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Evidence-based care of the child with deformational plagiocephaly, part II: management
Amanda B Kack Flannery1, Wendy S Looman, Kristin Kemper
1School of Nursing, University of Minnesota, Minneapolis, MN, USA.
Insights
Non-synostotic deformational plagiocephaly (DP) is common in infants. Early conservative management, including repositioning and physical therapy, effectively minimizes skull asymmetry, with best outcomes when diagnosis timing and severity guide interventions.
Area of Science:
- Pediatrics
- Developmental Pediatrics
- Public Health
Background:
- Non-synostotic deformational plagiocephaly (DP) affects up to 20% of infants within the first two months of life.
- Early identification and intervention are crucial for managing skull asymmetry.
Purpose of the Study:
- To synthesize evidence on deformational plagiocephaly management.
- To present an evidence-based clinical decision tool for multidisciplinary DP management.
Main Methods:
- Systematic literature review and grading of evidence quality (2000-2011).
- Focus on conservative management strategies and their effectiveness.
Main Results:
- Many DP cases show spontaneous improvement.
- Conservative strategies (repositioning, physical therapy, cranial molding) are safe and effective.
- Optimal outcomes depend on timely diagnosis and severity assessment.
Conclusions:
- Early intervention in the first year of life is key for managing DP.
- Multidisciplinary management, guided by child needs and family goals, is recommended.
- Primary care settings are ideal for prevention and initial management of DP.
Abstract:
Non-synostotic deformational plagiocephaly (DP) is a common condition that affects as many as one in five infants in the first 2 months of life. The purpose of this article, the second in a two-part series, is to present a synthesis of the evidence related to management of deformational plagiocephaly and an evidence-based clinical decision tool for multidisciplinary management of DP. We systematically reviewed and graded the literature on management of DP from 2000 to 2011 based on level of evidence and quality. The evidence suggests that although many cases of DP will improve over time, conservative management strategies such as repositioning, physical therapy, and cranial molding devices can safely and effectively minimize the degree of skull asymmetry when implemented in the first year of life. Outcomes are best when the timing of diagnosis and severity of asymmetry guide decision making related to interventions and referrals for DP. Prevention and management of early signs of DP are best achieved in a primary care setting, with multidisciplinary management based on the needs of the child and the goals of the family.
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