Cranial Asymmetry Program

In 1992, the American Academy of Pediatrics developed the "Back to Sleep Campaign," to encourage parents to place sleeping infants on their backs. Although the program has led to a reported 70% reduction in the rate of SIDS (Sudden Infant Death Syndrome), an increase in the number of infants with cranial asymmetries has been noted.

The NOPCO Cranial Asymmetry Remolding Program consists of two different treatment options. Dependent on age and diagnosis, the Plagio Cradle and/or the Boston Band may be prescribed for treatment of cranial asymmetry. 

There are many forms of cranial asymmetry that affect the shape and continued growth of an infants head:

• Plagiocephaly is a flattening on one side of the back of the head, with a bulging of the forehead on that same side.
• Brachycephaly is a symmetrical flattening on the back of the head that causes the head to look very wide above the ears, short from front to back, and from the side, the back of the head looks taller than the front.
• Brachycephaly with asymmetry is a head shape that has both brachycephaly and plagiocephaly.
• Scaphocephaly is a head that is shaped long front to back and very narrow from side to side.

Many factors can be associated with cranial asymmetries. Some occur before birth because of limited space in the uterus, including: multiple births, first born, breech births, and the male sex. Some asymmetries also occur during or after birth, including: long labors, extended time in the NICU, poor muscle tone, spine abnormalities, positioning, and neck muscle tightness (torticollis).

Doctors recommend alternating positioning to evenly distribute pressures of gravity on the growing skull. One way to reposition is to encourage an infant to respond to toys and stimulus on the right and left sides to evenly distribute pressures on the growing skull. Supervised tummy time during the day is also important. Your child should spend half of their waking time on their stomach.

For our downloadable guide on repositioning and tummy time, click here.

If repositioning does not improve the shape of your child's head your pediatrician may recommend a Plagio Cradle or Boston Band, dependent upon your child's age. 

The Plagio Cradle

The Plagio Cradle^TM (patent pending) is an alternative resting surface designed to help prevent and/or treat developing plagiocephaly during the first 20 weeks of life.  The device is intended to fit into a standard sized crib or bassinet and supports the infant’s entire body. Patients should receive instructions from their physician regarding the length of time the cradle should be used. This treatment must be discontinued immediately when the child exhibits signs of being able to roll over. 

The Boston Band

For infants who have outgrown the Plagio Cradle, or do not make progress with therapy or repositioning, a physician may recommend a custom orthosis. At NOPCO, we manufacture the Boston Band— a lightweight, plastic and foam cranial remolding orthosis made from a 3D scan of the infant’s head. We use a unique foam layering technique that gives the orthotist the ability to remove layers when necessary, allowing the infant’s head to grow in a normal fashion.  The infant typically wears the orthosis 23 hours a day for 4 months to grow into a more symmetrical head shape. Based on your child's age and head shape, your orthotist will outline a treatment plan specific to your child.  To view the different color options available for the Boston Band click here.