be applied as a novel approach in the treatment of distal radius fractures,” states the research team. “As the anatomical volumes of distal radius are small, a realized model can be created conveniently, with little time and cost expenditure. In addition, the high incidence of such fractures enables the collection of data on standard cases. Thus, we believe that distal radius fracture is a suitable example with which to evaluate the efficacy of use of 3D printing models in the treatment of fractures.”\nCT data was stored in DICOM format and then converted via Mimics software before 3D printing in PLA. The scientists reported success with the 3D printed models as they clearly displayed the fractures. Each surgery took around two and a half hours.\n“On the 3D model, we split the fracture fragments according to the fracture line, and then temporarily reset the fragments with K-wire, followed by fixation of the fragments with metal plates and screws,” stated the research team. “In this way, the type and dimensions of the implant required were determined preoperatively, and we could choose suitable metal plates and screws.”\nThe researchers note in discussion that 3D printed models allow for more accurate diagnosis and surgery, along with serving as guides during procedures when needed.\n“Because 3D printing can be used to produce an individualized, realized solid prototype of a fracture before complex surgery, junior surgeons can observe the anatomical structure of the fracture and simulate the surgical operation to determine the size of the implant required for internal fixation.”\nThe study also showed that 3D printed models allowed for faster procedure time, less blood loss in patients, and frequency of intraoperative fluoroscopy, but it ‘did not improve postoperative function.’ Limitations also include modeling of the bones only, without consideration to soft tissue, along with possible errors caused from the intricacies of software and hardware.\n“Our study revealed that 3D printing models effectively help the doctors plan and perform the operation and provide more effective communication between doctors and patients, but cannot improve postoperative function compared with routine treatment,” concluded the researchers.\nWhat do you think of this news? Let us know your thoughts! Join the discussion of this and other 3D printing topics at 3DPrintBoard.com.[Source / Images: ‘The efficacy of using 3D printing models in the treatment of fractures: a randomised clinical trial’]\nSubscribe to Our Email Newsletter\nStay up-to-date on all the latest news from the 3D printing industry and receive information and offers from third party vendors.\nYou May Also Like\n3D Printing News Unpeeled: Stratasys, Nano Dimension and 3D Systems\nToday we’re talking about all the merger options on offer between Desktop Metal, Stratasys, Nano Dimension and 3D Systems. It seems like most people in this industry are publicly saying...\n3D Printing Financials: Stratasys Reveals Strong Q1 Earnings Ahead of $1.8B Merger with Desktop Metal\nFollowing Nano Dimension (Nasdaq: NNDM)’s numerous failed attempts to acquire Stratasys (Nasdaq: SSYS), the 3D printing pioneer finally announced its merger with Desktop Metal (NYSE: DM) in a staggering deal...\nXJet Sets Sights on Metal 3D Printing IPO\nXJet, a 3D printing manufacturer based in Rehovot, Israel, plans to raise up to $10 million through an initial public offering (IPO) on the Nasdaq. According to a registration statement...\nPrinting Money Emergency Broadcast: Stratasys and Desktop Metal to Merge in All-stock Deal\nIn what is shaping up to be the biggest deal in the 3D printing industry of 2023, Stratasys and Desktop Metal will combine to form a $1.8 billion company. Alex...\nUpload your 3D Models and get them printed quickly and efficiently."

"Question: What is plagiocephaly in babies and do we need a helmet to treat the flat head? Answer: Another treatment option to restore the shape of the baby's head is OMT (osteopathic manipulation treatment), which is performed by a doctor of osteopathy (D.O.). DOs are medical doctors.\nParents seeking information on how to treat a baby's flat head syndrome or plagiocephaly often hear that a helmet is in order, but what if your baby did not have to wear one at all. Learn more about how a doctor of osteopathy can gently treat a flat head with osteopathic manipulation treatment.\nParents can feel despaired or blame themselves when their babies have plagiocephaly (flat head syndrome), but this is a treatable condition and Osteopathic Manipulation Treatment (OMT) is a gentle was for a doctor to treat your baby.\nWhat is plagiocephaly? Sometimes called positional plagiocephaly or deformational plagiocephaly, it literally means flat head. This can occur in babies as a result of sleeping on their back too long, being in a tight inuterine position (sometimes seen in twins) and due to the compressive forces of birth trauma. Instead of a helmet, osteopathic manipulation treatment by a doctor of osteopathy can natural restore the shape of the baby's head."

"Choosing the Right Physical Therapist for Plagiocephaly\nPlagiocephaly, also known as flat head syndrome, is a common condition caused by positional preference of the child’s head. It affects the shape of the skull and can be diagnosed through physical examination and imaging. Fortunately, physical therapy has become an effective treatment to help reshape babies’ heads and reduce further flattening.\nPhysical therapy for plagiocephaly is a safe and gentle approach that helps babies improve their head shape. It can also provide many other benefits, such as allowing the baby to move freely, encouraging healthy postural development, improving neck and shoulder alignment, and helping reduce tension in the facial muscles. In this article, we discuss what causes plagiocephaly and how it is diagnosed, the benefits of physical therapy for treating this condition, when treatment should begin, and tips on finding the right physical therapist for your child’s needs. Read on to get a better understanding of how physical therapy can help with plagiocephaly.\nUnderstanding Plagiocephaly: Definition, Causes, and Diagnosis\nPlagiocephaly is a condition where the head of an infant or young child becomes flattened on one side. This can occur as a result of wearing helmets or other protective headgear for long periods of time, lying in one position for too long (such as in a car seat or crib), or being born prematurely. Plagiocephaly is usually painless, does not affect the baby’s brain development, and can be corrected with early intervention.\nPlagiocephaly can also cause other secondary issues such as torticollis (tightness in the neck muscles) or facial asymmetry that may require additional treatment. It can be detected by examining the shape of the skull and can also be diagnosed through physical examination and imaging.\nBenefits of Physical Therapy for Plagiocephaly\nPhysical therapy treatment can be very effective in treating plagiocephaly. It is designed to help reshape babies’ heads and reduce further flattening. Physical therapists use a variety of techniques such as stretching, massage, and exercises to improve the strength of the baby’s neck muscles, correct the position of the head, and improve their ability to turn their head. This can help reduce pressure on the skull and promote better symmetry of the face and neck.\nWhen Should Physical Therapy Treatment Begin For Plagiocephaly?\nEarly intervention is key for treating plagiocephaly as it can prevent further flattening of the head. Physical therapy should be started as soon as possible after diagnosis and can begin as early as six weeks of age. Your therapist will work with you to develop an individualized treatment plan tailored to your baby’s needs.\nTips on Finding the Right Physical Therapist for Your Child’s Needs\nWhen choosing a physical therapist, it is important to ensure that they are experienced in treating plagiocephaly and are familiar with the latest treatment techniques. You should also make sure that your therapist is knowledgeable about other conditions such as torticollis. Finally, you should ensure that they understand your needs and goals for your baby’s care.\nPhysical therapy can be an effective treatment for plagiocephaly and its associated conditions. Early intervention is key for ensuring the best outcome, so it is important to begin treatment as soon as possible after diagnosis. When selecting a physical therapist, make sure that they are experienced and knowledgeable about plagiocephaly and other conditions associated with it. With the right therapist, you can ensure that your baby receives the care they need to reach their fullest potential."

"The bones that make up a baby’s skull are thin and flexible. Constant pressure in one area of the skull can alter its shape, which is called plagiocephaly (skull molding), which is one of the most common forms of an abnormal head shape.\nMany babies spend almost all of their time on their backs. Safe sleeping guidelines call for baby to sleep on his or her back. Car seats, strollers and other carries often also position babies on their backs. Babies with plagiocephaly often have noticeable flatness on the backs or sides of their head, and there is commonly little hair in those areas.\nIn other cases, your child may have a tight neck muscle causing a persistent twist of the neck to one side (torticollis). As your child lies down, one area of the head is consistently pressed against the bed surface and the area flattens.\nTreating an infant with plagiocephaly starts with encouraging parents to reposition their baby onto its side or stomach to relieve pressure on the side or back of the head.\nInfants with torticollis require dedicated physical therapy to stretch and straighten the neck. Through successful treatment of the torticollis, the head flattening usually improves.\nIn more severe cases, your doctor may prescribe a special helmet that helps distribute pressure around the baby’s entire head. That distribution of pressure helps prevent further flattening and promotes growth to a more rounded head shape. Ideally, helmet treatment is started at 6 months of age and is continued for at least 4months.\nEarly intervention in the treatment of plagiocephaly is recommended to achieve the best results. View Dr. Tahiri’s before and after photos of craniosynostosis patients in the photo gallery."

"Also known as ‘flat head syndrome’, deformational plagiocephaly is the most common craniofacial problem among babies today. It is characterised by a flattening on the back or one side of the baby’s skull, which can occur when the baby’s head lies in the same position for too long – usually when they’re left to sleep on their back for prolonged periods. Other causes include in-utero constraint, pressure put on the cranium during birth, and muscular/congenital torticollis.\nIf left untreated, the condition may correct itself. However, if it fails to do this, it can leave the child with an asymmetrical head shape and facial abnormalities.\nWhere necessary, it’s important to seek treatment between 4 to 8 months of age, as this is when the greatest correction can be achieved. Treatment may be sought from specialists including plastic surgeons, orthotists, chiropractors, and paediatric physiotherapists.\nThe most common forms of treatment are:\nCounter positioning – This involves repositioning the baby to ensure their head is not resting on the flat spot. Babies should also be encouraged to lie on their tummies and on their sides during playtime.\nHelmet therapy – In more serious cases, or where counter positioning has failed, a cranial remodelling helmet may be custom-fitted in order to mould the skull. The helmet removes pressure on the flat area, which allows the skull to grow into the available space. Helmet therapy typically lasts for 2 to 6 months, during which time the infant is required to wear the helmet for 23 hours each day.\nThere are a few simple things you can do to help prevent the development of plagiocephaly:\nI travel very frequently and I have received massages for well over ten years in different countries around the world. I keep a record of different people whose work is excellent and Kaitlyn for sure is on top of my list.\nBesides being extremely good at what she does, she is a very carin... - Kaitlyn Testimonials"

"Flat-Head Syndrome: What is Plagiocephaly?\nCould your baby develop plagiocephaly? One expert discusses this common skull deformity.\nIt's a big word for a fairly common occurrence: plagiocephaly (pronounced play-gee-oh-sef-a-lee), which is Greek for oblique or slanted head. The condition refers to an asymmetrical skull, and it occurs because of head molding in nearly 20 to 25 percent of babies. Here’s everything you need to know about plagiocephaly – also known as \"flat-head syndrome\" and \"positional molding.”\nWhat is Plagiocephaly?\nBabies have soft skulls that can be molded easily. Outside pressure – whether from a bed, a car seat, or the womb – can create flatness on the back or side of the head. Thankfully, though, the consequences of plagiocephaly are primarily cosmetic, and there are no known disabilities associated with the flattened head. In most cases, by time kids are 2 or 3 years old, it's difficult to see any evidence of plagiocephaly, according to James Laughlin, M.D., a pediatrician in Bloomington, Indiana, who is a Fellow in the American Academy of Pediatrics (AAP) and the primary author of \"Prevention and Management of Positional Skull Deformities.\"\nPlagiocephaly occurs for a couple of reasons. First, it can happen in utero. \"The way the baby may be positioned in the womb can cause some molding of the skull,\" Dr. Laughlin says. Plagiocephaly may also result if the baby consistently holds his or her head a particular way when lying down. \"If they have a preferential way of wanting to laid or be placed, then that can make the molding or flattening of the head as they're sleeping,\" he says. The shaping generally happens between 2 and 4 months of age.\n- RELATED: How to Prevent Flat Head\nSkull deformities have been on the rise since the 1990s, when the American Academy of Pediatrics began instructing parents to place babies on their backs to sleep, in an effort to decrease incidents of sudden infant death syndrome (SIDS). While these sleeping guidelines are still relevant, Dr. Laughlin says parents should actively watch for flattening or changes in the shape of the baby's skull, and contact their pediatrician of anything seems amiss.\nAside from Baby’s position in the womb or the crib, plagiocephaly could be a result of other medical issues, including torticollis (shortened or contracted muscles of the neck) and, rarely, craniosynostosis (a premature fusion of the skull bones).\nFlat head syndrome occurs more often if the mother is carrying multiple babies, since there’s less room in the womb. Similarly, premature babies have a higher risk because their heads are extremely soft, and they often lie for days or weeks in the neonatal intensive care unit.\nAccording to Dr. Laughlin, parents can take several approaches prevent plagiocephaly. For example, they can promote daily tummy time and encourage increased head and neck movement. You can also reverse your baby’s direction in the crib often, so she’s not constantly lying on the same side when looking out into the room.\nAlthough baby flat head won’t impact brain development, treatment is sometimes necessary to fix the condition. Plagiocephaly coupled with torticollis (twisted neck muscles) may require physical therapy. Severe cases may call for cranial helmet, which applies gentle pressure on the skull to promote proper growth. You should only use helmets that are recommended and approved by your child’s doctor. Plagiocephaly pillows, which have a rounded-out hollow interior to relieve pressure on the head, are also available on the market – but these since they can increase the risk of SIDS, we recommend avoiding them."

