Réhabital
Infant Plagiocephaly: Assessment and Treatment in Côte Saint-Luc
Plagiocephaly is a flattening of part of a baby's skull, most often on one side of the back of the head. It has become common since babies are placed on their backs to sleep — an essential recommendation that must not be abandoned — and it is almost always linked to a head rotation preference. At Réhabital in Côte Saint-Luc, on the island of Montréal, Shahram Ghasemi, MD (Iran), DOMP, targets the mechanical cause: restoring full neck mobility so the baby stops resting on the same spot.
Book an AppointmentUnderstanding This Condition
An infant's skull is malleable during the first months, which allows rapid growth but also makes it deformable under sustained pressure. When the head always rests in the same position, the contact area flattens, the ear on that side can shift forward and the forehead on the opposite side can become more prominent. We distinguish positional plagiocephaly, by far the most common and harmless to the brain, from brachycephaly, where the back of the skull flattens symmetrically, and from craniosynostosis, a premature fusion of sutures that is rare but must be ruled out by a physician because it requires surgical care. The key point often missed is that positional plagiocephaly is almost always secondary to torticollis or a rotation preference: treating only the skull shape, without restoring neck mobility, leaves the cause untouched. That is why our assessment always begins with cervical mobility and the baby's overall motor function.
Common Symptoms
Common Causes
Torticollis or rotation preference
This is the most common cause. A neck restricted on one side means the baby always rests on the same part of the skull, which eventually flattens. Restoring neck mobility is therefore the core of treatment.
Long periods on the back or in a seat
Back sleeping is essential for safety, but extra hours in a car seat, swing or bouncer add continuous pressure on the same region of the skull.
Prematurity
Premature babies have more malleable skulls and often spend more time lying down, which raises the likelihood of flattening.
Constraint in pregnancy or during birth
Twins, limited uterine space or an assisted delivery can already produce asymmetry at birth, which then increases with positioning.
Limited awake tummy time
Tummy time removes all pressure from the skull and builds neck muscles. When it is rare, flattening progresses faster during the period of rapid growth.
Our Treatment Approach
With Shahram Ghasemi, MD (Iran), DOMP, we first assess neck rotation and side bending on both sides, mobility of the cranial base and jaw, skull symmetry and how your baby moves overall. Treatment uses extremely light pressure to release tension in the neck, suboccipital muscles and cranial base: we do not mechanically reshape a skull and we do not claim to. The goal is to give the baby the freedom to turn the head both ways so that their own growth progressively corrects the shape. The most decisive part is the home positioning plan: crib orientation, alternating carrying sides, stimulation toward the avoided side, less time in seats and gradually more tummy time. We work alongside your pediatrician, who assesses whether a cranial orthosis is warranted. Physiotherapy is coming soon to the clinic.
What to Expect at Your First Visit
The first visit takes about 45 minutes. We discuss pregnancy, birth, sleep, feeding and positioning habits, then assess the neck, skull and movement. We document cervical mobility in degrees and the observed asymmetry so it can be compared objectively in four to six weeks. Your baby can be fed or comforted at any time. You leave with a written positioning plan that is simple and realistic to follow.
At-Home Self-Care Tips
- Always place your baby on the back to sleep, but alternate head orientation.
- Change the crib position or the baby's orientation in it weekly.
- Alternate carrying arms and feeding sides.
- Add many short supervised awake tummy-time periods.
- Reduce time in the car seat, swing and bouncer.
- Place interesting things on the side your baby avoids looking toward.
Prognosis & Recovery Timeline
The most favourable window is before six months, when the skull is still very malleable and spontaneous correction potential is high once neck mobility returns. In mild to moderate cases managed early, improvement is often clear within two to four months of consistent positioning. After eight to twelve months skull shape changes much less, which usually has no impact on the child's development: positional plagiocephaly does not affect the brain. In moderate to severe cases a cranial orthosis may be considered roughly between four and eight months, a decision that belongs to the physician.
When to See Us at Réhabital
Come in as soon as you notice flattening, ideally before six months, or if your baby keeps a rotation preference. See your physician first if the skull sutures feel like a hard ridge, if the fontanelle closes very early, if head growth is unusually fast or slow, or if you notice developmental delay, significant vomiting or unusual irritability.
Why Réhabital Clinic
We are clear about what actually works: the skull corrects mainly because the baby stops resting on the same spot, so we focus on neck mobility and daily positioning here in Côte Saint-Luc, on the island of Montréal, without promising to reshape a skull by hand.
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Address
D4-5800 Cavendish Blvd
Côte Saint-Luc, QC H4W 2T5
Phone
(438) 842-3550Hours
Mon–Fri: 10AM–8PM
Sun: 10AM–4PM
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