OPT-IN: Osteopathic Plagiocephaly Treatment for Infants and Neonates

This study (OPT-IN) tests whether osteopathic manipulative treatment (OMT) — a hands-on physical therapy approach used by osteopathic physicians — can improve positional plagiocephaly in young infants. Positional plagiocephaly is an asymmetrical flattening of the back or side of an infant's head, typically caused by spending too much time in one position. It has become increasingly common following public health recommendations for babies to sleep on their backs. While repositioning and helmet therapy are standard treatments, OMT offers a gentle, non-invasive alternative that may address underlying muscle tension (particularly torticollis) that causes infants to prefer one head position. Eligible participants must be infants diagnosed with positional plagiocephaly who are under 4 months of age at the time of enrollment. Preterm infants (born before 37 weeks), babies with genetic syndromes, craniofacial abnormalities, craniosynostosis (where skull bones fuse prematurely), muscle tone disorders, head trauma, or prior treatment with helmets, physical therapy, or OMT are not eligible. Infant participants will receive 8 sessions of osteopathic manipulative treatment, with head shape measurements taken at additional visits to track improvement. This research is important because plagiocephaly is common (affecting up to 50% of infants in some studies), can cause cosmetic and potentially developmental concerns if severe, and helmet therapy — the most effective current treatment — is expensive, requires continuous wear, and is often distressing for infants and families. An effective non-invasive alternative would be genuinely valuable.