Abstract
Developmental plagiocephaly (DP) has been an increasing problem since the successful “back to sleep campaign”. The referrals for DP have increased by >400% during the years 2004 to 2008. Many infants spend less time in the prone position nowadays and some of the risk factors for DP are as follows: less than 3 times per day for the tummy time, torticollis and slow achievement of motor milestones. There is a need for better information to the parents but also for other strategies to prevent DP. The aim of this study was to investigate the effect of a special pillow and thus to reduce pressure on the infant head. Method: infants aged zero to two months were included in the study. They were randomized to either intervention group or control group. Head shape was investigated on two occasions, on the second occasion motor development, mobility and muscle function of the neck were also investigated. The parents were asked about tummy time and sleep position. All infants were investigated by the same physical therapist, blinded to group belonging. Result: seven infants had CVAI >3.5 on the last assessment, five of these had not used any method to reduce pressure. Fishers exact test showed a tendency where infants with reduced pressure on the head had less DP (P 0.08). Paired t test showed significant decrease in CVAI for the infants who had had reduced pressure on the head (P 0.01). Among these infants the CVAI was zero for 47% in the last assessment. For the infants who had not had a reduction of pressure on the head, there was no indication of a decrease of CVAI (P 0.45), and only 12% of these infants had a CVAI that was zero in the last assessment. Conclusion: this pilot study shows that a specially designed pillow may prevent DP in young infants. However, a larger sample is needed to confirm or disprove this. The study is planned to go on until there are 200 participants.
Highlights
developmental plagiocephaly (DP) is a condition in which the infant’s skull is deformed as a result of prenatal or postnatal external moulding forces to the growing cranium [1,2]
As a result of the back to sleep campaign, there is no doubt that infants ought to sleep on the back as it has resulted in a successful decrease in sudden infant death syndrome (SIDS) [20]
A negative side effect of the campaign is that some parents never put their infant in the prone position [21,22], which increases the risk of a DP and late motor development [23]
Summary
DP is a condition in which the infant’s skull is deformed as a result of prenatal or postnatal external moulding forces to the growing cranium [1,2]. If an infant spends most of the time in supine with the head in the same position which leads to DP [3,4,5,6,7]. Risk factors to develop plagiocephaly are: to be a first-born child, male, twin, premature, tummy time < 3 times per day when awake, torticollis and slow achievement of motor milestones [2,3,4,5,6,7,10,11,12,13,14]. A negative side effect of the campaign is that some parents never put their infant in the prone position [21,22], which increases the risk of a DP and late motor development [23]
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