Deformational brachycephaly in supine-sleeping infants.

Abstract

OBJECTIVES:

Medical dictionaries and anthropologic sources define brachycephaly as a cranial index (CI = width divided by length x 100%) greater than 81%. We examine the impact of supine sleeping on CI and compare orthotic treatment with repositioning.

STUDY DESIGN:

We compared the effect of repositioning versus helmet therapy on CI in 193 infants referred for abnormal head shape.

RESULTS:

Eighty percent of the infants had a pretreatment CI > 81%. Their initial mean CI at mean age 5.3 months was 89%, and after treatment, their mean CI was 87% (+/-2 SE = 0.9%) at mean age 9.0 months. For 92 infants with an initial CI at or above 90%, their initial mean CI of 96.1% was reduced to a mean of 91.9%.

CONCLUSIONS:

Post-treatment CI was 86% to 88%, CI in neonates delivered by cesarean section was 80%, and CI in supine-sleeping Asian children was 85% to 91%, versus 78% to 83% for prone-sleeping American children. Repositioning was less effective than cranial orthotic therapy in correcting severe brachycephaly. We recommend varying the head position when putting infants to sleep.

• Authors: John M Graham Jr, Jeannie Kreutzman, Dawn Earl, Andy Halberg, Carlos Samayoa, Xiuqing Guo
• Journal: The Journal of pediatrics (J Pediatr) Vol. 146 Issue 2 Pg. 253-7 (Feb 2005) ISSN: 0022-3476 [Print] United States
• PMID: 15689919 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Topics

• Female
• Head Protective Devices
• Humans
• Infant
• Longitudinal Studies
• Male
• Plagiocephaly, Nonsynostotic (physiopathology, therapy)
• Skull (abnormalities)
• Sleep (physiology)
• Supine Position (physiology)
• Treatment Outcome