Craniosynostosis is when the sutures of the skull (the joints between skull bones) fuse together too early. Although this condition is very rare, we saw two little ones in January who both have craniosynostosis so it feels appropriate to raise awareness and explain the part that osteopathy can play in caring for babies before and after a diagnosis. Typically, craniosynostosis is present from birth but is hard to detect and often not noticed until later when there are signs of an altered head shape and/or ridging (a palpable bump or line) between skull bones. Craniosynostosis can occur in part of one suture or across multiple sutures. The most common location for premature fusion to appear is along the sagittal suture which is the suture running from front to back along the middle of the head. The skull grows perpendicular to the line of the sutures which is why, when craniosynostosis is present in the sagittal suture, the skull begins to develop a long and narrow shape. However, fusion can occur at any suture so any appearance of altered head shape should be taken seriously. In severe cases craniosynostosis can be problematic for a baby’s development as the sutures facilitate growth of the skull which itself follows the growth of the brain contained within it. Therefore, it is vital that a diagnosis is made as soon as possible.
When you bring your baby to see a paediatric osteopath they will perform a thorough examination on your baby’s head to check for the presence of ridging, abnormal growth and how well the body is accommodating growth generally. If craniosynostosis is suspected a referral will be made to your GP who will start the process of further investigations. Diagnosis of craniosynostosis is confirmed via imaging such as x-ray or a CT scan. Your baby will then be referred to a specialist center where multidisciplinary assessment and care is offered.
It’s worth drawing attention to another presentation of altered head shape in babies which can sometimes appear alongside craniosynostosis or get confused with it: plagiocephaly. This occurs when there is flattening on one side of a baby’s head which usually develops post-partum. In plagiocephaly there is no fusion of the sutures so the treatment approaches are very different.
In mild cases of craniosynostosis where the skull is growing well and there is no impact on vision or neurological development, the treatment of choice may be to wait and monitor head growth. In the remainder of cases, treatment often involves surgery which is carried out before the age of one with the goal of allowing space within the skull for the underlying brain to grow and develop. There are two kinds of surgery offered in the UK and the one chosen depends on the baby’s age, symptoms and type of craniosynostosis present. Long-term outcomes of surgery are good and, if intervention happens early, there is minimal risk to growth and development with most children going on to lead normal lives. It is also possible that the use of a corrective helmet may be required post-operatively to assist with continued skull growth along with regular check-ups and assessments. There may also be additional support offered, including regular hearing and eye tests, speech and language therapy, specialist dental treatments and counselling. These are offered on an individual case basis depending on the baby’s symptoms. In a small number of cases, craniosynostosis can be due to genetic factors, in these instances further surgery and more involved management may be necessary to prevent long-term difficulties.
Osteopathy is not a treatment for craniosynostosis and therefore should only be considered alongside other medical advice and interventions. However, osteopathy is a gentle, non-invasive and hands-on treatment approach aimed at supporting a child’s overall well-being. This may be particularly useful in mild cases of craniosynostosis where surgery is not needed. An osteopath will assess for and treat any strains or tensions in the musculoskeletal system that could be restricting growth within the head or through the rest of the body, plus how all parts of the body are influencing one another. This approach could also be helpful post-surgery when an osteopath might also work with the nervous system to help integrate the impacts of surgery. If a diagnosis has already been made, an osteopath will work with you and your baby alongside any additional treatment and management you will be receiving. They will use their professional knowledge, judgement and clinical assessment to treat each baby uniquely, ensuring they receive the best care and treatment appropriate for them.
If you have any queries or concerns about your baby then please don’t hesitate to get in contact with us at Frome Valley Osteopaths, we will be happy to answer your questions as best we can.
Finally, if you or someone you know has been impacted by craniosynostosis the following website is an excellent resource offering additional support and guidance:
Frome Valley Osteopaths 
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