Back to sleep

May 12, 2005 6:37 PM

The number of children with flattened heads(aka positional plagiocephaly) is on the rise. The cause? "Back to Sleep," the government program that urged parents to prevent SIDS by putting their babies to sleep on their backs. The condition can be treated through surgery, the use of an orthotic helmet, or just letting the kid be, in the hopes of growing out of it.

According to this article, though, the medical establishment has been less than willing to acknowledge the problem and deal with it proactively.
posted by greatgefilte (39 comments total)

That first article said that the frequency of occurance rose sixfold, to 33 out of 10,000 births. According to my calculator (yeah, I really needed a calculator) that's 0.33%.

Not quite an epidemic yet, and it still beats the hell out of SIDS.
posted by hammurderer at 6:45 PM on May 12, 2005

... is on the rise.

From the site: The number of positional plagiocephaly cases increased sixfold from 1992 to 1994

Unless I'm reading it wrong, it was "on the rise" more than 10 years ago. Is there more recent data?
posted by thedevildancedlightly at 6:57 PM on May 12, 2005

Shooter, grassy knoll, tinfoil is your friend.
posted by caddis at 6:59 PM on May 12, 2005

Hmm. This paper suggests the numbers might be a bit higher than previously reported. Then again, it's written by one of the companies that manufactures these helmets. Caveat lector.
posted by greatgefilte at 7:03 PM on May 12, 2005

Actually this is becoming more of a problem. Speaking as a paediatrician, it is relatively easy to reconcile the drop in SIDS against the more minor problem of positional plagiocephaly, which often resolves spontaneously. There isn't much of an answer for a parent wishing to avoid both though.
posted by dubious at 7:09 PM on May 12, 2005

I wonder what caused this point atop my head?

Seriously, Dr. Dubious, how often are you tempted to smack parents? "Would you rather have a kid with a slightly rumpled skull or a dead kid?" comes to mind.
posted by davy at 7:17 PM on May 12, 2005

I've always been curious about
the mattress suggestion, although I don't know if it can be taken seriously? Certainly plenty information on it if you google.

If there were some truth to that, it would (to me) also explain why sleeping on the back would also work, with respect to the distance and concentration of the fumes.
posted by lundman at 7:40 PM on May 12, 2005

It's the few kids that have flattened spots that don't just return to normal with time that you worry about. Some end up having extensive cranial vault remodelling surgery with high risks (and requiring intensive care monitoring post-op) for cosmesis. The treatments have moderate success, but are not guaranteed, and the helmets should certainly always be used through consultation with paediatric plastic surgeons as the cause of the plagiocephaly can be more serious. Behavioural treatment is the other option, but unfortunately is not quite as effective. I must say, this is a difficult subject for parents and physicians.
As for wanting to smack parents, believe me, if a parent is actually concerned about the wellfare of their child, they have my respect.
posted by dubious at 7:41 PM on May 12, 2005

Is the flattening really due to the sleeping on the back, or perhaps more related to the idea of not using a pillow? Because of their low weight, babies and infants do not depress a cot mattress to any discernable degree, so they are effectively resting the back of their heads on a hard surface. Given the relative softness of the skulls of infants, it is hardly surprising that they end up with flat heads.
posted by dg at 7:55 PM on May 12, 2005

I've always been curious about
the mattress suggestion, although I don't know if it can be taken seriously? Certainly plenty information on it if you google.

If there were some truth to that, it would (to me) also explain why sleeping on the back would also work, with respect to the distance and concentration of the fumes.
posted by lundman at 7:40 PM PST on May 12 [!]


Can anyone that has some SIDS knowledge comment on this article? Seems interesting, and as a new paranoid parent, I'm wondering if I should be rushing out to buy a mattress cover!

(thanks for the link lundman)
posted by jikel_morten at 8:07 PM on May 12, 2005

I have honestly no idea. I lived in New Zealand, and mum still does who ran some childcare centres for a few years, and don't recall hearing about anything about mattresses. But then, I was a teenager and tended to ignore everything as teenagers are prone to :)

We got a brand new bed and mattress, as it was our first born.

In Japan, nearly every child I see have a flat head. They do try to teach you to move the head around if the child can not do so itself. Ours already could lift his head when he was born, and learnt to flip to his stomach on his own after a few weeks. Not much we could do there. :)

You aren't supposed to have pillows or other junk (soft toys etc) in the baby's bed, or at least initially.

