Pediatric Cranial Health: Everything you need to know.

When my first daughter was born I quickly realized that there were so many things that I was not informed of when it came to her development. Cranial health was one of the those topics that just does not get talked about enough. Around 3-4 months she began to have some flattening on the back right side of her skull. So as any mom does I hit the computer keyboard at 100mph typing away to figure out what was causing this to happen. This was right before beginning chiropractic college so I had a gut feeling that this what not right, and that if I didn't act quickly it could get worse.

We did visits to the chiropractor as well as learning all the tips on how to correct the flattening of her skull and improve her cranial health at home which was able to resolve the flattening without further interventions. It wasn't until I was attending chiropractic college that I furthered my studies on this topic, and have spent the last 3 years diving deep into understanding the importance of infant and child cranial health. With 48% of children having "flat head syndrome" these days it encourages me even more to push for education for expecting parents and parents with infants.

---

Pediatric Cranial Anatomy: The Basics.

As parents we have all seen the soft spot on the top of your baby's head, and some times it will even have a pulse which looks kind of odd. Well it's actually normal for babies to have this soft spot, and in fact they have 4 of these spots. These spots are called fontanelles, and they will close at different times throughout the first 18 months of your baby's life. But first lets take a dive into the importance of these fontanelles.

When babies are born the bones of their skull are not completely fused together and instead are connected by cranial fascia. This allows for passage through the mothers birth canal during labor, and initiates the beginning of the breathing motion that helps facilitate pumping of baby's Cerebral spinal fluid up and down the down. The skull bones act more as joints at this stage in which they move and form as your baby's brain grows in the first years of life.

Before we move on it is important to understand that the fact these skull bones are not fused allows for the skull to easily become impacted by external pressures. External pressure could be anything such as impact, lying on one part of the skull more than others, lying on their back long periods of times.

Birth Trauma: Where does Cranial health begin?

A recent study showed that out of 100 babies that were evaluated after birth, 99% had a cranial strain pattern present. "The conclusion being that the somatic dysfunction of the cranial, cervical, lumbar, and sacral region was common in healthy newborns, and the total somatic dysfunction was directly related to the length of labor". (1)

So what exactly does this mean?

We'll it means that no matter how healthy baby was at birth it is likely that they have some cranial or spinal dysfunction. Not mention if there were any sort of interventions used at birth such as vacuum or forceps that can cause further damages to the cranium and its connective tissues. Trouble with latching, nipple pain while feeding, colic, head tilt, fussiness, and plagiocephaly are all issues that can result from cranial dysfunction post birth trauma.

Chiropractic cranial care: What does it involve?

On your baby's first visit in our office we like to get a very thorough history of the birth experience for mother and for baby. This is important since we know that the duration of labor has a direct positive correlation with the cranial strain on baby. Then we will evaluate first the appearance of their skull, checking for all fontanelles to be present and appropriate size. If the fontanelles are not present or are closing at to fast of a rate this could indicate a more serious condition. Checking as for any flat spots or asymmetries on either side of the head. This is more common between 2-6months of age and usually can be treated conservatively with chiropractic care if caught early enough. After that we do a full physical exam evaluating the position of the cranial bones, the function of the palate and TMJ, and the first and second vertebra. We also look for areas of increases tension within the connective tissue fascia that connects the cranial bones to other structures throughout the entire spine and nervous system.

All of this helps us come up with a plan for care, and this could vary from case to case. Much of the change after cranial adjustments occur in what we call the molding process. So usually after frequent care we can start to see as change in the appearance as well as an alleviation of any symptoms they may be experiencing.

Conclusion: Important takeaway's

Key points to note from this information is that every baby (even healthy babies) should have their cranium evaluated after birth to check for any trauma resulting from the birth process. When there are somatic dysfunction present after birth that are left unresolved it can have a lasting impact on their development especially when it comes to breastfeeding outcomes and other neurological development. By the time that your baby is 2 years old their brain volume will be the 80-90% of their adult size. That means that during the first years of life there is tremendous amount of brain development happening. Structure has a direct correlation to function when it come to cognitive function and cranial health. Starting your baby off on the right trajectory can be help ensure that they have to most optimal development from birth to adolescence.

1. VK;, W. (n.d.). Incidence of somatic dysfunction in healthy newborns. Retrieved January 16, 2023, from https://pubmed.ncbi.nlm.nih.gov/26501758/

2. Knickmeyer, R., Gouttard, S., Kang, C., Evans, D., Wilber, K., Smith, J., . . . Gilmore, J. (2008, November 19). A structural MRI study of human brain development from birth to 2 years. Retrieved January 16, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2884385/

3. Girault, J., Cornea, E., Goldman, B., Jha, S., Murphy, V., Li, G., . . . Gilmore, J. (2020, March 21). Cortical structure and cognition in infants and toddlers. Retrieved January 16, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306173/