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Prognosis
Parents frequently ask:
Do we just wait?
How long should we wait?
Is this only cosmetic?
Will it just get better by itself?
As a parent myself, I simply hope for the best for my children. And yes, I have seen mild cranial conditions spontaneously recontour or improve with little or no intervention at all. The American Academy of Pediatrics now advises parents to try frequent head turning, the repositioning of the head with foam wedges, and physical therapy for persistent torticollis and craniofacial conditions.
So what is best?
I believe that an informed decision is based on a complete clinical and individual evaluation. Today it is most Physicians' experience that if spontaneous recontouring of the calvarium does not take place by the infant's 5 month follow-up, the cranial asymmetry will persist and may increase. The expressed concern that this is only cosmetic in nature can best be answered that most craniofacial specialists concur that an abnormal head shape can affect the child's jaw (TMJ), the eye alignment, and unfortunately be a life-long cosmetic disability.
Please remember that the majority of craniofacial experts prescribe cranial orthotic treatment after repositioning has not been effective and that infants with torticollis who receive physical therapy along with the cranial orthosis have a far more positive prognosis with their plagiocephaly.
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