"Why does my baby have a flat spot on the back of his head?\nFlat head syndrome usually happens when a baby sleeps with the head turned to the same side during first months of life. This causes a flat spot, either on one side or the back of the head. Flat head syndrome is also called positional plagiocephaly (pu-ZI-shu-nul play-jee-oh-SEF-uh-lee).\nCan positional plagiocephaly correct itself?\nPlagiocephaly usually fixes itself as your baby grows, but sometimes treatment is needed. Help prevent plagiocephaly by giving your baby tummy time and alternating his head position.\nDo babies grow out of plagiocephaly?\nWhen does flat head syndrome go away? Flat head syndrome is most common between the ages of 6 weeks and 2 months old, and almost always resolve completely by age 2, particularly if parents and caregivers regularly work on varying baby’s positions when he’s awake.\nDoes plagiocephaly affect brain development?\nThe good news is that plagiocephaly and flat head syndrome do not affect brain development or cause brain damage. Head size is dependent on the brain size; head shape is dependent on external forces, which can either deform or reform.\nHow does tummy time help flat head?\nTummy time helps strengthen babies’ necks. It gets them off the back of their heads where flatness can occur and leads to strengthening of the extensors (straightening muscles) in the back of the neck, which hold the head up when babies are on their stomachs.\nHow long does it take to correct plagiocephaly?\nWhen treatment starts at the optimum age of 3-6 months, it usually can be completed within 12 weeks. Correction is still possible in babies up to age 18 months, but will take longer.\nWhat is considered severe plagiocephaly?\nThe CHOA scale defines plagiocephaly as mild when CVAI is 3.5–6.25, moderate when CVAI is 6.25–8.75, severe as a CVAI 8.75–11, and very severe as greater than 11 .\nCan positional plagiocephaly cause developmental delays?\nChildren with moderate-to-severe positional plagiocephaly showed lower cognitive, math, and reading scores at primary school ages. Positional plagiocephaly (PP) occurs in 20%–30% of infants and predicts higher risk for developmental delays in the toddler years.\nWhy is plagiocephaly bad?\nIf congenital plagiocephaly, which is caused by craniosynostosis, is left untreated, it can lead to serious complications, including: Head deformities, possibly severe and permanent. Increased pressure inside the head. Seizures.\nDoes plagiocephaly often correct itself?\nPlagiocephaly can correct itself without the need for treatment as long as the deformity is mild and it is detected at the earliest opportunity. When your baby is around 8 weeks old, you may notice that they have started to develop a flattening on the head.\nWhat to know about positional plagiocephaly?\nAs its name suggests, positional plagiocephaly is a deformity of the skull which is mainly caused by a baby lying with the head in one position for too long during the early stages of infancy. As babies cannot support themselves during the first few months of life, they tend to lie on their backs and develop a positional preference (a position in which they feel the most comfortable).\nWhat does plagiocephaly, nonsynostotic mean?\nU.S. National Library of Medicine(0.00 / 0 votes)Rate this definition: Plagiocephaly, Nonsynostotic A deformity of the SKULL that is not due to bone fusion (SYNOSTOSIS), such as CRANIOSYNOSTOSES, and is characterized by an asymmetric skull and face."

"Call (905) 553-3155 or email for more information\nWe help find solutions to the management of your child's health and well-being.\nFlattened Head Syndrome or Positional Plagiocephaly\nWhat is Flattened Head Syndrome/Positional Plagiocephaly?\nFlattened head syndrome or positional plagiocephaly refers to flattening of the skull in young babies. This can happen on one side (plagiocephaly), or in the middle, causing the head to look high and ‘cone shaped’ (brachycephaly).\nThe bones of the skull fuse together at approximately 12 months of age. Prior to this, the bones in baby’s head are soft and flexible. If a child prefers to look in one direction, either due to preference or torticollis, this can cause the head to become misshapen and flat on one side. In more moderate to severe cases, plagiocephaly can cause facial changes; the position of the ears may become misaligned, a bulging of the forehead may be seen, and eye shape can become asymmetrical.\nCan Plagiocephaly Affect Brain Development?\nThis is often a question that parents have. The answer is no. Positional plagiocephaly is purely a cosmetic concern. There is no evidence to suggest that plagiocephaly can affect the developing brain.\nMy Baby’s Head is Flat. What Can I Do?\n- Lots of tummy time. This helps to keep the baby off of the flat spot and develop the muscles required for rolling and sitting up.\n- Wear the baby in a carrier during the day, instead of using a stroller, when able.\n- Limit time spent in bouncy chairs, swings, car seats, etc.\n- Rotate the baby in the crib so he/she is not always looking in the same direction.\n- Ask your health care professional to check for torticollis and see a physiotherapist early to treat it if it arises.\n- In moderate to severe cases, a helmet can be prescribed at approximately 6 months of age to help correct head shape. These are worn approximately 23 hours a day and are extremely successful at correcting positional plagiocephaly. If your child is between 4-6 months of age, and you are concerned that your child’s head shape is worsening or not starting to improve, ask if a referral to orthotist is recommended.\nLuxford, B.K., Hale, L., & Piggot, J. (2009). The physiotherapy management of infants with congenital muscular torticollis: A survey of current practice in New Zealand. New Zealand Journal of Physiotherapy, 37 (3).\nRobertson, R. (2011). Supine infant positioning – Yes ,but there’s more to it. The Journal of Family Practice, 60 (10), pp. 605-8.\nVan Vlimmeren, L.A., Helders, P.J.M., Adrichem N.A., & Engelbert, R.H.H. (2006). Torticollis and plagiocephaly in infancy: Therapeutic strategies. Pediatric Rehabilitation, 9 (1), pp. 40-46."

"What is Flat Head Syndrome?\nPositional plagiocephaly or flat head syndrome is a condition in which the back or one side of an infant\"s head becomes flattened. This flattening is most often the result of spending a lot of time lying on their backs or often being in a position where the head is resting against a flat surface (such as in cribs, strollers, swings and playpens). Torticollis is often present in babies suffering from plagiocephaly. Torticollis, sometimes called wryneck, is a condition in which an infant\"s head and neck become tilted to one side, creating a shortened neck muscle on one side. Torticollis can be caused by positioning in uterus or from a lack of proper head and neck movement.\nIn 1992, the American Academy of Pediatrics launched the \"Back to Sleep\" Campaign to reduce the occurrence of Sudden infant Death Syndrome (SIDS) in newborns. While \"Back to Sleep\" has been a truly life-saving service and has decreased SIDS deaths by over 50 percent, this initiative has had some unintended consequences...\n\"Back to Sleep\", coupled with the amount of time newborns spend on their backs not only sleeping/napping, but in their car seats, bouncers and swings has given way to a shockingly steep increase in the occurrence of positional plagiocephaly or \"flat head syndrome.\nFlat Head Syndrome causes cosmetic deformities in babies that can be permanent. Even more concerning are the findings of developmental delays, There are studies that show intellectual differences between children with plagiocephaly and those without. One study demonstrated that 39 percent of children with persistent deformational plagiocephaly received special educational services versus 7.7 percent of their siblings. (Pediatrics 200,;105:e26) . Trouble with binocular vision and long-term developmental issues are also closely associated with the development of flat head syndrome.\nThese conditions, when caught, can be extremely expensive and emotionally and physically difficult to treat. Physical therapy can be uncomfortable for the child, but is often required, and in severe cases, cranial remolding (the helmet) is necessary. When not diagnosed early enough, they can develop into life-long issues for the individual.\nOne study indicates the presence of intellectual difference in children with plagiocephaly versus those without, demonstrating that 39 percent of children with persistent deformational plagiocephaly received special education service vs. 7.7 percent of their siblings.\nPrevention is Key\nTo prevent the development of flat spots, parents should actively reposition their infant\"s heads throughout the day. The goal of repositioning is to encourage baby to place equal weight distribution on various areas of the head (to avoid the formation of a flat spot) as well as to stretch the neck muscles through rotation to both sides of their body.\nDr. Jane Scott is a Board-Certified Pediatrician, a wife, and a mother of four. Over the last 20 years practicing, she has watched flat head syndrome grow exponentially in infants to, now epidemic numbers and has witnessed countless parents struggle to treat this. Some are fortunate to receive an early diagnosis, when the issue is still fairly easy to correct. However, there are also many emotionally devastated parents who are faced with many difficult choices to make because of something that could have been easily prevented. After seeing so much unnecessary heartache, Dr. Jane made it her mission to end flat head syndrome across the US and the world.\nIn addition to educating new parents on the prevention of plagiocephaly, Dr. Jane created Tortle, a non-invasive affordable solution that not only helps to treat mild cases of early-diagnosed positional plagiocephaly and torticollis in young infants, but can prevent it from ever occurring.\nThe Tortle is an FDA cleared, simple, safe, and comfortable beanie designed to aid parents in positioning their infants. By switching the Tortle from side to side with each feeding, parents alleviate the flat spots and neck tightness that newborns often develop. For more information about Tortle and Dr. Jane\"s mission, visit Tortle.com.\nDr. Jane is currently writing her first book, which is slated for release in Spring 2013. It is important to remember that prevention is key and flat syndrome doesn\"t have to affect your baby. Speak with your pediatrician about plagiocephaly and torticollis. Get informed and be prepared before your baby is born. Help spread awareness by talking to your friends and family. There are numerous online resources for information and support from other families who have had a baby diagnosed with flat head syndrome. Through education and awareness we can keep our babies heads beautiful and round!\nCopyright © Tortle.com Photo courtesy of Tortle.com."

"Contrary to Dutch study, child helmet therapy does work\nA recent study by Dutch researchers that challenges the benefits of helmet therapy in infants with plagiocephaly1 – meaning \"crooked or oblique head\" – claims that only 26 percent of patients reached a full recovery to a normal head shape using the procedure, deeming it ineffective.\nPlagiocephaly and brachycephaly – the flattening of the back of the head – result from a prolonged external force applied to an infant's malleable skull. The deformation usually is related to excessive time spent in one position and often is associated with torticollis, a twisted neck.\nSince the successful \"Back to Sleep\" campaign in 1992 to reduce SIDS, plagiocephaly has become quite common, with an incidence of approximately 20 percent. Plagiocephaly is preventable with careful attention to alternating an infant's head position. Once recognized it can be improved with position changes and keeping a baby off the flat spot on the back of the head as much as possible. If an infant has torticollis, physical therapy is helpful. For more-severe cases of plagiocephaly, a molding helmet can be worn to influence the growth of the skull to a more-normal shape.\nAt Children's Hospitals and Clinics of Minnesota, we have developed an abundance of clinical experience in treating children with plagiocephaly and brachycephaly. Our craniofacial team consists of a craniofacial surgeon, neurosurgeon, pediatric nurse practitioner, physical therapist and certified orthotist. This multidisciplinary team approach for managing infants is in agreement with the American Academy of Pediatrics policy statement on skull deformities.\nWe see the infant early and offer conservative measures such as \"tummy time,\" position changes and physical therapy to try to improve the head shape. We have conducted our own study showing the long-term results of conservative therapy.2 If these interventions aren't successful and the plagiocephaly or brachycephaly is severe, we offer helmet therapy to correct the head shape.\nIn our experience, helmet therapy is most successful if started between four and six months of age. We typically achieve a high rate of success in improving an infant's head shape if the helmet is worn as directed. Additionally, we have few complications and a high rate of compliance and parental satisfaction. Because our success rate with helmet therapy is significantly higher than that reported in the Dutch study, we plan to continue to offer helmet therapy to the more severe cases of plagiocephaly and brachycephaly. As always, we'll continue to adapt our therapies, monitor our results and compare them to the world's leading craniofacial centers.\n1. Van Wijk RM, van Vlimmeren LA, Groothuis-Oudshoorn CGM, Van der Ploeg CPB, IJzerman MJ, Boere-Boonekamp MM. Helmet therapy in infants with positional skull deformation: randomized controlled trial. BMJ 2014;348:g2741.\n2. Roby BB, Finkelstein M, Tibesar RJ, Sidman JD. Prevalence of positional plagiocephaly in teens born after the \"Back to Sleep\" campaign. Otolaryngol Head Neck Surg. 2012;146:823–828."

