1 Various degrees of brachycephaly (ie, a shortened, broad head) occur in most children who sleep solely on their backs. Posterior-type deformational plagiocephaly is caused by constant gravitational forces applied to the occiput when the infant remains for prolonged periods in the same supine position-the sleep position promoted by the American Academy of Pediatrics (AAP) Back to Sleep campaign ( Figure 2). Craniofacial Anomalies. Available at: /healthinfo/pediatric/craniofacial/cranio.htm.)ĭeformational plagiocephaly. (Reprinted with permission from: University of Utah Health Sciences Center. Three of the more common types are shown here. There are numerous types of craniosynostosis, each of which involves a different suture or combination of sutures and results in a distinctive head shape. In craniosynostosis, one or more of the sutures close prematurely, causing problems with normal brain and skull growth and resulting in an abnormal, asymmetric appearance. Reassure parents that a cephalohematoma poses no long-term risk.īecause molding secondary to the birthing process typically resolves in hours to weeks, persistent or progressive shape deformities beyond that time should raise suspicion for deformational plagiocephaly or craniosynostosis.įigure 1 – A normal newborn’s skull consists of several plates of bone that are joined by fibrous sutures that facilitate vaginal delivery and expansion of the growing brain. When discovered by a concerned parent (usually when the child is 1 to 2 months old), such a lump often prompts a visit to the pediatrician. In addition, the calcification of a healing cephalohematoma can produce a distinct lump on the skull, usually on one of the parietal convexities. Difficult deliveries that require the use of forceps or vacuum extraction can result in severe molding. During parturition, the strong forces applied to the skull as it is squeezed through the birth canal cause the bones that make it up to override one another this process can "mold" the head into various shapes. In utero, molding can result from uterine crowding, such as occurs when multiple fetuses share the same womb.
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