In 1994 the US National Institute of Child Health and Human Development (NICHD) launched “Safe to Sleep” (also known as “Back to Sleep”) encouraging parents to put their infants to sleep on their backs in order to reduce the risk of Sudden Infant Death Syndrome (SIDS). Since this initiative began, the incidence of SIDS has declined by more than 50%.
Since the implementation of the “Safe to Sleep” program experts have noticed a five-fold increase in cases of plagiocephaly or “flat head syndrome”. Studies show that 20 to 25 percent of infants who sleep on their backs develop some degree of plagiocephaly. (Boston Children’s Hospital)
Plagiocephaly develops when an infant’s soft skull becomes flat in one area, due to repeated pressure on one part of the head because they are sleeping regularly in one position.
Even though your baby may have a greater risk for plagiocephaly, the recommendation to put your baby to sleep on her back significantly reduces your baby’s risk for SIDS. Therefore, continue putting your infant to sleep on her back and follow these prevention guidelines (Cincinnati Children’s):
- Change your baby’s position often when awake.
- Limit the amount of time your baby rests in positioning devices – car seats, bouncy seats, baby swings, and strollers.
- It is very important to put your baby on their tummy (Tummy Time) when they are awake and supervised. This takes the pressure off the back of your baby’s head, so there is less chance of developing a flat spot. Being on their tummy or, while you are with them will strengthen the neck, arms, tummy and back muscles. With stronger muscles, your baby will be able to turn their head, which will help put pressure on both sides.
- The American Academy of Pediatrics recommends that babies lie on their backs to sleep and have frequent supervised tummy time when they are awake.
Children with severe plagiocephaly may need treatment. If you are concerned about your infant’s head shape seek the advice of a physician immediately. Treatment for your baby may include:
- Physical Therapy.
- Referral to Plastic Surgery or Neurosurgery. Children with plagiocephaly often see a plastic surgeon or neurosurgeon to make sure they do not have craniosynostosis. Craniosynostosis occurs when the skull bones meld together and create an abnormal head shape that can look like plagiocephaly. However, unlike plagiocephaly, craniosynostosis requires surgery.
- Cranial Orthotic Therapy with a Helmet or Headband. Babies with severe plagiocephaly usually wear either a custom-fitted helmet or a headband (called a cranial orthotic) for about 23 hours a day to correct the shape of their head. This treatment generally lasts two to six months, depending on how early you start and how severe the problem is.
If you are concerned about your baby’s head shape, check with your baby’s doctor. Continue putting your baby down to sleep on her back. This is the safest position. Have regular Tummy Time sessions to help your baby build strong muscles. If you see a cute baby with a cute helmet on, just wave; don’t judge (unless you were dropped on YOUR head).