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Impacting infant head shapes
1Loyola University Medical Center, Maywood, Ill 60153, USA. phummel@lumc.edu
Insights
Infant sleep position changes, like the Back to Sleep Campaign, have altered typical head shapes, increasing plagiocephaly. Proper positioning and therapy can prevent or treat abnormal infant head shapes.
Area of Science:
- Pediatrics
- Developmental Biology
- Craniofacial Development
Background:
- Infant sleep position significantly influences head shape development.
- The widespread adoption of supine sleep has shifted the norm from dolichocephalic to brachycephalic head shapes.
- The American Academy of Pediatrics' Back to Sleep Campaign is associated with increased incidence of positional plagiocephaly and torticollis.
Purpose of the Study:
- To review the impact of infant sleep position on head shape.
- To discuss the increased incidence of positional plagiocephaly and torticollis.
- To outline diagnostic and treatment strategies for abnormal infant head shapes.
Main Methods:
- Literature review on infant sleep position and head shape.
- Analysis of trends in infant head shape norms.
- Discussion of clinical presentation and management of positional plagiocephaly and related conditions.
Main Results:
- Supine sleep has led to a change in the definition of normal infant head shape towards brachycephaly.
- Positional plagiocephaly and torticollis have increased since the Back to Sleep Campaign.
- Premature infants in neonatal intensive care are at higher risk for positional plagiocephaly and dolichocephaly.
Conclusions:
- Abnormal infant head shapes, including positional plagiocephaly and dolichocephaly, can be prevented or minimized with proper positioning.
- Evaluation for abnormal head shape is crucial, considering etiologies like craniosynostosis.
- Treatment involves positioning, physical/occupational therapy, and potentially helmet therapy.
Abstract:
Infant sleep position impacts the development of head shape. Changes in infant sleep position, specifically the movement toward supine sleep, have led to a redefinition of normal head shape for infants in the United States. Historically, a dolichocephalic (elongated) head shape was the norm. Currently the norm has changed to a more brachycephalic (shorter and broader) shape. Since the American Academy of Pediatrics' Back to Sleep Campaign, the incidence of positional plagiocephaly has increased dramatically with a concurrent rise in the incidence of torticollis. Infants who require newborn intensive care, particularly premature infants, are more prone to positional plagiocephaly and dolichocephaly. Both can be prevented or minimized by proper positioning. The infant with an abnormal head shape requires careful evaluation; treatment varies according to the etiology. Craniosynostosis, a less common but pathological etiology for plagiocephaly, should be considered in the diagnostic process. Successful treatment of positional plagiocephaly and dolichocephaly includes systematic positioning changes to overcome the mechanical forces of repetitive positioning, physical and/or occupational therapy to treat underlying muscle or developmental challenges, and in some cases, molding helmet therapy.
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