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Journal of Undergraduate Research

Keywords

sleep patterns, infants, positional plagiocephaly, misshapen or flattened heads

College

Family, Home, and Social Sciences

Department

Psychology

Abstract

A significant increase in misshapen or flattened heads (positional plagiocephaly) in infants has been recognized since pediatricians began advising parents to position their infants supine for sleep in 1992 in order to diminish the risk for Sudden Infant Death Syndrome (Back-to-Sleep Program, American Academy of Pediatrics, 1992). Prior to 1992, the incidence of positional plagiocephaly was quite rare (< 1/300) [Capri, 1999] and was usually observed in children who were neglected, institutionalized, or developmentally delayed (Figure 1). Recent research has found an association between supine positioning for sleep as a result of the Back-to-Sleep program and plagiocephaly (Turk, 1996). The incidence of plagiocephaly is now greater than 1/50 newborns (Kane, Mitchell, and Craven, 1996), resulting in upwards of 20 new referrals for cranial asymmetry per week in one of the authors’ clinical practice (KHM). Other unintended consequences of the Back to Sleep Program include a change in the roundedness of the head in the new generation of children. Prior to 1992 the normal Caucasian cephalic index or ratio of width-to-length was mean of 0.76; now it is 0.85 to 0.90 and this appears to be permanent. In addition, the infants with plagiocephaly have been shown to have delayed acquisition of gross motor skills, such as of rolling over and sitting, by approximately 2 months. Additionally, evidence of diminished motor coordination at 6 years has been showed compared to normocephalics peers.

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