"Babies are born with soft skull bones to allow them to pass easily through the birth canal.\nThis clever design also allows for rapid brain growth in the first year of life. Soft skull plates make it possible for the head to expand constantly.\nMore parents notice their baby has a flattish spot that forms on the back of the head. This spot causes a lot of alarm and often leads parents to seek treatment for flat head syndrome or plagiocephaly.\nUsually, this happens as a result of babies being placed on their backs for sleep and staying in this position for play and transportation during much of their early life.\nIn part, this is due to the increased awareness, since the 1990s, that back sleeping reduces the risk of sudden infant death syndrome (SIDS). Although back sleeping has reduced the incidence of SIDS, there’s also been an increase in flat head syndrome during the same period.\nWhat is a flat head syndrome?\nFlat head syndrome is also known as positional plagiocephaly and brachycephaly.\nPositional plagiocephaly is simply when a baby’s head is misshapen, flat or uneven in shape. It usually happens because the head remains in the same position for a long time.\nBrachycephaly is when the back of the head is flat and the forehead bulges as the baby’s head become wider.\nI know! Sounds scary, doesn’t it? Often the baby’s hair even falls out in these areas, which leaves parents even more concerned.\nHow common is a flat head syndrome?\nFlat head syndrome or plagiocephaly is more common than you’d think.\nResearchers have found that 47% of 2 month-olds have a flat spot or plagiocephaly.\nAs explained in a report by the American Academy of Pediatrics, positional plagiocephaly is found in 20-50% of 6 month-old babies. Around 80% are noted within the first 4-12 weeks.\nCan you get rid of flat head syndrome?\nMost babies with plagiocephaly don’t need specialist treatment. A very small number of babies have severe or persistent cases that need intervention.\nIn severe cases, a pediatrician or doctor might recommend helmet therapy before the skull fuses. This helps to create the right amount of space for the baby’s brain to grow. Helmet therapy isn’t very common and it’s usually less scary than it sounds.\nHow long does a baby have to wear a helmet for a flat head?\nIf your pediatrician recommends the use of a helmet for plagiocephaly, your baby will probably need to wear it for about 23 hours a day for approximately 6 months.\nIt’s most effective when treatment starts between 6 and 8 months of age, and is finished before the first birthday. This is the time of rapid growth of a child’s skull.\nThe helmet is specially made and fitted for your baby. It’s designed to take the pressure off the flat area and encourage the skull to grow into the space provided.\nWearing the helmet doesn’t hurt at all, and your baby will quickly get used to wearing it.\nDoes a flat head affect brain development?\nThere is some research that suggests infants with severe cases of positional plagiocephaly or brachycephaly can be at higher risk of motor, language, and cognitive delays.\nOther studies have shown the research to be limited and in need of further examination.\nAlthough it is rare, some babies are born with a congenital condition called craniosynostosis, where the skull bones are already fused. Craniosynostosis is completely separate from flat head syndrome.\nHow to prevent the flat head syndrome\nPrevention is better than cure. Although you want to make sure your baby sleeps safely on his back, you also want to be sure his head grows evenly.\nHere are 7 tips that can help prevent flattening of the head, or treat developing flat head syndrome:\n#1: Babywearing is flat head syndrome prevention\nThere are many reasons parents wear their babies, but not everyone is aware of how babywearing helps reduce flat head syndrome.\nThe more time your baby stays upright in a safe and comfortable baby carrier, the stronger the baby’s head and neck muscles become.\nBeing upright strengthens the neck muscles and core and is naturally a position babies enjoy. Wear your baby as you go about routine tasks like vacuuming or mopping, grocery shopping, hanging out laundry, or doing the dishes.\nWhile babies are awake, the changing scenery encourages them to look around, and the gentle movement will lull them off to sleep (bonus!)\nSome baby carriers allow your baby to face forward (outwards). However, there are concerns about forward-facing carriers, so it’s not recommended to use them for very long periods of time.\nInstead of forward-facing, a side carry in a ring sling will allow for a full view of the world but also a safe retreat to mama when needed.\n#2: Look at your baby’s whole body\nIt’s important to look beyond the physical appearance of a baby with positional plagiocephaly.\nOsteopath Doctor Lauren Boundy explains:\n“From my perspective as an osteopath, flat head syndrome (plagiocephaly and brachycephaly) is all about the movement available in the body, not just the head or neck.\n“A whole-body assessment to check for ease or limitation of movements is probably the most important preventative tip I would suggest. This is because awkward positions in the womb can lead to muscle imbalances if the neck, torso, or shoulders are twisted unevenly.\n“Birth efforts and duration can also add to this mechanical asymmetry. The use of vacuum or forceps, or manual extraction (e.g. during c-sections) can also add stress, particularly to the head and neck.\n“Typically the sternocleidomastoid muscle is blamed, but osteopathically we must know WHY and HOW this occurred in an infant in order to help correct it”.\nLauren’s recommendations to reduce plagiocephaly include:\n- Assessment by an experienced pediatric osteopath or chiropractor after birth\n- Minimal (if any) swaddling for sleep\n- Safe baby-wearing options, to enhance motion and reduce pressure on the back of the head when awake and asleep\n- Caregivers alternating the way they hold babies to allow for varied postures\n- The use of baby capsules for car travel only, and not for sleeping when away from the home.\n#3: Change the view\nIf your baby spends time in the cot before sleeping, vary the position you place your baby in, to encourage turning of the head in different ways.\nHang a mobile above the cot, put brightly colored pictures where they can be seen, and even move the cot itself occasionally, to change the view and encourage your baby’s head to move positions.\nChange the baby’s sleep position regularly to reduce the pressure on one side and prevent plagiocephaly.\n#4: Limit the time in seats\nCar seats, transport systems, infant seats, capsules, and other equipment are all great ways to move a sleeping baby as you go about your busy day at home and away.\nThese seats, however, hold babies’ heads in a very limited position, and this is a contributor to flat head syndrome.\nWhenever you can, leave the capsule in the car and carry your baby in a baby sling or in your arms. Choose a pram with the option of laying the seat down flat, so the baby doesn’t spend a lot of time in a semi-reclined position.\nAt home, choose tummy time on the floor rather than time in bouncers and baby seats.\n#5: Get down on the floor with your baby\nEncourage your baby to enjoy tummy time by lying on the floor with him. You can sing, look at toys or books to get his attention and help him feel more comfortable on his tummy.\nPlace your baby on his side to look at books or toys, and vary the side he lies on.\nLying on your back, tummy to tummy with your baby can also be fun. There are even exercise programs you can do with your baby, which incorporate tummy play that is enjoyable for both of you.\nTummy Time – 6 Ways To Do It (And How To Make It Fun!) has lots of ideas for you.\nHow does tummy time help flat head?\nThe American Academy of Pediatrics says tummy time is recognized as one way to reduce the time babies spend flat on their backs on a hard surface.\nNot all babies enjoy tummy time, unfortunately, and parents worry a lot about what else they can do to reduce the risk of plagiocephaly.\nGradually build up the amount of floor and tummy time each day during the first few months. Even short bursts can help your child strengthen his neck muscles, lift and move his head and reduce the chance of remaining stuck in one position.\n#6: Mix it up\nChanging sides when breastfeeding isn’t just about accessing the other breast. Your baby’s vision, neck and arms benefit from this regular alternating of position.\nIf you’re bottle-feeding, your baby will also enjoy being swapped from one arm to the other during feeds.\nVary the scenery by moving the changing table or mat occasionally, to give your baby new views and interesting things to look at.\nEncourage him to turn his head by positioning a mobile to one side or the other rather than directly overhead, or hang pictures on the wall at eye-level.\nOnce babies begin to roll, shuffle, crawl and move, they are no longer restricted to the position they’ve been placed in.\nThey’ll naturally turn their heads from side to side while sleeping and probably spend less time lying on their backs to play.\n#7: Reach out to an osteotherapist\nFor a thorough head-to-toe check, look for a reputable pediatric osteopath in your area, and find out whether your baby could benefit from some bodywork to help correct plagiocephaly.\nOsteotherapists are experts in infant muscles and bones and can do a thorough assessment of your baby’s skull.\nGentle exercises can be introduced to help correct plagiocephaly if your baby is starting to show signs of the condition.\nCan flat head correct itself?\nPlagiocephaly can definitely correct itself over time.\nBy following these tips in the first six months or so, parents can help keep their baby’s head shape naturally, and reduce any flattening.\nHow long does it take for baby’s head to round out?\nUsually you will notice a change in your baby’s skull shape over a few months.\nKeeping the head turned to one side and changing the head position as your baby sleeps on his back can take the pressure off one area and reduce plagiocephaly.\nIn most cases, by the time your child is one or two years old, flat head syndrome will barely be noticeable.\nIf you have any concerns about plagiocephaly, follow them up with your health care provider."

"To use all functions of this page, please activate cookies in your browser.\nWith an accout for my.bionity.com you can always see everything at a glance – and you can configure your own website and individual newsletter.\n- My watch list\n- My saved searches\n- My saved topics\n- My newsletter\nPlagiocephaly is a type of cephalic disorder. Plagiocephaly is a condition characterized by an asymmetrical distortion (flattening of one side) of the skull. It is a common finding at birth and may be the result of a restrictive intrauterine environment. If there is premature union of skull bones, this is more properly called craniosynostosis. The unusual head shape in plagiocephaly is caused by pressure in the womb giving a \"diamond\" shaped head when seen from above. In pronounced cases there may be flattening of one side of the chest as well. As the child's head grows rapidly after birth, this visible inequality nearly always gets much less marked as the first year progresses.\n|This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article \"Plagiocephaly\". A list of authors is available in Wikipedia.|"

"It’s a condition that impacts one in five children – flat head syndrome. This week, researchers at the University of Sydney published their new recommendations for parents who have children with this seemingly harmless condition.\nParents Urged to Pay Close Attention to Flat Head Syndrome\nFlat head syndrome is not something that has just developed but it is something that is becoming increasingly more common after the SIDS safety guidelines suggest babies be put to sleep on their backs. As a baby is asleep on his back, his head tends to lay flat. Because a baby’s head is still soft and malleable, this extra pressure can cause his head to flatten.\nFlat head syndrome, also known as positional plagiocephaly, is usually noticed in children up to the age of 18 months.\nAn estimated one in five infants will be affected by this condition and, while they may grow out if it, studies have now shown that flat head syndrome could indicate more serious health and developmental concerns.\nThe connection between flat head syndrome and developmental delays\nAfter careful observation of 19 different studies, researchers at the University of Sydney uncovered that this condition is often linked to many developmental delays in:\n- fine motor skills (such as holding a spoon)\n- gross motor skills (such as walking)\n- language and speech (such as sounding out letters correctly)\n- cognition skills (such as understanding one’s name)\nThese delays were most common in infants up to the age of two but some delays persisted to preschool and beyond.\nAssociate Professor at the University of Sydney states, “We make the recommendation that children with flat head be assessed for developmental delays.”\nMost children with flat head syndrome will be fine\nAfter examining the 19 different studies, the researchers conclude that “about 10-25 percent of the children with flat head syndrome were recognised of having a developmental delay.” However, this number varied from 3 per cent to 51 per cent depending on the study.\nOne study also concluded that “children with a flat head were up to ten times more likely to experience developmental delays than children without it.”\nWhat should parents do?\nHowever, parents are urged to offer babies plenty of tummy time while awake and supervised. Using a carrier can also provide another position for bub that helps strengthen his neck and decreases the pressure on his head.\nIf you do notice your child does have a flat head, see your doctor. It’s always a good idea to have it checked out, just in case.\nFor more articles related to kids health, click here."

"What the research says about Flat Head Syndrome\nFlat Head Syndrome and developmental delays\nThe current research points to the fact that there are potential neurological issues which may develop as a direct result of Flat Head Syndrome - but know that there are treatments available.\nIn this video, Pediatric Chiropractor Dr Glenn Maginness will go through just a small sample of some of the research available which clearly links Flat Head Syndrome to a large variety of potential health issues.\nThis is information we believe all parents should know. These delays can present as an infant who is not meeting developmental milestones like rolling, sitting, or crawling, or perhaps a school age child with learning difficulties or balance issues.\nThis research supports the fact that we need to be better in our management of infants with Flat Head Syndrome and is the reason Tiny Years was founded.\nOver the last 35 years Dr Glenn has helped helped hundreds of concerned parents effectively treat and manage flat head syndrome in his practice. Dr. Glenn has an absolute passion for what he does as a Pediatric Chiropractor, and his mission with Tiny Years is to provide valuable, and research based resources for you as a parent so that any decisions you make relating to your child is done so from a position of knowledge and confidence, in the hope that it can guide you through a stressful time."

"Have you ever noticed a flat spot on your infant’s head? Or maybe you’ve started to see that they only look or roll to one side? They might even sit with their head tilted to one side – where they look like they’re posing for a cute photoshoot? Any of these attributes may relate to what is known as “torticollis” (i.e. neck muscle tightness) and/or “plagiocephaly” (i.e. flattening of the skull).\nWhat is torticollis and plagiocephaly?\nWith the onset of the Safe to Sleep Campaign in 1994, the goal was to reduce the risk of Sudden Infant Death Syndrome (SIDS) – commonly known as “crib death”. This campaign advocated for infants to sleep on their backs (which reduced SIDS by 94%) but led to the increase of plagiocephaly from 1 in 300 to 1 in 50 live births. In turn this has increased the number of infants with flat heads leading to more referrals for paediatric physiotherapy treatments. Though the numbers may seem daunting, parents should take comfort in the fact that paediatric physiotherapists see one in two infants with this condition – and simple treatments have been proven to be most effective in the first six months since birth!\nAlongside the increase in plagiocephaly, there has been a spike in positional torticollis – i.e. neck tightness due to infants sleeping with their head turned to one side, or favouring moving/rolling to one side. This tightness comes from shortening of the “sternocleidomastoid muscles” – two large muscles on the front of your neck which tip your head to the same side of the muscle and rotate your head to the opposite side of the muscle. As with plagiocephaly, the rise in numbers may concern parents but getting in to see a paediatric physiotherapist within the first four months since birth proves to be very beneficial – with a lot of the therapy being done at home with the helping hands of parents!\nWhat does torticollis and plagiocephaly look like?\nIf you are querying whether your infant may have torticollis and/or plagiocephaly, watch for these common indicators:\n- Your infant mostly looks to one side;\n- Your infant tilts their head to one side in sitting;\n- Your infant has a flat spot on their head (either on one side, or the entire back of the head); and/or;\n- Your infant has difficulty breastfeeding on one side.\nIf any of these apply to your infant, contact your family doctor for a referral to a paediatric physiotherapist or self-refer yourself to a child’s treatment centre.\nWhat can I do at home in the meantime?\nSince infants sleep so much in the first few months (and do so mainly on their backs), you want to counteract this position by getting lots of tummy time! Not only does this get infants from laying on the back of their heads but it also activates the muscles at the back of the skull which play a role in shaping it (thus reducing plagiocephaly) and stretches the muscles on the front of the neck as well (thus reducing torticollis). The current standard is to get 60 minutes of tummy time per day – which doesn’t need to be done all at once.\nYou can use these simple strategies to get in the needed amount of tummy time:\n- After a diaper change, roll your infant on to their side and wait to see them initiate bringing their ear to their shoulder instead of picking them up to place them on their tummy (this strengthens and stretches their neck muscles);\n- If you’re relaxing and laying on the couch, place your infant on your chest so they are looking up at you – this not only achieves tummy time but also initiates bonding with your infant!\n- Instead of holding your infant facing you, position your infant facing out. This is considered tummy time since your infant has to extend their neck up and back in order to see – which activates the muscles at the back of their neck.\nOther strategies include: positioning your infant so they lay on the side opposite of their flat spot when sleeping, and manually stretching their tight muscles by bringing their opposite ear to their opposite shoulder.\nFor more targeted strategies and treatments, go see your local paediatric physiotherapist!\nHow physiotherapy can help your infant\nThe role of a physiotherapist in the treatment of torticollis and/or plagiocephaly is to correct the position of your infant’s head/neck, as well as ensure proper neck alignment in the future. Specific to torticollis, therapists will stretch out the tight sternocleidomastoid muscles causing the head tilt or positional preference, as well as strengthen the muscles on the opposite side to get their head back into neutral. In terms of plagiocephaly, physiotherapy can help to strengthen the muscles on the back of the skull which aids in shaping your infant’s skull. For either case, a typical session with a physiotherapist would include: education on how to position your infant and different types of holds to stretch out your infant’s neck, as well as hands-on techniques by the therapist.\nKasha Pyka is a 2nd year Physiotherapy student graduating from Queen’s University in August 2017. She has had a number of experiences volunteering in paediatric heath settings (including: SickKids® and Holland Bloorview), as well as recently completing a Physiotherapy placement at Five Counties Children’s Centre – a paediatric out-patient rehabilitation facility. Alongside her clinical experience, Kasha also supports the knowledge translation of other physiotherapy content through her role as the Communication Coordinator for The Movement Centre.\nThe Canadian Physiotherapy Association (CPA) represents physiotherapists, physiotherapist assistants and physiotherapist students across Canada. CPA members are rehabilitation professionals dedicated to the health, mobility and fitness of Canadians.\nPhysiotherapists are primary health care professionals who combine their in-depth knowledge of the body and how it works with specialized hands-on clinical skills to assess, diagnose and treat symptoms of illness, injury or disability.\nMore than 20,000 registered physiotherapists work in Canada, in private clinics, general and rehabilitation hospitals, community health centres, residential care and assisted-living facilities, home visit agencies, workplaces, and schools.\nThe CPA presents its educational references as a public service and for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. The opinions expressed do not necessarily represent the opinions of the CPA membership."

