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Do preterm infants always have flattened heads?

N Rutter1, W Hinchliffe, P H Cartlidge

  • 1Department of Neonatal Medicine and Surgery, Nottingham City Hospital.

Insights

A soft mattress may reduce early head flattening in preterm infants. However, head shape issues in premature babies typically resolve by age 4, irrespective of neonatal mattress type.

Area of Science:

  • Neonatal care
  • Developmental pediatrics
  • Infant health

Background:

  • Premature infants often experience positional head flattening (plagiocephaly) in the neonatal period.
  • Previous research suggested soft mattresses could mitigate this early head deformation.
  • The long-term impact of neonatal sleep surfaces on infant head shape remained unclear.

Purpose of the Study:

  • To investigate the long-term resolution of head flattening in very preterm infants.
  • To determine if neonatal mattress type influences head shape development by early childhood.

Main Methods:

  • A follow-up study included 31 infants born before 32 weeks' gestation.
  • Infants' head shapes were assessed in the neonatal period and again at 3-4 years of age.
  • Comparison was made between infants who used different types of mattresses in the neonatal intensive care unit.

Main Results:

  • Head flattening observed in the neonatal period resolved in all infants by 3-4 years of age.
  • Infant head shape at follow-up was similar to that of full-term controls.
  • No significant difference in head shape resolution was associated with the type of mattress used during infancy.

Conclusions:

  • Positional head flattening in very preterm infants typically resolves naturally by early childhood.
  • The type of mattress used in the neonatal period does not appear to affect the long-term outcome of head shape.
  • Neonatal interventions regarding mattress type may not be critical for correcting plagiocephaly in the long run.

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