So much information to take in :) Who knows whats true and whats heresay. Hell, there are no food restrictions in Japan when you are pregnent, apart from "avoid eating cold food, like straight out of the fridge".

We bought a motion sensor mat thing, it was a wonderful purchase (even if it is only false sense of security) and since a mattress isn't that expensive, we would probably buy a new one for the second child, if we have one.

Lund
posted by lundman at 8:17 PM on May 12, 2005

Yeah..so much to consider. I think I may go for the mattress cover ($30). Our baby is 7 months, so she is over the 0-6 month high risk stage, but I'd still like to take the precaution.
posted by jikel_morten at 8:28 PM on May 12, 2005

speaking of weirdly shaped heads: what's up with Tut? : >
posted by amberglow at 8:28 PM on May 12, 2005

Since the AAP's campaign, the incidence of SIDS has decreased by almost 40% in the United States

A 40% reduction in SIDS versus a .33% increase in this syndrome. I'll take it.

With that said, my 3 month old now sleeps with a little pillow-- softer than the mattress but not so soft that it would be dangerous.
posted by gwint at 8:33 PM on May 12, 2005

I think it's not so much the bed as it is leaving the child constantly in one of those baby buckets. They have quilted covers but behind that it's just plastic. Many parents leave their child in the damn thing all the time when the child is awake.

Babies need to be held by human arms for many reasons, but getting the back of the head away from a flat surface is one of those reasons.

The only kid I ever saw with a flat head was the child of parents who didn't hold her hardly at all. Poor kid :(
posted by beth at 8:39 PM on May 12, 2005

On the plus side, you can get them to stand next to your TV-watching chair to rest your beer on ;-)
posted by dg at 8:41 PM on May 12, 2005

I for one welcome our new flat-headed overlords.
posted by Ty Webb at 9:13 PM on May 12, 2005

I saw an article on television about this issue not long ago. It showed how parents here in Australia were actually taking their children to specialists to be fitted with the special helmets mentioned above. Apparently this method only works for children under a certain age though.
posted by sjvilla79 at 9:20 PM on May 12, 2005

A 40% reduction in SIDS versus a .33% increase in this syndrome. I'll take it.

The increase in positional plagiocephaly is 6x, a 500% increase. The 0.33% number is the frequency. Presumably before the recommendation to have kids on their backs the frequency was 0.33/6 or 0.055%.
posted by tkb at 9:54 PM on May 12, 2005

Do those helmets come in different fun shapes?
posted by HTuttle at 10:25 PM on May 12, 2005

When my now two month old daughter was born, one of the first things the nurses told us was, "make sure she sleeps on her back." Problem is, she naturally loves to sleep on her side. Those first couple of nights we were frightened because she would never stay on her back. Mom and I took turns trying to keep her on her back.

Finally they told us the side was OK, just not on the stomach. These days she sleeps on her back, but usually with her head turned 90 degrees.

Maybe I should make sure she switches sides every other night to prevent unbalanced flattening. Or will she end up with a pancake head?

Bottom line: humans have been around for a while. I think babies are more resilient than we give them credit for. Hell, just for kicks I put mine through the dryer (OK, that was a joke).
posted by b_thinky at 10:30 PM on May 12, 2005

What would the Kids in the Hall have to say about this?
posted by dreamsign at 11:11 PM on May 12, 2005

Totally insensitive:

posted by thedevildancedlightly at 12:09 AM on May 13, 2005

I've got a one year old, and I never had a problem with him having a flat head. I think Beth is onto something here, because we didn't leave him in a "Baby Bucket" all the time. He was only in his car seat when we went out, and at home he was being held or in a bouncer, which is a cloth seat held up by a wire frame.
posted by Shoeburyness at 1:21 AM on May 13, 2005

While I am understanding of the sensitivities of new parents, I don't great reserves of patience for parental vanity. Is plagiocephaly a cosmetic concern or a health-threatening condition?
posted by mistersquid at 3:34 AM on May 13, 2005

I once worked with a guy from Pakistan. One day I noticed that the back of his head was quite flat. Having no sense of propriety I blurted out "dude, why is the back of your head so flat?". He told me that this had been done intentionally using special boards when he was a baby as it was believed that a flat head conferred nobility or some such thing. But now I'm not so sure he wasn't intentionally misleading me.
posted by Turtles all the way down at 4:17 AM on May 13, 2005

Certain families were famous for it.
posted by Wolfdog at 4:58 AM on May 13, 2005

The Mayans used to use boards to flatten the front of kids heads, in order to make them more attractive and "lucky."
posted by klangklangston at 5:07 AM on May 13, 2005

I've got mad skull shape and it's not a problem. I like it. It gets me noticed. People say, 'Woah, check out the dome! How hangs it, Tefal dude?" Money can't buy that kind of attention.

