It is now recommended that infants sleep on his or her back in order to prevent sudden infant death syndrome, or SIDS. This recommendation has been successful, and the number of babies dying from SIDS has significantly decreased.
It is now recommended that infants sleep on his or her back in order to prevent sudden infant death syndrome, or SIDS.
This recommendation has been successful, and the number of babies dying from SIDS has significantly decreased. However, as a result of sleeping in this position, the baby’s head can become misshapen.
Usually, there is flattening on one side of the back of the head; this is called a positional skull deformity. Or, the entire back of the head maybe flattened. Fortunately, there are ways to decrease the severity of the skull deformity.
When the baby is awake during the day and the parent can observe the infant, it is OK for the baby to be positioned on his or her stomach. This is called “tummy time.”
Also, when the baby is sleeping on his or her back, the position of the baby’s head can be alternated each night with the head positioned to the right on one night and to left the following night.
It is also important to avoid prolonged sitting indoors or in car seats because the infant’s head may remain in one position for too long, also leading to flattening.
Once significant flattening of the head takes place, head-molding helmets have been used to reshape the skull. However, presently there is no evidence that such helmets are any better than repositioning the head as mentioned above.
In severe flattening, it is possible that head helmets may be beneficial, but they need to be started within the first year of life.
Although positioning is the major cause of a misshapen head, there are other causes. In some babies, an asymmetrical head is result of abnormal positioning of the skull while the baby was still in-utero.
There may also be premature fusion of the sutures of the head that results in an abnormal head shape. This has nothing to do with positioning. In these cases, neurosurgery is usually necessary to open the sutures.
Also associated with head flattening is torticollis or a wryneck, which limits range of motion and can cause pain.
However, head positioning remains the most common cause of head asymmetry and, fortunately, most of the time, it can be prevented.
Dr. Murray Feingold is the physician in chief of The Feingold Center for Children, medical editor of WBZ-TV and WBZ radio in Massachusetts, and president of the Genesis Fund, a nonprofit organization that funds the care of children born with birth defects, mental retardation and genetic diseases.