"Plagiocephaly (a.k.a. Flat Head Syndrome)\nWhat is plagiocephaly?\nPlagiocephaly is sometimes known as “flat head syndrome.” You probably know a baby or two who has this. It’s a flat spot on baby’s head that doesn’t go away.\nWhat are the symptoms of plagiocephaly in babies?\nThey’re exactly that — the flat spot. While some babies have funny-looking heads after birth, they usually become rounded pretty quickly. Plagiocephaly is a flat spot that stays flat.\nAre there any tests for plagiocephaly?\nPlagiocephaly can typically be diagnosed by a physical exam, but baby’s doctor may refer you to a specialist for additional testing and assessment. “There are a number of medical conditions that can cause unusual head shapes,” says Natasha Burgert, MD, FAAP, a pediatrician at Pediatrics Associates in Kansas City, Missouri. “That’s why consultation with a specialist is sometimes needed.”\nHow common is plagiocephaly in babies?\nMore common than it used to be. Healthcare providers noticed an uptick in the number of babies with flat heads after the American Academy of Pediatrics launched its “Back to Sleep” campaign in 1992, which was meant to help prevent SIDS. Before that, many (if not most) American babies slept on their stomachs, and flat heads were rare. After babies began routinely sleeping on their backs, the incidence of plagiocephaly increased. Today, as many as 13 percent of American babies have plagiocephaly.\nHow did my baby get plagiocephaly?\nMost likely, it was caused by positioning. Because babies’ skulls are so flexible, a baby who spends too much time lying in one position may develop a flat spot on the side of his head that rests on the mattress.\nBabies who spend a lot of time in car seats, swings and infant seats are also more likely to develop plagiocephaly, since infant seats and swings restrict head movement.\nPremature babies are especially prone to plagiocephaly because their skulls are even softer at birth than those of full-term babies.\nWhat’s the best way to treat plagiocephaly in babies?\nTreatment depends on how severe baby’s flat head is. Mild cases of plagiocephaly can be treated with repositional therapy, which basically means changing your baby’s position often enough that his head eventually rounds out on its own. Instead of always lying him in the same place in his crib, have his head pointing toward the head of the crib at naptime and toward the foot of the crib the next time you put him down. Use infant seats sparingly, and give baby as much tummy time as possible. Hold your baby frequently (that one’s pretty easy!).\nIn moderate to severe cases of plagiocephaly, specialized helmets can be used to reshape the head. Treatment usually starts between four and six months of age. Helmets are custom-fitted to the child and must be worn 23 hours a day. The helmet is usually worn for two to six months.\nWhat can I do to prevent my baby from getting plagiocephaly?\nDon’t let baby lie or sit for extended periods of time. “Remember the importance of tummy time,” Burgert says. “People tell me all the time that their baby hates tummy time, but we underestimate the variations of tummy time. Carrying your baby as you walk around the house counts. Holding your baby against your chest as you watch TV counts. Anything that gets them off the back of their head counts. You should be doing that for as many of your baby’s waking hours as you can.”\nIt’s still very important to put your baby to sleep in his back, though. Back sleeping has been shown to drastically reduce the risk of Sudden Infant Death Syndrome (SIDS), and it’s worth doing, even if it slightly increases your baby’s risk of developing a flat spot on his head. As a preventative measure, try laing your baby in a slightly different spot in the crib each time you put him down. The different positions will encourage him to move his head and decrease the risk of plagiocephaly.\nWhat do other moms do when their babies have plagiocephaly?\n“We noticed our daughter had mild plagiocephaly around two-months-old. She’s an excellent sleeper and from what I’ve read this makes plagio a little more likely, since sound-sleepers don’t switch positions much. We did repositioning, and I wore her as much as I could, and as she got bigger packed her in the exersaucer with rolled blankets and had her in the Bumbo. She is now four-months-old and we have definitely seen improvement.”\n“My son had mild plagiocephaly. No helmet, but about four months of physical therapy.”\n“My baby had moderate to severe plagiocephaly and we chose to helmet (DOC band) when he was eight-and-a-half-months old. They typically wait until around six months to helmet, so the child has good neck control. It was seriously no big deal, aside from an appointment every two weeks to resize it. It didn't change his sleep, play, or eating at all. He wore it for just under four months and I am so, so, so happy with the results!”\nAre there any other resources for plagiocephaly in babies?\nMore from The Bump:"

"Leeds, United Kingdom, May 12, 2014 --(PR.com\n)-- Leading clinicians and healthcare professionals all over the world are hitting out against a report published in the British Medical Journal last week.\nThe Dutch study (1) investigated the success rate of plagiocephaly treatment. Also known as flat head syndrome, plagiocephaly is a head shape deformity often seen in babies, treated in severe cases using a special kind of corrective helmet.\nThe report concludes that helmets make no meaningful difference to the head shape, and can cause unpleasant side effects including sweating and skin irritation. However, experts have identified several flaws in the research procedure that completely undermine these conclusions.\nIn particular they condemned the uncomfortable, poor-fitting helmets that were used in the study. These rubbed and rotated, causing inflammation and dramatically reducing the treatment’s efficacy. Comparisons were drawn with helmets from legitimate clinics, which are generally custom fitted.\nIt may come as little surprise that the study had an drop-out rate of around 70%. The report states that 66% of infants ended treatment early, with only 27% expressing satisfaction with the results (2). Amazingly, those subjects who abandoned treatment early continued to be reported as part of the treated group and were regarded as having received fully successful treatments.\nTo compound matters further, the group failed to take into account the statistical range of head shape deformity in the population. Most clinics only treat those babies whose heads are within the ‘moderate’ to ‘severe’ range – a tiny percentage of the population. Many of those in the untreated group would have had ‘mild’ plagiocephaly, which is already known to correct itself in most cases.\nSteve Mottram, Managing Director and Consultant Orthotist at Technology in Motion, one of the UK’s top plagiocephaly clinics, said:\n\"The way that the data has been presented mixes all head shape deformities and therefore minimises the specific effect for each type. It’s like reporting on 10 children who had broken arms and 10 who had broken legs. Combining the data ‘proves’ that only 50% of children with fractures recovered from a broken arm. The way that the data has been presented makes it meaningless and in this case, huge and misleading assumptions have been drawn from the results.\"\nPlagiocephaly helmets are currently unavailable on the NHS on the grounds that the condition is cosmetic and usually sorts itself out (3). However, a significant number of parents continue to pay the £2,000 fee for treatment at a private practice – and are generally very pleased with the results.\nMany physicians now agree that some babies can only be treated using a helmet. However, a considerable lack of research has prevented a definitive standard of care from being established in the UK (4).\nTo assess the true success rate of helmets, a reliable randomised controlled clinical trial or comparative study is needed. Until then, this area of research remains somewhat grey.\nTechnology in Motion has successfully treated thousands of babies over their ten years in practice, with excellent correction rates seen in over 95% of patients. Visit their website or call 0113 218 8030 to enquire further or for more information on their products and services.\n1. Helmet therapy in infants with positional skull deformation: randomised controlled trial - BMJ 2014;348:g2741\n2. Helmet therapy in infants with positional skull deformation: randomised controlled trial - BMJ 2014;348:g2741\n3. Plagiocephaly (Flat Head Syndrome) Purely a Cosmetic Concern? - Whiz News Hub, 3 July 2013\n4. Head Deformity Ignites Debate Among Baby Experts - LiveScience, 18 March 2011"

"Since the Back to Sleep campaign in the 1990’s, the incidence of SIDS has decreased 40-50% while plagiocephaly, or flat head syndrome, has increased exponentially.1 Plagiocephaly can be prevented by holding children, according to the NIH (National Institute of Health).2 Traditional treatment for plagiocephaly has included several months up to a year of wearing a rigid foam helmet costing $1500-3000, for up to 23 hours a day. The studies that showed improvement using this therapy were not controlled, randomized studies. The results of the first randomized study were released on May 1st, 2014 and showed no statistically significant differences in improvement between infants with mild to moderate plagiocephaly who wore helmets, and those who did not. In addition, 77% of the parents in the helmet wearing group complained that helmet therapy hindered cuddling with their infants. 33% reported perceived pain, and 96% reported skin irritation3. Coupled with the finding that children with plagiocephaly are more likely to have developmental problems1 the complaint of less cuddling is even more concerning. About 70% of babies with plagiocephaly do not improve, whether they wear helmets or not. Prevention is the best treatment we have available and babywearing can be that prevention."

"(Natural News) A study published in the European Journal of Epidemiology reveals that soured whole milk products are more effective at reducing the risk of suffering from brain thrombosis or ischemic stroke compared with other dairy products — such as low-fat soured milk products and cheese, buttermilk, or milk — with varying fat percentages. A team of researchers at the Aarhus University in Denmark examined up to 57,000 Danes aged between 50 and 64 years with equal dairy intake as part of the study. However, the participants had a specified difference in whole milk and whole milk yogurt consumption.\nThe experts noted that the products the volunteers consumed include both skimmed and semi-skimmed low-fat milk, whole milk, and buttermilk as well as Danish soured milk products with 1.5 to 3.5 percent fat content. The research team also monitored the participants for years in order to determine the relationship between their dietary habits and the onset of brain thrombosis.\nLikewise, the scientists recorded ill health among the participants. Certain products had been phased out and new products had arrived on the market during the course of the study. The health experts also compared and examined the differences in the participants’ intake of both red and processed meat, fruit, vegetables and fish. Moreover, the research team assessed the volunteers’ smoking habits, alcohol habits, obesity, and educational level.\n“The result is not quite what we had expected. We had mostly expected that semi-skimmed milk was a better choice than full-fat yogurt in relation to this risk. In other words, we look at the significance of eating the whole product – not whether it is the product’s content of calcium, salt, fat and so on that makes a difference. Of course, we eat all these things together when they come out of the carton,” the researchers say.\nThe findings revealed that 2,272 of the participants suffered a stroke, 1,870 of whom developed brain thrombosis. However, the research team observed that adult participants who consumed more soured milk products had up to 15 percent lower risk of suffering a thrombosis in the brain, compared with adults who consumed standard milk products regardless of their fat percentages.\n“Statistically, it is our best suggestion for the risk of thrombosis in the brain, when we look at different ways to combine your intake of dairy products. We can see a 16 percent lower immediate risk of thrombosis in the brain among those who, for example, choose high-fat soured milk products rather than whole milk. If people choose low-fat soured milk products instead of the high-fat, we see a twenty percent higher immediate risk of blood clots. This may actually be as high as 45 percent. However, due to the statistical uncertainty, we cannot rule out that it is a single percent lower,” researchers Anne Sofie Dam Laursen and Associate Professor Marianne Uhre Jakobsen states in a university release.\nHowever, the research team has not clarified whether the lower thrombosis risk is due in part to the individual nutrients found in the products, or whether the added bacteria cultures in soured milk products play a key role in the process. The scientists also added that the reduced risk may not be a result of consuming different amounts of other foods. Furthermore, the research team has stressed that differences in the participants’ body weight, education level, and smoking and alcohol habits have nothing to do with the lower odds of suffering brain thrombosis.\n“But even though our result points in a specific direction, one study is obviously not sufficient grounds to publicly recommend that people change the items they have in their fridges,” Dam Laursen stresses."

