MONDAY, July 8 (HealthDay News) -- Putting babies on their backs
to sleep has sharply cut the rate of Sudden Infant Death Syndrome
(SIDS), but it has also left nearly half of infants with a
flattened heads, a new Canadian study estimates.
Researchers found that 47 percent of 440 2-month-olds having
routine check-ups had what doctors call positional plagiocephaly --
where the back or one side of the head has a flat spot. It develops
when infants spend a lot of time with the head resting in the same
position against a flat surface.
Flat spots are a cosmetic issue -- not a medical problem --
experts stressed, and parents should keep putting their infants on
their backs to sleep.
"It still is very important to put infants to sleep on their backs to prevent SIDS," said study author Aliyah Mawji, an assistant professor in the School of Nursing at Mount Royal University in Calgary, Alberta.
But parents can do things to prevent or alleviate the flat spot,
she said -- like making sure infants have "tummy time" when they
are awake and under someone's watchful eye.
The study, published online July 8 and in the August issue of
Pediatrics, gives a better estimate of the incidence of flat
head than past research has, according to Mawji.
That's because the babies were assessed for flat spots during
routine check-ups at four community health centers across Calgary.
Past studies included babies at just a single center, Mawji said,
and their estimates of the rate of flat head ranged hugely -- from
3 percent to 61 percent.
Still, Mawji said it's not clear whether the rate in her study
would reflect what's going on everywhere. The United States, for
example, is generally more diverse than Calgary, so the rate could
be different there -- and could vary across different parts of the
Young infants are susceptible to flat spots because the bones of
the skull are not fused together -- so that the head can get
through the birth canal and the skull can accommodate a rapidly
growing brain later.
In recent years, doctors have been seeing more and more cases of
flat spots, which is thought to be related to the Back to Sleep
campaign. For the past 20 years, experts have been advising parents
to put infants on their backs to sleep, on a flat crib surface, to
reduce the risk of SIDS.
The campaign (now called Safe to Sleep) seems to have worked. In
the United States, it's credited with a 50 percent drop in SIDS,
according to the U.S. National Institutes of Health.
So keep putting your baby on her back to sleep, said Dr. Roya
Samuels, a pediatrician at Cohen Children's Medical Center in New
Hyde Park, New York.
"Positional plagiocephaly is really a cosmetic issue," Samuels said. "There's no evidence that it affects the brain."
Still, she added, "parents can get concerned." To help reshape a
flat spot, Samuels said she tells parents to lay their baby on her
back with the head facing right, on Mondays, Wednesdays and
Fridays. On the other days, face the head to the left.
If your baby has a flat spot on one side of the head, Samuels
said you can also place mobiles or other interesting visuals to the
opposite side of the crib. That will encourage your baby to turn
her head to the non-flattened side.
When babies are awake, limiting the amount of time their heads
are against a flat surface -- as in a swing or "bouncy" seat -- is
also a good idea, according to Mawji. "Parents should also place
their infant on their stomachs when awake and supervised," she
said. "Tummy time helps promote neck strength, arm strength and
shoulder girdle strength, which will help the infant reach
Most of the babies in the current study had mild flat spots, and
simple measures are enough to address that. Some infants, though,
develop more severe flattening, causing the face to appear
In those cases, some doctors prescribe a corrective helmet that
can help redirect the growth of the baby's head.
Samuels said the most important thing is for parents to make
routine well-child visits, so their baby's overall health and
development -- including changes in head shape and size -- can be
While plagiocephaly is cosmetic, Samuels noted that there is
another, far rarer condition that causes a misshapen head, called
craniosynostosis. In that disorder, the skull bones fuse
prematurely, which can harm normal brain development. It usually
Fortunately, positional plagiocephaly is usually the culprit
behind infants' flat spots, Samuels said.
Plus, she pointed out, few people actually have perfectly
symmetrical heads. "Underneath our hair, most of us have lumps and
bumps," she said.
Boston Children's Hospital has more on
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