Monday, May 5th, 2014
A new study published in the journal BMJ is calling into question the conventional wisdom that molded plastic helmets can help babies who have deformational plagiocephaly, or flat heads caused by sleeping on their backs or a neck condition called torticollis. More from WBUR.org, Boston’s NPR station:
The paper is small but it’s the first randomized, controlled study — the gold standard in medical research — of helmets for plagiocephaly in babies. And it found that, at least in 84 babies without other risk factors, the helmets don’t help. The babies tended to improve with or without helmets. From the press release:
“There was no meaningful difference in skull shape at the age of two years between children treated with therapy helmet and those who received no active treatment. Both groups showed similar improvements although only a quarter made a full recovery to a normal head shape, according to the team of researchers based in The Netherlands.”
The results are especially underwhelming when you consider that the helmets, made of firm foam in a hard plastic shell, can cost as much as several thousand dollars, even in Great Britain, where the national health system doesn’t tend to pay for them.
The findings can also seem a bit daunting when you consider that once the flat-headedness developed in babies, only about a quarter of them fully “normalized,” helmet or not.
Dr. Carolyn Rogers-Vizena, a craniofacial surgeon in the department of plastic and oral surgery at Boston Children’s Hospital, emphasizes this point: By no means should concerns about head flatness dissuade parents from putting babies to sleep on their backs, which is known to protect against Sudden Infant Death Syndrome. Back-sleeping alone should not be blamed, she added; babies who develop flat heads usually have other risk factors that lessen mobility, including neck tightness, prematurity or developmental delays.
Also, the study offers useful new knowledge but it’s only one small study, she said, “it’s certainly not the be-all and end-all.”
Image: Girl wearing a helmet, via Shutterstock
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Tuesday, July 9th, 2013
Nearly half of two-month-old babies who were part of a recent study were found to have flat spots on their heads. Researchers at Mount Royal University in Calgary believe that the culprit could be the widespread use of devices like swings and seats that hold babies in static positions, and the practice–recommended as the safest way to protect against sudden infant death syndrome (SIDS)–of laying babies to sleep on their backs. More from NBC.com:
“The reason why we want to catch this early is because if we see children with flattened heads, sometimes there are changes in their facial features,” says Aliyah Mawji, a registered nurse at the university who led the study.
Pediatricians and pediatric nurses have noticed a big increase in the number of babies with flat spots on their heads – a condition known as positional plagiocephaly (“oblique head” in Greek).
Most experts say it’s due to advice to put babies to sleep on their backs – which in turn has slashed rates of sudden infant deaths syndrome or SIDS. But babies have big, heavy heads and weak little necks, which means their heads tend to roll to one side. Because their skulls are still soft, this can cause a flat spot….
…So [Mawji] and colleagues did a survey in four Calgary clinics where parents bring their babies – each in a different type of neighborhood. They looked at 440 babies aged 7 to 12 weeks. “We found that 46.6 percent actually had some form of plagiocephaly,” Mawji says.
A slight majority, 63 percent, had the flat spot on the right, and Mawji says that comes from the moment of birth.
“This is actually due to the birthing process itself,” Mawji says. “The majority of infants come out in such a way that their head is turned to the right.” This is in part because the mother’s pelvic bone and spine don’t move – they’re hard bones – so the more flexible baby ends up squished and twisted.
If a baby doesn’t move around enough, this flat spot can become more permanent. And if no one does anything, and the skull hardens, it could become really permanent.
Most of the cases Mawji saw were mild. And while she took care to get a range of family types into her study, she stresses that more research is needed to really show how common the issue is across the larger North American population. But her findings show it is probably more common than most people thought.
Experts recommend parents make a concerted effort to move their babies regularly, still putting them to sleep on their backs, but encouraging them to alternate which side of their head is against the mattress, seat, or swing.
Image: Sleeping baby, via Shutterstock
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Tuesday, November 29th, 2011
A new report published this week in the journal Pediatrics contains new recommendations for pediatricians and parents on how to prevent and correct head flattening in babies. The number of babies diagnosed with the misshapen skull syndrome known as positional plagiocephaly has increased exponentially since safe sleep recommendations have had infants spending so much time on their backs, researchers found. And while they in no way suggest that parents ignore the recommended safe sleep practices, researchers suggest that pediatricians counsel parents from their babies’ very first checkups on ways to prevent and correct flattening heads.
CNN.com lists 5 of the recommendations, which can help parents avoid placing their babies in skull-correcting helmets if the problem has not improved by 6 months of age:
- - Increase “tummy” time, which is supervised time during the day when baby lies on its stomach. A baby should spend at least 30 to 60 minutes a day on it’s belly, something that can be done immediately after birth. This will help develop neck and shoulder muscles, says [the report's lead author, Dr. James] Laughlin. It has also been shown to “enhance motor developmental scores,” according to this new report.
- - The NIH recommends changing the direction your baby lies in the crib each week. They say this change will encourage the baby to turn his or her head in different directions to avoid resting in the same position all the time.
- - Some babies prefer to hold their head to one side. Laughlin suggests laying them down in a different way when they’re awake, so they have something interesting to look at on the opposite side. If you have them in a car seat or sitting in something else, you can also change the position to make the baby look in the opposite direction.
- - Parents may find their babies sleep well sitting in a car seat, but this is another way they can develop an asymmetrical shape, especially in the first 6 months of life. So experts suggest babies shouldn’t spend a prolonged period of time in a car seat (unless they are in a car of course) or bouncy seat.
- - Cuddle! The NIH says “getting cuddle time with the baby by holding him or her upright over one shoulder often during the day,” is another way to prevent flat spots.
Image: Baby doing tummy time, via Shutterstock.
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