"En español | Got milk? And is it low-fat?\nYour risk of stroke might be reduced if it is, according to a new Swedish study that found that older adults who ate more low-fat dairy foods — including skim milk and low-fat yogurt and cheese — had a lower risk of stroke.\nSign up for the AARP Health Newsletter.\nIn what researchers called the largest study on the issue to date, nearly 75,000 older adults were tracked for 10 years after filling out a dietary questionnaire on what foods they ate and how often.\nSwedish scientists reported that people who consumed a daily average of four servings of low-fat dairy foods had a 12 percent reduction in overall stroke risk and a 13 percent lower risk of ischemic stroke (the most common kind), compared with those who ate little or no dairy.\nThe study was published April 19 in Stroke, a journal of the American Heart Association.\nSusanna Larsson, lead author and associate professor of epidemiology at the Karolinska Institute in Stockholm, said that the most likely explanation is that the nutrients in low-fat dairy foods — including vitamin D, calcium, potassium and magnesium — help lower blood pressure, which is a key risk factor for stroke. “If people consume more low-fat dairy foods rather than high-fat,” said Larsson, “they will benefit from a reduced risk of stroke and other positive health outcomes.”\nThe researchers followed 74,961 Swedes, ages 45 to 83, beginning in 1997. Over the next decade, the group had 4,089 cases of stroke — 3,159 of which were ischemic, in which a clot blocks a blood vessel supplying the brain. Another 583 cases were classified as hemorrhagic (bleeding) strokes, and 347 were unspecified. For ischemic strokes, the more low-fat dairy food subjects consumed, the lower the risk, the study found.\nThe researchers found that full-fat dairy products, such as whole milk, didn’t raise or lower the stroke risk.\nAdam Bernstein, M.D., research director of the Cleveland Clinic’s Wellness Institute who recently led a large study of how different protein sources affect stroke risk, says his research did not find the same benefit from low-fat dairy, but he points out that Swedes consume much more dairy on average than Americans.\nSwedes also eat some dairy products that are not widely consumed in the United States, such as soured milk and crème fraiche. And Swedish low-fat milk has 0.5 percent fat, equivalent to U.S. skim milk, while medium-fat milk has 1.5 percent fat, a bit less than the 2 percent reduced-fat milk in the States.\nFurther, the Swedish study didn’t identify what foods people might have been eating less of, notes Bernstein, whose own research has linked both red meat and soda consumption to heightened stroke risk. Perhaps people who ate more low-fat dairy were at lower risk of stroke because they also ate less meat or fatty junk food.\nBernstein thinks simply recommending that people add more low-fat dairy foods to their diets may be overly simplistic. Health experts need to make sure that people don’t just add more dairy at the expense of other healthy foods, such as fruits and vegetables, he says.\nAlso of interest: 7 simple steps to heart health.\nDiscounts & Benefits\nNext ArticleRead This"

"Dairy Doesn’t Affect Stroke Risk\nDairy products have sometimes been given a bad rap. While they are a good choice for those looking to consume their daily amount of calcium, some people believe they have negative health effects that can outweigh the positive ones.\nA study of more than 74,00 men and women over 10 years found that “consumption of total dairy, full-fat dairy, milk, sour milk/yogurt, cheese, and cream/crème fraiche was not associated with stroke risk.” But an even better choice is low-fat dairy foods. The researchers found that “consumption of low-fat dairy foods was inversely associated with risk of total stroke.” This means that the more low-fat dairy foods a person ate, the lower their risk of stroke."

"Eating low-fat dairy foods may reduce your risk of stroke\nIf you eat low-fat dairy foods, you may be reducing your risk of stroke.\nIn a Swedish study published in the American Heart Association's journal Stroke, people who drank low-fat milk and ate low-fat yogurt and cheese had a lower risk of stroke compared to those who consumed full-fat dairy foods.\nAmong 74,961 adults 45 to 83 years old, those who ate low-fat dairy foods had a 12 percent lower risk of stroke and a 13 percent lower risk of ischemic stroke than those who ate high-fat dairy foods.\nParticipants were free of heart disease, stroke and cancer at the start of the study. All completed a 96-item food and beverage questionnaire to determine dietary habits. Food and drink consumption frequency was divided into eight categories, ranging from never to four servings per day.\nDuring the 10-year follow-up, 4,089 strokes occurred (1,680 in women and 2,409 in men): 3,159 ischemic, 583 hemorrhagic and 347 unspecified strokes.\n\"This is the largest study to date to examine the association between consumption of total, low-fat, full-fat and specific dairy foods and the risk of stroke in adult men and women,\" said Susanna Larsson, Ph.D., the study's first author and associate professor of epidemiology in the Division of Nutritional Epidemiology, National Institute of Environmental Medicine, at the Karolinska Institute in Stockholm, Sweden.\n\"From a public health perspective, if people consume more low-fat dairy foods rather than high-fat dairy foods, they will benefit from a reduced risk of stroke and other positive health outcomes.\"\nThe benefits of low-fat dairy foods are likely due to the vitamins and minerals they contain: calcium, potassium, magnesium and vitamin D.\n\"It is possible that vitamin D in low-fat dairy foods may explain, in part, the observed lowered risk of stroke in this study because of its potential effect on blood pressure,\" Larsson said.\nLow-fat dairy food is one part of the Dietary Approaches to Stop Hypertension (DASH) Diet, which reduces blood pressure. High blood pressure is a major risk factor for stroke.\nNorthern Europeans and North Americans traditionally consume much more dairy foods than other global populations. So switching to low-fat dairy products could impact stroke risk for millions of people, Larsson said. More research on the link between low-fat dairy consumption and risk of stroke is needed, Larsson said."

"If you eat low-fat dairy foods, you may be reducing your risk of stroke.\nIn a Swedish study published in the American Heart Association’s journal Stroke, people who drank low-fat milk and ate low-fat yogurt and cheese had a lower risk of stroke compared to those who consumed full-fat dairy foods.\nAmong 74,961 adults 45 to 83 years old, those who ate low-fat dairy foods had a 12 percent lower risk of stroke and a 13 percent lower risk of ischemic stroke than those who ate high-fat dairy foods.\nParticipants were free of heart disease, stroke and cancer at the start of the study. All completed a 96-item food and beverage questionnaire to determine dietary habits. Food and drink consumption frequency was divided into eight categories, ranging from never to four servings per day.\nDuring the 10-year follow-up, 4,089 strokes occurred (1,680 in women and 2,409 in men): 3,159 ischemic, 583 hemorrhagic and 347 unspecified strokes.\n“This is the largest study to date to examine the association between consumption of total, low-fat, full-fat and specific dairy foods and the risk of stroke in adult men and women,” said Susanna Larsson, Ph.D., the study’s first author and associate professor of epidemiology in the Division of Nutritional Epidemiology, National Institute of Environmental Medicine, at the Karolinska Institute in Stockholm, Sweden.\n“From a public health perspective, if people consume more low-fat dairy foods rather than high-fat dairy foods, they will benefit from a reduced risk of stroke and other positive health outcomes.”\nThe benefits of low-fat dairy foods are likely due to the vitamins and minerals they contain: calcium, potassium, magnesium and vitamin D.\n“It is possible that vitamin D in low-fat dairy foods may explain, in part, the observed lowered risk of stroke in this study because of its potential effect on blood pressure,” Larsson said.\nLow-fat dairy food is one part of the Dietary Approaches to Stop Hypertension (DASH) Diet, which reduces blood pressure. High blood pressure is a major risk factor for stroke.\nNorthern Europeans and North Americans traditionally consume much more dairy foods than other global populations. So switching to low-fat dairy products could impact stroke risk for millions of people, Larsson said.\nMore research on the link between low-fat dairy consumption and risk of stroke is needed, Larsson said.\nCo-authors are Jarmo Virtamo, M.D., and Alicja Woik, DMSc. Author disclosures are on the manuscript.\nThe Swedish Council for Working Life and Social Research and the Swedish Research Council funded the study.\nThe American Heart Association offers information on Diet and Lifestyle Recommendations and Milk Products. For information on stroke visit strokeassociation.org.\nDiet has an important role in the primary prevention of hypertension. The Dietary Approaches to Stop Hypertension (DASH) trial has shown that a dietary pattern rich in fruit, vegetables, and low-fat dairy products and with reduced total and saturated fat (the DASH diet) can be effective in the prevention of hypertension. This pattern was more effective than was a diet rich in fruit and vegetables in which dairy consumption was low. However, the DASH study was conducted in a controlled setting with a short follow-up (8 wk), and it was not specifically designed to assess the individual effects of each element of the protective dietary pattern.\nNonetheless, substantial epidemiologic and clinical data exist that show that a long-term high consumption of fruit and vegetables, one of the main components of the DASH diet, is inversely associated with blood pressure (BP) levels independent of other dietary factors. However, the relation between dairy consumption, another important building block of the DASH diet, and BP is not so clear. Some prospective studies have found a beneficial relation between dairy consumption and the incidence of hypertension or a change in BP, but this association was only evidenced in young adults and in children. On the other hand, dairy consumption has been associated with a higher cardiovascular disease mortality risk in postmenopausal women, whereas the nutritional intervention in the Oslo study, which was mainly focused on reducing whole-fat dairy consumption, was associated with a lower risk of coronary events. In addition to this apparent inconsistency in epidemiologic results, no prospective studies have assessed the relation between dairy consumption and the incidence of hypertension in persons in Mediterranean countries where intake of fat, particularly monounsaturated fatty acids, is high and where, perhaps, results from the DASH trial could not be directly applied. The objective of the present study was to prospectively assess the potential association between dairy consumption, particularly low-fat dairy products, and the risk of hypertension in a Mediterranean population.\nStatements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at http://www.heart.org/corporatefunding .\nNR12 – 1058 (Stroke/Larsson)\nSOURCE: American Heart Association"

"By: Justin Chan\nWhile foods high in sodium may put one at risk of experiencing a stroke, a study revealed that fried food significantly raises that risk among older women.\nAccording to the Daily News, researchers from the University of North Carolina discovered that older women who consume large amounts of fat found in fried food and baked goods are more likely to experience strokes than women who eat lower fat diets. Approximately 800,000 people in the United States are affected by strokes annually; in fact, strokes are the fourth leading cause of deaths in the country.\nThe researchers studied the eating habits of about 87,000 women between the ages of 50 and 79. Most of the women were considered in good health when the study began. Those who ate meals that contained at least 6.1 grams of trans-fatty acids per day had a 39 percent greater chance of facing a stroke than those who had no more than 2.2 grams. The report also noted that aspirin may help reduce the connection between trans-fat consumption and strokes.\n\"Our findings confirm that postmenopausal women with higher trans-fat intake had an elevated risk of ischemic stroke, but aspirin use may reduce the adverse effects,\" said Ka He, the lead author of the study. \"We recommend following a diet low in trans fat and adding an aspirin regimen to help women reduce their risk of stroke, specifically following the onset of menopause.\"\nAlthough the consumption of trans fat has generally decreased over the years, it has not completely disappeared. \"Trans fats are rare in living nature, but can commonly occur in foods as a result of food processing called partial hydrogenation when a liquid vegetable oil is turned into a solid fat,\" said Nancy Copperman, director of public health initiatives at North Shore-Long Island Jewish Health System."

"By Margarita Nahapetyan\nA new research suggests that women older than 50 years who consume a lot of fat, especially the type that is present in processed food, crackers, stick margarine, pastries and fried food, highly increase their chances of developing ischemic stroke.\nThe study researchers at University of North Carolina in Chapel Hill have come to the conclusion that those women who had the highest daily intake of dietary fat were 44 per cent more likely to have ischemic stroke when compared to those women who ate less fat. Ischemic stroke is a stroke that is caused by blockages in the blood vessels that are located in the brain or lead to the brain.\nIt is believed that women have a reduced risk of having stroke before they go through menopause, but after menopause occurs they are at the same risk as men for developing strokes. For the purposes of their new study, the experts analyzed data that was collected from 87,230 postmenopausal women with the ages between 50 and 79 years, who took part in the Women's Health Initiative (WHI) Observational Study. All women were asked to fill out a food frequency questionnaire at the beginning of the study and were followed then for an average of 7.6 years, the researchers said. During that period of time, 1,049 ischemic strokes occurred.\nScientists assigned the women into quartiles based on the amount of total dietary fat and types of fat (saturated fat, mono-unsaturated fat, polyunsaturated fat and trans fat) they reported consuming on a daily basis. Researchers took into consideration factors, such as women's age, ethnicity, smoking habits, physical activity, alcohol or drug use, BMI (body mass index), hormone therapy, history of heart disease, diabetes, systolic blood pressure and whether the women were taking medication for high blood pressure or to reduce cholesterol, vitamin E supplementation, fruit and vegetable consumption, total calories and dietary fiber.\nThe results revealed that the women in the top quartile for total fat consumption had an average intake of 86 grams of total fat a day when compared to 26 grams of total fat per day for women in the lowest quartile. In the study, researchers considered intake of 7 grams of trans fat per day as the highest intake, whereas intake of 1 gram of trans fat per day was considered as lowest.\nThe new study is the largest to examine a risk of stroke in women and across all types of fat. It demonstrated a clear trend: women who consumed the most fat had nearly 45 per cent higher risk of the most common type of stroke when compared to women who ate the least.\nAccording to the Harvard epidemiologists and nutritionists, each year an estimated 100,000 deaths from heart disease in the United States are associated with trans fat intake. Federal health statistics show that, on average, American women in their 50s and 60s consume between 63 and 68 grams of fat on a daily basis. The American Heart Association strongly recommends that the intake of fat is limited to less than 25 to 35 per cent of total calories, and the intake of trans fat to less than 1 per cent. The healthiest fats come from nuts, seeds, fish and vegetable oils.\nThe findings were presented last week at the American Stroke Association's International Stroke Conference 2010."