Mad skull shapes are cool. On the other hand, those orthotic helmets are WAY cool. I think mad skull shape coupled with orthotic helmet would be "I-am-the-God-of-hellfire-and-I-bring-you-FIRE" cool.
posted by Decani at 5:40 AM on May 13, 2005

While I am understanding of the sensitivities of new parents, I don't great reserves of patience for parental vanity.

Tell that to your 18 year old flat headed kid.
Son: "Mom, Dad, why is my head flat?"
Dad: "Well, we could have fixed that for you, but we decided to buy a TV instead. "

It's not so much about parental vanity as it is wanting what's best for your child. I think providing them with a round head isn't unreasonable.
posted by petri at 6:19 AM on May 13, 2005

The Mayans used to use boards to flatten the front of kids heads, in order to make them more attractive and "lucky."

They also used to dangle a little ball between their eyes to make them cross-eyed and filed their teeth into points. Great looking bunch those Mayan aristocrats must have been, then again I wonder what they'd think of Hollywood.
posted by Pollomacho at 6:35 AM on May 13, 2005

speaking of weirdly shaped heads: what's up with Tut?

He really did look like Jaye Davidson!
posted by octobersurprise at 6:47 AM on May 13, 2005

My wife took care with our boy, and now takes with our newborn girl, to rotate the head placement to avoid flatheadedness. While correllation isn't causation, our boy's head is quite round at nearly 3 years old.
posted by MattD at 7:08 AM on May 13, 2005

My kid had this problem. He slept on his back, but we couldn't change his head placement because he had a nick on one side from the C-section surgery.

Four months later, my wife noticed the head sloping, and that one ear was higher than the other. So he had to wear one of those orthotic helmets for about three months. Pain in the ass, and expensive (although insurance covered it, after much convincing). If you look his head from the top now, you can still see some sloping, but it's nothing to worry about.

The thing is, most babies are actually more comfortable on their stomachs and sleep better. The whole "back to sleep" is predicated on statistics - those children (no pillows allowed!) are statistically less likely to die of SIDS. Nobody really knows for sure why it works. But better safe than sorry.
posted by fungible at 8:32 AM on May 13, 2005

Is plagiocephaly a cosmetic concern or a health-threatening condition?

Oh - just read this comment. They say it's probable that it can lead to learning disorders later in life. Not exactly life threatening, but something to think about. My kid's smart as a whip now, and I couldn't be happier.

those orthotic helmets are WAY cool.

You would be surprised (or would you?) how many parents thought we had him in the helmet just as a precaution against bumped heads? "Wow, where do I get one of those?" I certainly don't share that sentiment - bumped heads are an important part of growing up (although I could do without hospital visits).
posted by fungible at 8:38 AM on May 13, 2005

I want an orthotic helmet embossed with a goblin face, so that my kid has a really interesting skull shape as an adult. Imagine it!

I've got a flat spot on my head. I am told that I would persistently sleep pressed up against the end of the crib... but maybe that's just a story my Pakistani-adoring mother made up! (I do wish she'd thought to, you know, toss some padding against the wall of the crib. I can't shave my head out of fear of looking too freaky.)
posted by five fresh fish at 10:38 AM on May 13, 2005

No problems here
posted by Outlawyr at 11:16 AM on May 13, 2005

From what I understand, the suggested solution is to let the child have "tummy time," which is plenty of time face down when awake. This also addresses the (very slight) delays in some developmental milestones (like holding his/her head or chest up) that can also happen with too much time on the back.
posted by deliquescent at 11:31 AM on May 13, 2005

actually, to correct myself before anyone else has to... what i meant was not so much a solution if you already have it, as a preventative measure
posted by deliquescent at 11:33 AM on May 13, 2005