In the two decades since the start of the “Back to Sleep” campaign, doctors and surgeons have seen a surge in the number of infants with position-related head deformities called deformational plagiocephaly (DP). Amid often-conflicting recommendations, there’s still a lack of solid scientific data to guide diagnosis and treatment of this problem, according to a special topic section of the Journal of Craniofacial Surgery.
The special issue presents a series of articles and editorials by noted experts, highlighting the need for specialist evaluation and conservative management of infants with DP. Mutaz B. Habal, MD, FRCSC, editor-and-chief, believes the time has come for definitive studies to resolve unanswered questions about infant sleep position, sudden infant death syndrome (SIDS), and position-related skull deformities, according to a press release.
Gary F. Rogers, MD, of Children’s National Medical Center in Washington, D.C., outlines the causes, diagnosis, and treatment of DP. Mild flattening may lend to no treatment or simple repositioning, while more severe cases may benefit from the use of a helmet orthotic to gently redirect the growing cranium into a more normal shape. While these devices are widely used, the effectiveness of this treatment is debated by experts.
Rogers’ review contrasts the clinical features of deformational cranial flattening with those of other causes of abnormal skull growth — especially conditions called synostoses, in which one or more of the sutures of the infant’s head close prematurely. Infants with synostoses require highly specialized surgery and multidisciplinary treatments to prevent serious complications.