"Chapter 13 : Dietary fat, hypertension and stroke\nContents - Previous - Next\nCholesterol and total fat\nWhile salt intake and obesity have been related to hypertension, studies on the possible roles of dietary fat in the regulation of blood pressure and the pathogenesis of hypertension have shown many inconsistent results (Beilin, 1987; Sacks, 1989; Iacono and Dougherty, 1993).\nCholesterol and total fat\nIn stroke-prone, spontaneously hypertensive rats, cholesterol-rich, high-fat diets decreased blood pressure and decreased the incidence of stroke (Yamori, 1977). This may be due to the attenuation of vascular activity (Yamori, 1981). Epidemiological data are generally consistent with the animal experiments, they indicate that diets which are very low in fat increase the occurrence of some forms of stroke (Jacobs et al., 1992). Societies with a low intake of fat and animal protein, such as traditional Japan, tend to have high rates of haemorrhagic stroke. An elevated risk of stroke is found among segments of the Japanese population with low levels of serum cholesterol, particularly among those with high blood pressure (Komachi et al., 1976). In a large, screened population of men in the USA, those with the lowest serum cholesterol levels had an elevated risk of haemorrhagic stroke, even though the risks of ischemic stroke, coronary heart disease and total cardiovascular disease were positively and linearly related to serum cholesterol (Kagan, Popper and Rhoads, 1980; Iso et al., 1989). While not proving causality, the rates of stroke have declined greatly in Japan since the early 1950s, during which time the amount of fat consumed increased from about 10 percent to 25 percent of total dietary energy. This increase was due primarily to the greater consumption of animal fat.\nA number of large epidemiological studies (Kay, Sabry and Csima, 1980; Salonen, Tuomilehto and Tanskanen, 1983; Khaw and garret-Conner, 1984; Gruchow, Sobocinsky and Barboriak, 1985; Elliott et al., 1987; Joffres, Reed and Yano, 1987) did not find any association between blood pressure and either dietary fat or cholesterol. Only one epidemiological study of Japanese immigrants living in Hawaii showed that blood pressure fell with an increase in total dietary fat and cholesterol (Reed et al., 1985). The WHO CARDIAC cross-sectional study, which was conducted on a world-wide basis, demonstrated a significant positive correlation between serum cholesterol levels and diastolic blood pressure (Yamori et al., 1993). Although there are methodological limitations in determining the effect of dietary fat on hypertension, the current evidence indicates that chronic elevation of plasma cholesterol is associated with higher diastolic blood pressure, probably as a result of atherosclerotic vascular changes.\nSaturated fat and monounsaturated fatty acids. Two dietary surveys carried out in Finland showed a significant inverse association between the intakes of saturated fat and blood pressure (Salonen, Tuomilehto and Tanskanen, 1983; Salonen et al., 1988), however, many other studies found no such association (Gruchow, Sobocinski and Barboriak, 1985; Elliott et al., 1987; Joffres, Reed and Yano, 1987; Williams et al., 1987; Rubba et al., 1987). In several populations studied, the level of saturated fatty acids in the adipose tissue tended to be inversely related to blood pressure (Riemersma et al., 1986; Hudgins, Hirsch and Emken, 1991).\nControlled trials testing the effect of various dietary monounsaturated fatty acids showed no significant effects (Mensink, Janssen and Katan, 1988; McDonald et al., 1989).\nPolyunsaturated fatty acids. Regulation of blood pressure is impaired in animals which are deficient in linoleic acid. When such animals were made hypertensive by 9 days of drinking saline, the addition of linoleic acid to the diet normalized blood pressure despite the continued administration of saline (Cox et al., 1982). When there is no deficiency, linoleic acid has little effect on blood pressure in animals (Smith-Barbaro et al., 1980; McGregor, Morazain and Renaud, 1981; Mogenson and Box, 1982; Tobian et al., 1982; Singer et al., 1990; Shimamura and Wilson, 1991).\nThe results of human cross-sectional studies provide little evidence of an effect of n-6 fatty acid intake on blood pressure. The National Health and Nutrition Examination Surveys (NHANES) of adults in the USA indicated that the nutritional factor most strongly and consistently related to blood pressure was body mass index (Harlan et al., 1984); serum calcium was related directly and serum phosphorus was related indirectly to systolic blood pressure. The study failed to show any relationship between diastolic blood pressure and dietary fats. In general, intakes of fatty acids and total fat, as determined by dietary histories, are not significantly correlated with blood pressure (Sacks, 1989). Moreover, there is little convincing evidence that the amount or type of dietary fat has an effect in persons with normal or mildly elevated blood pressure. Cross-sectional population studies are often confounded by the complexity of dietary and other life-style differences. The NI-HON-SAN study found that fat provided 15 percent of energy intake in Japan. Among ethnic Japanese in Hawaii and San Francisco, energy intakes from fats were 33 percent and 38 percent, respectively. The differences were mainly due to intakes of saturated fat (Kagan, Marmot and Kato, 1980). Blood cholesterol levels paralleled fat intake among all three groups. While blood pressures were similar in studies in Japan and Hawaii, they were higher in San Francisco. The prevalence of stroke, hypertension, hypertensive heart disease and left ventricular hypertrophy were higher in Japan than in the other two populations, possibly because of the higher intake of salt and alcohol and the lower intake of protein.\nThe ratio of polyunsaturated fat to saturated fat is generally higher in vegetarians than in non-vegetarians. The consumption of food of animal origin has been found to be highly correlated with both systolic and diastolic blood pressures (Sacks, Rosner and Kass, 1974). Vegetarian Seventh-Day Adventists in western Africa had lower blood pressures than non-vegetarians and showed a gradient of increasing blood pressure with increasing egg consumption (Armstrong, van Merwyk and Coates, 1977). With a lacto-ovo-vegetarian diet, normotensive persons showed a lowering of blood pressure (Rouse, Armstrong and Beilin, 1983). In line with this, a fall in systolic blood pressure in untreated, mildly hypertensive persons who changed to a vegetarian diet has been demonstrated (Margetts et al., 1986). Replacing saturated fat with carbohydrate or with oils high in linoleic acid, however, does not always produce a favourable change in blood pressure (Sacks et al., 1987). Many factors are influenced by vegetarian dietary habits, consequently the interpretation of studies from these populations is limited. It would be difficult to find an association of dietary fat with blood pressure, even if it exists, because of the low sensitivity of dietary methods such as the 24-hour recall and 3-4 day record of food frequency. However, biochemical analyses on the ratio of polyunsaturated to saturated fatty acids in adipose tissue also showed no association with blood pressure (Berry and Hirsch, 1986; Riemersma et al., 1986; Ciocca et al., 1987; Rubba et al., 1987).\nSeven studies have shown a significant decline in systolic blood pressure, up to 13 mm Hg, and diastolic blood pressure, 7 mm Hg, in mildly hypertensive individuals eating n-6 enriched diets (Iacono and Dougherty, 1993). Seven other studies were identified in which no significant change in blood pressure occurred in individuals eating similarly enriched diets. Differences in subject selection or adherence to diet may account for these observations. Five community-based intervention studies in Finland, Italy and the USA showed decreases in blood pressure with an increased ratio of intake of n6 polyunsaturated fat to saturated fat. Two extensive, prospective cohort studies of health professionals in the USA, one covering females (Witteman et al., 1989) and the other involving males (Ascherio et al., 1992) did not show any association between dietary polyunsaturated fatty acids and the development of hypertension during a period of 4 years. In two, large, controlled intervention trials, conducted by the National Diet Heart Study Research Group (1968) and the Research Committee to the Medical Research Council (1968), no significant influence of dietary fat on blood pressure was observed in normotensives.\nN-3 fatty acids. Many experimental studies have examined the effect of the n-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The discrepancies in observations on blood pressure may be due to the complexity of regulatory mechanisms. The syntheses of vasodilator prostaglandins, such as prostacyclin and PGE2, as well as constrictors such as thromboxane A2 and leukotriene B2, are suppressed by the production of three series of eicosanoids. Thromboxane A3 from n-3 fatty acids is not as active as the 2-series of eicosanoids. The effect of n-3 fatty acids on blood pressure is, therefore, due to the balance of vasodilator and vasoconstrictor eicosanoids in the vascular wall and in the kidney (Yin, Chu and Beilin, 1992; Shimokawa et al., 1987; Lorenz et al., 1983; Beilin, 1992).\nIn a controlled trial, 50 ml of fish oil (lSg of n-3 fatty acids) decreased systolic and diastolic blood pressure in mildly hypertensive subjects, but 10 ml of fish oil was ineffective (Knapp and Fitzgerald, 1989). Supplementation of a diet with EPA plus DHA, compared to linoleic acid or a -linolenic acid, also lowered blood pressure (Kestin et al., 1990).\nWhen the consumption of fish (100 g of mackerel per day) was compared to meat, there was no effect on blood pressure and bleeding times were significantly prolonged (Houwelingen et al., 1987). A trial in which there was supplementation of either oil containing EPA + DHA or the same amount of corn oil indicated that a reduction in blood pressure depended on the increase in plasma phospholipid n-3 fatty acids (Bonaa et al., 1990).\nIn the elderly, a reduction in blood pressure occurred with fish oil only when it was combined with a low intake of sodium (Cobiac et al., 1992). It may be noted that there was a high incidence of hypertension and haemorrhagic stroke among the Japanese who ate fish with salt.\nThe WHO multi-centre, cross-sectional study, known as CARDIAC, involving 55 centres in 24 countries, showed that serum cholesterol levels were positively related to diastolic blood pressure in populations worldwide (Yamori et al., 1992).\nFor effective treatment of hypertension, intakes of n-3 fatty acids from foods would generally be too high for practical use. Such use should be based on their potential benefits for preventing atherosclerotic or thrombotic disease.\nModification of dietary fat to lower blood lipids indirectly affects blood pressure by slowing down or reversing the atherosclerotic process. Although higher levels of n-6 and long chain n-3 fatty acids lower elevated blood pressure, their effect is modest, especially when compared to the effects of weight reduction or sodium restriction.\nContents - Previous - Next"

"Saturated Fats Such as Butter May Not be Bad for Your Heart\nButter, cows milk and eggs, which are rich in saturated fat, have long been linked to increased risk of heart disease. However, a recent study suggests that saturated fats actually may not be associated with a higher risk of heart disease, stroke, type-2 diabetes, or all cause mortality. The study did find however that trans fats do contribute to increased risk of coronary heart disease death, coronary heart disease, and all cause mortality.\nConfused about the difference between saturated and trans fats? Saturated fats are those found in nature, usually in animal products. Some examples include butter, cows milk, meat, salmon, egg yolks, and certain plant products including chocolate and palm oils. Trans unsaturated fats are industrially produced fats that come from plant oils in a process called hydrogenation, and are commonly used in margarine, snack foods, and packaged baked goods.\nFor their review, the researchers examined the data from 50 observational studies that assessed the association between saturated and/or trans fats and health outcomes. They found no association between saturated fat intake and coronary heart disease, cardiovascular disease, ischemic stroke, type-2 diabetes, or all cause mortality.\nThey did, however, find a 28% increased risk of coronary heart disease death, a 21% higher risk of coronary heart disease, and a 34% increased risk in all cause mortality associated with trans fat consumption.\nThe researchers were unable to find any association between trans fats and type-2 diabetes or ischemic stroke, which they credited to inconsistencies in the studies.\nResearchers from McMaster University conducted the study. It was published on August 11, 2015, in British Journal of Medicine.\nWhile this study suggests that saturated fats may not be as bad for us as previously thought, the researchers cautioned against increasing the recommended limit for saturated fats, as they don’t seem to have any discernible health benefit.\nIf you want to cut more trans fats from your diet, however, pay attention to the ingredients in your food. It’s also a good idea to cut back on packaged foods and focus on consuming whole foods that can readily be identified, such as fruits, vegetables, and lean meats."

