___________________________________________________________________________________________________________________________________________ Copyright Graham Kennedy June 2010 Enhancing the Future
www.enhancingthefuture.co.uk
CRANIOSACRAL THERAPY,
CRANIAL MOULDING & HELMETS
Craniosacral therapy is well known for its effective treatment of babies and children.
Whilst babies are brought for treatment with a wide range of conditions, one of the more
distressing for parents is severe unresolved cranial moulding. Although there are many
different types of moulding patterns, one of the more common is known as
plagiocephaly.
Also known as deformational plagiocephaly, positional
plagiocephaly or flat-head syndrome, plagiocephaly is
the medical term used to describe a flattening on one
side of the back of a babys head.
This flattening is usually accompanied by a bulging on
the same side of the babys forehead, a bald area at the
flat spot as well as ear and eye misalignments. Some
estimates state that plagiocephaly occurs in up to 50%
of all babies under a year old to some degree.
Another form of severe cranial moulding, known as
brachycephaly is associated with both sides of the
back of the head being completely flat. This particular
moulding pattern is also associated with a head shape
that is wider than it is long, and also has a high or
peaked appearance.
This extreme moulding can occur due to the fact that at
birth the bones of a babys skull are not fully formed
and have not fused together to make the familiar sutures seen in an adult skull. As a
result, they remain susceptible to the effects of external forces acting upon them.
Plagiocephalic Head shape
Brachiocephalic head shape
___________________________________________________________________________________________________________________________________________ Copyright Graham Kennedy June 2010 Enhancing the Future
www.enhancingthefuture.co.uk
Usually, the first port of call for worried parents is their GP or health visitor.
Conventional wisdom considers plagiocephaly to be essentially a cosmetic issue, with
little or no physiological consequences. Its primary cause is considered to be due to
babies spending more time (especially when sleeping) on their backs as a result of the
back to sleep campaign, which highlighted babies sleeping on their fronts as a significant
risk factor in Sudden Infant Death Syndrome (or SIDS).
As a result, the most commonly given advice is to have more tummy time during the
day in order to reduce the pressure on the back of the head, that it will flatten out in its
own time, or if not the eventual growth of the hair over the area will serve to conceal it.
Many parents feel dissatisfied with these options and so seek out alternative forms of
treatment. Two of the most common treatment options that parents look into are
craniosacral therapy (along with other practitioners offering treatment in the cranial
field e.g. cranial osteopaths) and cranial remoulding orthoses, also known as baby
helmets.
Before we look at the effectiveness and impact of these different treatment processes,
lets explore the different causes of these severe forms of cranial moulding.
Causes of Severe Cranial Moulding
As a result of the structure of a babys skull, cranial moulding is almost always associated
with external forces acting upon the different cranial bones and distorting their natural
positions. One important exception to this is a condition known as craniosynostosis,
which is a premature fusing of one or more of the cranial sutures. This rare congenital
condition (affecting 1 in every 2500 to 3000 births) needs to be medically diagnosed and
treated, most commonly through surgery.
___________________________________________________________________________________________________________________________________________ Copyright Graham Kennedy June 2010 Enhancing the Future
www.enhancingthefuture.co.uk
Aside from craniosynostosis, the causes of cranial moulding can be placed into three
main categories:
Prenatal factors
Birth factors
Postnatal factors
Prenatal factors the main prenatal causes of cranial moulding are due to compression
of the cranium as a result of reduced inter-uterine space. This can occur as a result of
uterine fibroids, an asymmetrical uterus, a reduction of amniotic fluid, multiple
pregnancy or from the babys head getting stuck in an unfavourable position (e.g. breech
with head wedged under mothers ribs) towards the end of pregnancy.
Birth factors it is during birth that the babys cranium experiences the most intense
compressive forces as a result of being squeezed through his mothers pelvis. Whilst
moulding of the cranium at birth is a normal physiological process, if the baby
experiences any aspect of the birth as stressful, distressing or even traumatic, these
cranial compressions can become more firmly locked into the system along with high
levels of shock, neurological charge and emotional intensity.
The moulding pattern produced by babies with both
plagiocephaly and brachycephaly are typically associated with
posterior (back to back) presentations. This occurs as a result
of the babys occiput (the cranial bone at the back of the head)
being compressed against the mothers lumbo-sacral
promontory. If a baby has been in this position for an
extended amount of time, or if the contractions have been
quite intense (as occurs with induced births), then the
moulding produced may be more severe.
Intense compression of the occiput can also occur during the
last stage of labour, when the baby is negotiating his mothers
pelvis outlet. During this time, the babys face is pressing
directly against his mothers sacrum and the occiput is being
dragged and compressed by the pubic bone.
___________________________________________________________________________________________________________________________________________ Copyright Graham Kennedy June 2010 Enhancing the Future
www.enhancingthefuture.co.uk
Rotational forces introduced into the babys cranium, neck and body during the
rotational stage of birth are also instrumental in the development of plagiocephaly and
other severe moulding patterns. These forces can create a preference for the head to
turn towards one direction as opposed to the other. In extreme cases, this can manifest
as torticollis.
Torticollis is a contraction in one of the sternocleiomastoid muscles in the neck causing
the head to preferentially turn or tilt more towards one direction. Where babies are
unable to turn their heads equally to both sides, they will favour the side of the easiest
rotation. This leads to increased pressure being put on that side of the occiput, especially
if the baby has weak neck muscles, or for some reason has reduced control of head
movements. This positional preference can then get locked into the system and becomes
reinforced every time the baby lies down on his back.
It may be worth mentioning here that these factors do not in any way justify the
increased use of caesarean sections over vaginal births. Whilst elective C-sections are
performed in some countries in order to optimise cranial symmetry, it is by no means a
certainty. In fact, both of these moulding patterns can be found in babies born by C-
section, where the head has been compressed by the pelvis (or the ribs) for some
considerable time. In addition to that, C-sections are not free from their own
consequences to the baby. They can introduce significant amounts of shock into the
babys system, even where there has been little or no cranial compression.
However, there is certainly no guarantee that babies born by C-sections will be free from
severe moulding patterns. I have seen many babies born in this way who have significant
moulding. These patterns can arise as a result of many different factors depending on
whether the section was an emergency or elective.
Other significant risk factors include prematurity (the cranial bones of premature babies
are softer and therefore more vulnerable to compression than those of full-term babies),
low birth weight, prolonged labour, use of forceps, ventouse (vacuum extraction) and
induction drugs.
___________________________________________________________________________________________________________________________________________ Copyright Graham Kennedy June 2010 Enhancing the Future
www.enhancingthefuture.co.uk
Post-natal factors it is these factors that are considered to be