Here we offer a practical, objective approach to determining which patients with odd head shapes require further evaluation and treatment. Because molding secondary to the birthing process typically resolves in hours to weeks, persistent or progressive shape deformities beyond that time should raise suspicion for deformational plagiocephaly or craniosynostosis. Figure 1 – A normal newborn’s skull consists of several plates of bone that are joined by fibrous sutures that facilitate vaginal delivery and expansion of the growing brain. Any condition that is associated with abnormal bone formation or muscle tone (especially torticollis) can also cause deformational plagiocephaly. Figure 2 – The incidence of occipital plagiocephaly has risen dramatically since the AAP suggested the supine sleep position.(Reprinted with permission from Losee JE et al. Crouzon syndrome is associated with various facial and skull deformities, exophthalmos, and hydrocephalus. When craniosynostosis occurs, the growth of the skull is impeded in a plane that is perpendicular to the fused suture, but the skull continues to grow in the parallel plane. A 10-year-old boy is brought by his mother for evaluation of persistent “acne” that started when the boy was a baby.
When Walker and her Facebook friends decided to re-post baby Grayon’s photos in protest, the mother was placed on a 24-hour ban from the social networking website.
Amazed at the amount of support she received from all over the country, Walker says the photo is raising awareness. Sixteen weeks into her pregnancy, Heather Walker found out her baby had a fatal birth defect.

With the help of non-profit organization, Now I Lay Me Down To Sleep, the Walker family had a photographer capture the hours they had with baby Grayson.
By treating his birth like any other special delivery, the Walkers hope to keep Grayson’s memory alive forever.
LifeNews Note: Carole Novielli is the author of the blog Saynsumthn, where this article originally appeared.
The bones are able to move because they are adjoined by fibrous sutures (junctures between 2 bones) and fon- tanelles (junctures between more than 2 bones) that remain unossified throughout the first years of life to facilitate vaginal delivery and allow expansion of the growing brain. In utero, molding can result from uterine crowding, such as occurs when multiple fetuses share the same womb. In craniosynostosis, one or more of the sutures close prematurely, causing problems with normal brain and skull growth and resulting in an abnormal, asymmetric appearance. Exactly why sutures fuse early is not known, but genetic and environmental fac- tors--such as single gene mutations, teratogen exposure, and fetal constraint--probably play a role.4 Craniosynostosis may also be an asso- ciated feature of several genetic syndromes, including Apert, Crouzon, Dubowitz, and Treacher Collins- Franceschetti syndromes. Apert syndrome is also associated with significant craniofacial deformities, hydrocephalus, and exophthalmos, along with mental retardation and syndactyly.
He was born with Anencephaly, a rare neural tube birth defect in which a baby is born without parts of the brain and skull.
The anterior fontanelle, easily palpated at the top of the head, typically closes by 18 to 24 months of age. During parturition, the strong forces applied to the skull as it is squeezed through the birth canal cause the bones that make it up to override one another; this process can "mold" the head into various shapes.

There are numerous types of craniosynostosis, each of which involves a different suture or combination of sutures and results in a distinctive head shape. Dubowitz syndrome5 is associated with marked microcephaly and facial anomalies (as well as other features); Treacher Collins-Franceschetti syndrome6 is associated with severe craniofacial abnormalities and hearing loss.
Action News 5 shared the Walker’s story about their sons eight hours of life shortly after he died. The posterior fontanelle is more difficult to appreciate on physical examination and often closes in the first few months of life. Difficult deliveries that require the use of forceps or vacuum extraction can result in severe molding. In addition, the calcification of a healing cephalohematoma can produce a distinct lump on the skull, usually on one of the parietal convexities. When discovered by a concerned parent (usually when the child is 1 to 2 months old), such a lump often prompts a visit to the pediatrician.

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