"A new research shows that butter as well as other saturated fats are not linked with an increase in deaths or heart diseases. In fact, researchers from McMaster University say that it is trans fats that are associated with a greater risk of death, stroke, type 2 diabetes or coronary artery disease.\nLead author and assistant professor Russell de Souza, said that for years, people have been advised to limit their fat intake. Trans fats do not have any health benefits and tend to pose a significant amount of risk for heart diseases, though the case for saturated fats is not very clear.\nSaturated fats are taken from animal products such as cow’s milk, butter, meat, egg yolks, salmon and some types of plant products such as palm oils and chocolate. Trans fats are produced mainly industrially from plant oils to be used in margarine, packaged baking goods and snack foods.\nAccording to the current US guidelines, saturated fats are limited to less than 10 percent and trans fats to less than one percent of energy a day so as to reduce risk of heart disease and stroke.\nThe team had analysed results of 50 observational studies that assessed association between saturated and/or trans fats and the health outcomes in adults. They did not find any clear association between higher intake of saturated fats as well as death for any reason, cardiovascular disease, coronary heart disease, type 2 diabetes or ischemic stroke. The authors keeping in mind that an alternative must be suggested if intake of less saturated or trans fats is recommended, said that you should replace foods that are high in fats, such as processed meats and donuts with whole grains, nuts and vegetable oils.\nRead more health news\nImage source: Getty"

"I enjoyed writing this article about the very topical issue of saturated fat, which was first published in the December 2017 edition of NHD Magazine.\nSaturated fats contain single bonds between carbon atoms which causes the fat to be ‘saturated’, or to be linked to as many hydrogen atoms as possible. Sources of saturated fat include: butter, coconut oil, palm oil, lard, full fat dairy products, pies, pastries, cakes and biscuits and the visible fat on meat1.\nDue to the association between saturated fat and increased LDL cholesterol levels, most public health bodies recommend limiting saturated fat intake in order to reduce the risk of heart disease1,2.\nAs there has been a lot of recent debate surrounding this topic, this article will examine some of the common arguments put forward by those who challenge the link between saturated fat intake and heart disease.\nArgument One: “Studies have found that saturated fat intake is not associated with heart disease”\nA large meta-analysis by Chowdhury et al. (2014) is often quoted to support this argument, as this study did not find a significant association between saturated fat intake and cardiovascular disease (CVD)3. However, there have several criticisms of this study, such as: errors in some of the data, omitting relevant studies, a lack of consistency (for example whether saturated fat was substituted for refined carbohydrates), and the fact that data representing monounsaturated fats was taken from meat and dairy rather than more relevant sources such as nuts and olive oil4.\nFurthermore, numerous other large meta-analysis’ have found that lowering saturated fat intake is associated with a reduced risk of heart disease5-7.\nThese studies also found that neither a lower total fat intake or replacing saturated fat with refined carbohydrates was associated with a lower risk of heart disease, but that replacing saturated fat with unsaturated versions or wholegrains was associated with a reduced risk of CVD5-7. For example, a large systematic review by Hopper et al. (2015) found that a reduced saturated fat intake was associated with a 17% reduced risk of CVD7. A more recent large prospective cohort study, called the PURE study, found that there were no significant differences between the type of fat consumed and the risk of cardiovascular events, and that lower intakes of saturated fat were associated with an increased risk of stroke8. Although these are interesting results it is important to remember that no causal relationship can be assumed due to the observational design of this study. Another limitation is the potential confounding effect of socio-economic status. Although education status was corrected for, the PURE study was predominantly carried out in low and middle income countries, and the researchers themselves state that “high-carbohydrate and low-fat diets might be a proxy for poverty or access to healthcare”8.\nArgument Two: “The initial research about saturated fat intake and heart disease is flawed”\nThe Seven Countries Study (SCS) by Ancel Keys et al. which started in 1958 was one of the first large studies to identify an association between saturated fat intake and heart disease. A recent white paper report which was issued by the ‘The True Health Initiative’ addressed the numerous recent criticisms related to the SCS which mainly focus on reported issues with the study methods 9. This paper concluded that as with every scientific study the SCS had limitations, especially as it was an observational study10.\nTherefore, the SCS should be viewed within the wider context of epidemiological evidence10.\nHowever the overall body of evidence which has emerged since the SCS was published, including the famous Framingham Heart Study and the studies discussed above, supports the link between saturated fat intake and heart disease risk5-7,10.\nArgument Three: “The French eat high levels of saturated fat, yet have low levels of heart disease”\nShortly after this “French Paradox” theory was suggested in the 1980s, it was proposed that this may have been caused by the under-classification of CVD in France and the time-lag between the increased consumption of saturated fat in France (which was relatively recent at the time) and the subsequent increase in CVD levels11.\nBased on recent statistics, the average intake of saturated fat in France remains high at 14.6% of total energy intake12.\nHowever, France does not have a low prevalence of heart disease anymore13.\nThe age-adjusted average prevalence of CVD in France in 2015 was 6101 per 100,000 for males and 4666 per 100,000 for females, which was close to the EU average and was also very similar to the UK average; despite the higher obesity levels found in the UK13. There are currently many other countries with a lower prevalence of CVD in Europe, including countries which have a lower average saturated fat intake than France, such as: Italy, Portugal, Switzerland, Ireland, Spain etc13-14.\nArgument Four: “Sugar and carbohydrates are the problem, not saturated fat”\nThere is a grain of truth to this argument, as recent studies have shown that replacing fats with refined carbohydrates does not have a cardio-protective effect (as discussed above)3,5-8.\nHowever, vilifying carbohydrates as a whole ignores the numerous health benefits of wholegrains and fibre which includes a reduced risk of: cardiovascular disease, diabetes and colorectal cancer15. In the UK we currently consume more free sugars and less fibre than recommended levels, therefore current public health guidelines advise that “a greater proportion of total dietary energy from foods that are lower in free sugars and higher in dietary fibre whilst continuing to derive approximately 50% of total dietary energy from carbohydrates”15. As with argument number two, there can often a conspiracy theory element to the ‘sugar vs. fat’ argument which may blame certain governments and the sugar industry. Drastic claims such as these should be assessed critically as to whether this could have occurred on such a large scale, considering the knock on effect this would have on health care systems and taxpaying workforces. Furthermore, sugar has never been promoted in public health guidelines, and there has been a recent emphasis on reducing sugar intake worldwide15-16.\nOverall this argument creates a false dichotomy, as it suggests that a diet which has a lower saturated fat intake will result in an increased intake of refined carbohydrates.\nBut this isn’t necessarily the case, as ideally some saturated fat should be replaced with heart healthy alternatives such as: wholegrains, unsaturated fats, fruit, vegetables and legumes.\nArgument Five: “All saturated fats are not equal”\nSaturated fats can be classified as odd-chain or even-chain depending on the number carbon atoms attached to the molecule.\nThere is some emerging research which has found that odd-chain saturated fatty acids (which are generally found in full fat dairy products) may have a protective effect against cardiometabolic disorders3,17-19.\nHowever, it has also been suggested that the ‘whole food effect’ of dairy and other nutrients which it contains may contribute to this association, such as: CLA (a naturally occurring form of trans fat), protein, the numerous vitamins and minerals present and the fact that some sources also contain probiotics20.\nAlthough this is a fascinating area, more randomised controlled trials are needed before it can be stated that there is a causal relationship between individual types of saturated fat and health outcomes.\nArgument Six: “Coconut oil is good for your heart”\nDue to its high saturated fat content (82% compared to butter which is 63%, and olive oil which is 14%), the UK department of health advises to consume only small amounts of coconut oil21-22. Some argue that coconut oil is healthy because it contains medium chain tryglycerides (MCTs), however, less than 16% of the fats present in coconut oil are MCT as the main fat present is lauric acid which is a long chain tryglyceride (LCT)23. There are some studies which have found that a high intake of coconuts was not associated with an increased risk of heart disease23. However no conclusions can be made about coconut oil based on this, as these studies were observational and were also based on the consumption of coconut flesh and coconut milk rather than the extracted oil. There is a lack of human research in relation to coconut oil and health, however the best available published evidence indicates that coconut oil consumption is associated with an increase in total and LDL cholesterol when compared to consumption of unsaturated vegetable oils22,24.\nCoconut oil is fine to have in small amounts as part of a balanced diet, but there is currently no good evidence that it adds any specific health benefits.\nThe Bottom Line:\nAlthough moderate amounts of total fat in the diet should not be vilified, the current body of evidence in relation to heart disease risk supports limiting saturated fat intake and consuming the majority of fat from unsaturated sources25. It is also important to remember that on average in the UK we currently exceed the recommended intake of saturated fat which is <11% of total dietary energy25. Whilst there is some emerging research in relation to how individual types of saturated fat may affect the risk of heart disease in different ways, more high quality research is needed to investigate this. Although this is often an emotive debate, it is crucial to be guided by the best available evidence and to be wary of the potential appeal of conspiracy theories. It is also important to acknowledge that as with all areas of science, nutrition is a complex and constantly evolving area which rarely provides one black and white answer to a topic such as this. It will be interesting to see whether we gain more clarity about this when SACN publish its upcoming review of saturated fat26.\n- BDA (2014) Food Facts Sheet “Fats”\n- NICE (2010) “Cardiovascular Disease Prevention”\n- Chowdhury et al (2014) “Association of Dietary, Circulating, and Supplement Fatty Acids With Coronary Risk: A Systematic Review and Meta-analysis”\n- Annals of International Medicine (2014): http://wphna.org/wp-content/uploads/2014/08/2014-03_Annals_of_Int_Med_Chowdhury_et_al_Fat_and_CHD_+_responses.pdf\n- Mensink et al (2003) “Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials”\n- Mozaffarian et al (2010) “Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials”\n- Hooper (2015) “Reduction in Saturated Fat Intake For Cardiovascular Disease”\n- Deghan et al. (2017) “Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study”\n- Pett et al. (2017) “Ancel Keys and the Seven Countries Study: An Evidence-based Response to Revisionist Histories”\n- Kromhout et al. (2002) “Prevention of Coronary Heart Disease: Diet, Lifestyle and Risk Factors in the Seven Countries Study”\n- Law (1999) “Why heart disease mortality is low in France: the time lag explanation”\n- WHO (2013) “Nutrition, Physical Activity and Obesity – France”\n- Wilkins et al. (2017) “European Cardiovascular Disease Statistics 2017 edition”\n- Micha et al. (2014) “Global, regional and national consumption levels of dietary fats and oils in 1990 and 2010: a systematic analysis including 266 country-specific nutrition surveys”\n- SACN (2015) “Carbohydrates and Health”\n- WHO (2016) “Report of the Commission on Ending Childhood Obesity”\n- Forouhi et al. (2014) “Differences in the prospective association between individual plasma phospholipid saturated fatty acids and incident type 2 diabetes: the EPIC-InterAct case-cohort study”\n- Khaw et al. (2012) “Plasma phospholipid fatty acid concentration and incident coronary heart disease in men and women: the EPIC-Norfolk prospective study”\n- De Oliveira et al. (2012) “Dietary intake of saturated fat by food source and incident cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis”\n- Gebauer et al. (2011) “Effects of ruminant trans fatty acids on cardiovascular disease and cancer: A comprehensive review of epidemiological, clinical, and mechanistic studies”\n- NHS Choices (2015) “Is saturated fat bad for me?”\n- Sacks et al. (2017) “Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association”\n- NZ Heart Foundation (2014) “Coconut Oil and The Heart”\n- Eyres et al. (2016) “Coconut oil consumption and cardiovascular risk factors in humans“\n- BNF website “Fat” (accessed September 2017 via: https://www.nutrition.org.uk/nutritionscience/nutrients-food-and-ingredients/fat.html"

"Researchers at McMaster University have found that trans fats are associated with a greater risk of death and heart disease, but that doesn't make saturated fats the lesser evil – consumers have to watch their sat fat intake too\nHamilton, Ont. – Trans fats versus saturated fats: which is the lesser evil?\nNew research has found that trans fats are associated with a greater risk of death and coronary heart disease. Saturated fats, on the other hand, are not associated with an increased risk of death, heart disease, stroke or type 2 diabetes. But that doesn’t mean you can bulk up saturated fats.\n“For years everyone has been advised to cut out fats. Trans fats have no health benefits and pose a significant risk for heart disease, but the case for saturated fat is less clear,” explains Russell de Souza, an assistant professor in the Department of Clinical Epidemiology and Biostatistics with the Michael G. DeGroote School of Medicine. He’s also the lead author on the study.\n“That said, we aren’t advocating an increase of the allowance for saturated fats in dietary guidelines, as we don’t see evidence that higher limits would be specifically beneficial to health.”\nCurrent guidelines, reports DailyNews.McMaster.ca, recommend that saturated fats be limited to less than 10 per cent, and trans fats to less than one per cent of energy, to reduce the risk of heart disease and stroke.\nSaturated fats come mainly from animal products, such as butter, cows’ milk, meat, salmon and egg yolks, and some plant products such as chocolate and palm oils.\nTrans unsaturated fats (trans fats) are mainly produced industrially from plant oils (a process known as hydrogenation) for use in margarine, snack foods and packaged baked goods.\nContrary to prevailing dietary advice, a recent evidence review found no excess cardiovascular risk associated with intake of saturated fat.\nIn contrast, research suggests that industrial trans fats may increase the risk of coronary heart disease, says DailyNews.McMaster.ca.\nMaking sense of controversies\nTo help clarify these controversies, de Souza and colleagues analysed the results of 50 observational studies assessing the association between saturated and/or trans fats and health outcomes in adults.\nThe researchers took into account the study designs and quality to minimise bias, and the certainty of associations were assessed using a recognized scoring method developed at McMaster.\nThe team found no clear association between higher intake of saturated fats and death for any reason, coronary heart disease (CHD), cardiovascular disease (CVD), ischemic stroke or type 2 diabetes.\nHowever, consumption of industrial trans fats was associated with a 34 per cent increase in death for any reason, a 28 per cent increased risk of CHD mortality, and a 21 per cent increase in the risk of CHD, says DailyNews.McMaster.ca.\nInconsistencies in the studies they analysed meant that the researchers could not confirm an association between trans fats and type 2 diabetes. And, they found no clear association between trans fats and ischemic stroke.\nThe researchers stress that their results are based on observational studies, so no definitive conclusions can be drawn about cause and effect. However, the authors write that their analysis “confirms the findings of five previous systematic reviews of saturated and trans fats and CHD.”\nDe Souza, a registered dietitian, added that dietary guidelines for saturated and trans fatty acids “must carefully consider the effect of replacement foods.\n“If we tell people to eat less saturated or trans fats, we need to offer a better choice. Unfortunately, in our review we were not able to find as much evidence as we would have liked for a best replacement choice, but ours and other studies suggest replacing foods high in these fats, such as high-fat or processed meats and donuts, with vegetable oils, nuts, and whole grains.”\nImage of donut courtesy of Serge Bertasius Photography at FreeDigitalPhotos.net\nImage of buttered toast courtesy of tiverylucky at FreeDigitalPhotos.net"

"A study led by researchers at McMaster University has found that that trans fats are associated with greater risk of death and coronary heart disease, but saturated fats are not associated with an increased risk of death, heart disease, stroke, or Type 2 diabetes.\nGuidelines currently recommend that saturated fats are limited to less than 10 per cent, and trans fats to less than one per cent of energy, to reduce risk of heart disease and stroke.\nSaturated fats come mainly from animal products, such as butter, cows' milk, meat, salmon and egg yolks, and some plant products such as chocolate and palm oils. Trans unsaturated fats (trans fats) are mainly produced industrially from plant oils (a process known as hydrogenation) for use in margarine, snack foods and packaged baked goods.\nContrary to prevailing dietary advice, a recent evidence review found no excess cardiovascular risk associated with intake of saturated fat. In contrast, research suggests that industrial trans fats may increase the risk of coronary heart disease.\nTo help clarify these controversies, de Souza and colleagues analysed the results of 50 observational studies assessing the association between saturated and/or trans fats and health outcomes in adults.\nStudy design and quality were taken into account to minimise bias, and the certainty of associations were assessed using a recognized scoring method developed at McMaster.\nThe team found no clear association between higher intake of saturated fats and death for any reason, coronary heart disease (CHD), cardiovascular disease (CVD), ischemic stroke or type 2 diabetes.\nHowever, consumption of industrial trans fats was associated with a 34 per cent increase in death for any reason, a 28 per cent increased risk of CHD mortality, and a 21 per cent increase in the risk of CHD.\nInconsistencies in the studies analysed meant that the researchers could not confirm an association between trans fats and type 2 diabetes. And, they found no clear association between trans fats and ischemic stroke."

"Research has revealed a greater ischemic stroke risk in women that consume higher quantities of trans fatty acids, generally found in fried foods, baked goods and packaged foods.\nIschemic stroke is caused by an artery blockage which leads to the brain. As reported by the American Heart Association, 795,000 Americans experience new or recurrent strokes every year. Reports show that stroke is the 4th reason for death in the US, with over 137,000 deaths every year and 60% of these deaths are women.\nPast studies suggest that increased number of cases of cardiovascular disease, a risk factor for stroke, is linked to trans fat intake. However, in other past research no significant connection was found between dietary fat consumption and stroke.\nIn the biggest study of stroke in women so far, data was analyzed from a study of 87,025 postmenopausal women aged 50 to 79 that were generally healthy. Study participants received a questionnaire on food frequency at the time of enrollment and again 3 years later to evaluate their diet. In the questionnaire they were asked about consumption frequency and size of portions for 122 food groups and goods throughout a period of 3 months which included questions regarding fat intake from cooking, meat, dairy and reduced fat foods.\nWomen that had the greatest trans fat intake had a 39% greater incidence of stroke than others that had a lower trans fat intake. No significant associations were found between dietary cholesterol, total fat and other kinds of fat.\nOf the cases of ischemic stroke, it was determined there were 234 cardioembolic infarctions, 101 atherotherombotic infarctions and 269 lacunar infarctions, with another 445 cases which weren’t part of the subtype analysis. After making adjustments for lifestyle, dietary and clinical factors, results revealed that trans fat intake was linked to a greater risk of lacunar infarction.\nWant to use our images on your site? Right click on image for embed code"

"What foods belong in your fridge if you want to protect your heart and cut your risk of diabetes and cancer at the same time?\nAs long as you start with a healthy core diet-heavy on the fruits and vegetables and light on the bad fats, salt and sweets-it's up to you.\nAccording to a landmark study called the OmniHeart Trial, you can round out your core diet with good fats, good protein or good carbs. Or you can switch from one to the other, depending on your mood.\n\"That gives people more options for lowering their risk of heart disease,\" says OmniHeart researcher Frank Sacks of the Harvard School of Public Health in Boston. \"And if you want an extra edge,\" he adds, \"you can replace some carbs with good protein or good fats.\"\nThe bottom line: \"Diet can have powerful effects on blood pressure and LDL cholesterol,\" says Lawrence Appel of the Johns Hopkins School of Medicine in Baltimore, who led OmniHeart.\nFirst came DASH, then OmniHeart. When researchers planned the first DASH (Dietary Approaches to Stop Hypertension) study, they only had money to pit one sort of diet against what Americans typically eat.\n\"We decided to test a higher-carb, lower-fat diet because vegetarians have that kind of diet and they have lower blood pressure,\" explains Frank Sacks of the Harvard School of Public Health.\n\"But we would have liked to also test a Mediterranean diet\"-that is, one that's higher in unsaturated oils like olive, canola and safflower.\nThe first DASH study found that blood pressures dropped dramatically when its participants-all people with high blood pressure or prehypertension-switched from a typical American diet to meals that were high in fruits, vegetables and low-fat dairy foods, but with only modest portions of lean meat, poultry or seafood and few sweets.\n\"The reductions in blood pressure in people with hypertension were much greater than we expected,\" says Lawrence Appel of the Johns Hopkins School of Medicine.\nThe DASH study couldn't tell exactly what made the difference. \"Fruits and vegetables probably accounted for about half of the impact on blood pressure,\" says Appel.\nWas it the extra potassium or fiber or the calcium in the DASH diet that explained the rest of the drop? \"The study wasn't designed to say,\" Appel explains.\nThen came the DASH-Sodium study, which found that trimming sodium from the original DASH diet cut blood pressure even further.\"Many people have trouble changing to the DASH diet and reducing sodium,\" says Appel. \"But it's worth trying to do both because your blood pressure will fall even if you only get part way with each.\"\nMeanwhile, it became clear that both DASH diets cut not just blood pressure, but LDL (\"bad\") cholesterol, another major risk factor for heart attacks.\nThe DASH-Sodium was starting to look like one of the best all-around diets for the heart. But the question remained: when the DASH researchers cut saturated fat, did they replace it with the best foods?\nThat paved the way for OmniHeart.\nOmniHeart started with three basic DASH-Sodium diets. All had roughly 10 daily servings of fruits and vegetables, two servings of low-fat dairy foods and four or five servings of grains (bread, pasta, rice, etc.).\nAll were fairly low in sodium (2,300 milligrams a day) and high in potassium (4,700 mg) and magnesium (500 mg). But other features differed.\nFor example, the higher-carb diet had more sweets, the higher-unsaturated-fat diet had more oils (canola, olive and safflower), and the higher-protein diet had more poultry, beans, tofu and nuts. After six weeks:\nBlood pressure and LDL (\"bad\") Cholesterol dropped (that's good) on all three diets. But pressure dropped more with extra unsaturated fat or protein and LDL dropped more with extra protein.\nTriglycerides dropped (that's also good) with extra unsaturated fat or protein, but not with extra carbs.\nHDL (\"good\") Cholesterol dropped (that's bad) with extra carbs or protein, but not with extra unsaturated fat.\nThen the researchers used blood pressure, cholesterol and other risk factors to calculate the participants' odds of having a heart attack in the next 10 years. Taking all the changes into account, says Sacks, \"the higher-carb diet reduced the estimated risk of heart disease by 20 percent, while the higher-protein and higher unsaturated-fat diets both lowered risk by 30 percent.\""

"Hypertension and Veggie Diets\nAfter scientifically analyzing the impact of dietary changes on high blood pressure, nutritionist Susan E. Berkow, Ph.D., C.N.S., and physician Neal D. Barnard, M.D., authored a report revealing that a vegetarian diet can help patients with hypertension, according to the lead article in the January issue of the medical journal Nutrition Reviews.\nby Joanne Eglash\nThe duo evaluated a variety of published studies on this topic, concluding that vegetarians in general are less apt to suffer from high blood pressure, also known as the “silent killer.” High blood pressure is dangerous because although there often are no symptoms, it contributes to severe health problems such as strokes and heart attacks. According to Berkow and Barnard, “plant-based dietary patterns are assigned with a significantly lower prevalence of hypertension and correspondingly lower risk of CVD (cardiovascular disease) and stroke.”\nThe two medical experts also note that vegetarians as a group are slimmer than the general population, which is one reason that their blood pressure is more likely to be in the optimal range. Also adding to the health of vegetarians is their increased intake of potassium.\n“Many people fear the side effects of blood pressure-lowering drugs, along with the expense. Our analysis of 80 scientific studies suggests that a vegetarian diet may be a simple, drug-free treatment for the ‘silent killer,’” Dr. Berkow says. His advice to those who have hypertension: “Substitute a veggie burger for a hamburger tonight and have pasta marinara without the meatballs tomorrow. After about six weeks of such simple changes you might see your blood pressure—and your body weight—begin to drop.”\nBefore you make any changes in your diet, however, you should always check with your health care provider. High blood pressure is dangerous, and only a physician or other health expert can professionally evaluate your own health situation and advise re modifications.\nOne option for vegans who do suffer from hypertension and want to modify their diets to try lowering their blood pressure is the food plan known as the DASH (Dietary Approaches to Stop Hypertension) diet, according to Georgianna Donadio D.C., M.Sc., Ph.D.. Dr. Donadio has conducted a private practice in Whole Person Health Care since 1976. She is the Founder and Director of The New England School of Whole Health Education in Wellesley, Massachusetts; the pioneer of Whole Health Education and a provider of patient and healthcare professional education since 1977. For more information, visit www.wholehealtheducation.org.\nDonadio says that the DASH diet is advantageous for lowering blood pressure because it is low in sodium and high in potassium. “It has been clinically proven to significantly reduce hypertension.” In addition, the DASH diet is “low in total fat, saturated fat, and cholesterol,” says this expert.\nThe DASH diet includes extensive amounts of fruits and vegetables, as well as other foods, all of which result in an increase in potassium that serves to “calm the adrenals and nervous system,” while the reduced sodium levels lower “vascular tension and swelling associated with hypertension,” explains Donadio.\nConsequently, she regards the DASH diet as one of the better “vegetarian-based diets around because it addresses eating certain amounts and kinds of foods that have been clinically shown to reduce the hypertension.”\nWondering what kinds of vegetables and fruits to choose to battle hypertension? “Blackberries, carrot juice, orange juice, tomato juice (especially the low sodium kind) and of course bananas, are marvelous easy ways to get potassium,” adds Donadio.\nThe DASH Diet is described in detail on the National Institutes of Health Web site. In addition to fruits and vegetables, the DASH diet includes grains and grain products, such as cereal, bread, and rice; and nuts, seeds, and legumes, such as almonds, sunflower seeds, and kidney beans. Although the government’s Web site does list meats, poultry, and fish, it calls for “two or less” servings, making it easy for vegans to adapt the diet to their own guidelines.\nTo learn more, visit http://www.nih.gov/news/pr/apr97/Dash.htm."

"Saturday, November 15, 2014\n4 Health Benefits of a Vegan Diet\n· Reduced Risk of Heart Disease: The antioxidants and fiber in plant foods are associated with improving cardiovascular health. It has been found that people who eat less meat and more vegetables are more likely to have lower cholesterol, lower blood pressure, and a lower risk of heart attack and stroke.\n· Reduced Risk of Cancer: If you are looking for a way to reduce the risk of cancer, then vegetables and whole grains are the way to go. \"The China Study\" was a large research study that found a direct correlation between animal protein consumption and cancer.\n· Stronger Bones: Even though milk is commonly associated as a food that is good for bone health, the truth is that increased milk consumption is directly associated with an increased risk of osteoporosis. Instead of milk, increase your consumption of leafy greens for a healthier source of calcium.\n· Weight Loss: Many people who follow a healthy, vegan diet can quickly lose weight. If you want to lose weight, make sure you are eating natural ingredients, such as nuts, seeds, fruits and vegetables.\nIf you are following a vegan diet, you don't need to give up the foods that you love! Here at Premium Chocolatiers, we make vegan chocolate that tastes just as good as regular chocolate. Visit our website to learn more about the vegan desserts that are available for you!"

"With more than 67 percent of Americans now categorized as overweight\nor obese, according to the Centers for Disease Control and Prevention,\nmany people are searching for ways to lighten up and become healthier.\nStudies find that going vegetarian can be a step in the right\nVegetarians tend to live longer and have lower risk of heart disease,\ndiabetes and cancer, according to research by the Academy of Dietetics\nand Nutrition, and as a group they weigh less and gain less weight over\ntime. Even eating vegetarian part of the time can lead to improvements\nin health and get the needle on the scale moving in the right direction,\na five- year study by Cancer Research UK found.\nAnyone interested in vegetarian eating should check out Tuesday’s\nABC health tweet chat moderated by Dr. Richard Besser, ABC News’ chief\nhealth and medical correspondent. Besser, along with Whole Foods, the\nCenter for Science in the Public Interest, registered dietitians,\nbloggers, and other veggie lovers, tweeted out great tips and\ninformation to help anyone become a healthy, happy vegetarian.\nRead Full Story Here"

"A recent article published by \"Time\" details seven different ways in which vegetarians are poised for longer, healthier lives than their meat-eating counterparts.\nResults of various studies reveal that vegetarians are less likely to suffer from high blood pressure, heart disease, cancer, and diabetes. They are also less likely to be overweight, and have a lower overall risk of death. To top it off, vegetarians have even proven to have better moods!\nIn fact, according to the article, \"A 2012 study randomly split participants into three diets: all-meat allowed, fish-only, and vegetarian no-meat. The researchers found that after two weeks, the people on the vegetarian diet reported more mood improvements than those on the other two diets.\"\nThe science is clear. A healthy, vegetarian diet not only prevents some of the most common chronic diseases, but also leads to an overall improved quality of life.\nFor free recipes and more information on transitioning to a healthy and humane vegetarian diet, visit ChooseVeg.com.\nAny Way You Look at It: Vegetarians Live Longer\nby - March 5, 2014"