Baby Flat Head Syndrome and prevention from Pediatric Nurse Perspective

     Flat Head Syndrome in babies became an after-effect of the Sudden Infant Death Syndrome (SIDS) prevention campaign “Back to Sleep,” launched in the USA. This campaign promoted babies sleeping on their back which led to a remarkable reduction of mortality due to sudden death among infants. This intervention was generally accepted by many but required certain modifications in order to prevent deformation of the cranium (head).

     Some parents who are afraid of SIDS, never put their infant in the prone position which led to an increase in the risk of Developmental Plagiocephaly (Ohman, 2013) or commonly known as Flat Head Syndrome. With the “Back to Sleep” movement, parents were advised to put their baby in the supine position and never in prone position to reduce SIDS. Less than a decade later, mortality rate due to SIDS significantly decreased by 40% in countries that implemented the “Back to Sleep” approach in preventing sudden death among infants.

     Thus, a new campaign started in 2000 called, “Back to Sleep-Tummy Time to Play” which promoted interventions that free the infants’ head from the effects of too long gravitational pressure against a hard or flat surface. Parents were then advised to put their baby in prone position or let the baby lie on his/her belly when awake.

What is baby Flat Head Syndrome?

     Some people call the baby Flat Head Syndrome as positional plagiocephaly, others call it Developmental Plagiocephaly or sometimes Deformational Plagiocephaly. Regardless of how you may prefer to call this alteration in the baby’s head shape, you ought to know that there are two main types of plagiocephaly: Synostosis (sutural fusion) and Non-synostotic (Deformational). Let us focus more on the Deformational type for now.

     Deformational Plagiocephaly is more common and you will notice the baby’s head may look flat on one side or even both sides of the head. If you look at the flat side of the baby’s head, you’ll find the forehead of the baby protruding forward as well as the baby’s ear.

What causes baby Flat Head Syndrome?
The most common causes of Flat Head Syndrome are:

1. Multiple births

2. Breech position

3. Small maternal pelvis

4. Torticollis (congenital or traumatic)

5. Sleeping on his/her back most of the time

How can baby Flat Head Syndrome be prevented?

1.  Stretching exercises for the neck

2. When Sleeping face up (supine)

     -rotate the head alternately while asleep

     -change orientation in the cot/crib daily

3. Tummy Time while awake

     -must begin at 4 weeks of age or even while the baby is still a newborn

4. Support the head by using cushion/pillow that allow equal distribution of pressure

            Avoid fixed positioning of your baby’s head. This means you have to rotate the baby’s head position alternately to one side and to the other side when you put your baby to sleep. Also change your baby’s orientation in the cot or crib every day or every night. This will enable your baby to turn his/her head on different side when stimulated by sounds and movements around.

            Place your baby on his/her belly when awake. This will prevent the continual pressure of gravity against the back of the head or one side of the head. This will lead to strengthening of the baby’s neck and spine muscles and helps prepare your baby for crawling.

            At first, your baby may resist and may not like the position but time after time, your baby will get used to it. Don’t worry if your baby cries when you change position. That is an expected reaction. Doing this will also increase your bond with your baby promoting normal development.

            One effective measure is for you to use pillows for head support. Do not however use just any pillow but choose those that are designed to reduce cranial pressure. Choose the kind of pillow that has a hollow part in the middle that will enable it to adjust to the baby’s head. This wonderful type of pillow increases the contact surface and spread the pressure on the head exerted by gravity.

            Be careful when choosing the right pillows because not all kinds of pillows in the market today are recommended. According to the guidelines for diagnosis, prevention, treatment, monitoring and referral from primary care by Hugas and Clara on their Positional Plagiocephaly: A Task for Primary Care, there is “Only one pillow stuffed with a three-dimensional structure of polyester that enables air flow and keeps its shape, spreading the pressure properly,” and that is  Mimos® Pillows.

How effective are Mimos® Baby Pillows in preventing Flat Head Syndrome?

         

            Mimos® Pillows are designed to effectively prevent Flat Head Syndrome by reducing the pressure on the infant’s head. This type of pillow is breathable and safe for your baby compared to an ordinary pillow. A recent research study was conducted by Ohman (2013) that showed there is a significant decrease in the Cranial Vault Asymmetry Index (CVAI) for the infants who had reduced pressure on the head. This study further demonstrated that the special Mimos® Pillow which is designed to reduce pressure on the baby’s head may prevent or decrease Developmental Plagiocephaly or baby Flat Head Syndrome. This is due to its innovative features made of 100% 3D spacer fabric that provides pressure relief, regulation of heat and moisture as well as 180° free rotation of the baby’s head and neck that prevents asymmetry in neck muscle tightness and Flat Head Syndrome.

            Parents should understand that early intervention is needed to prevent the occurrence of Flat Head Syndrome in babies. Remember that the most important thing to do is to change the head position of your baby even when he/she is still a newborn. Early detection and prompt intervention are better than going for medical and surgical procedures. If you also start late with tummy time for your baby, he/she may resist and you can easily give up. Start positioning your newborn on his/her belly and feel safe while using the European Authority Approved Mimos® Pillow.

Go ahead and allow your baby to sleep on his/her back using the anti-suffocation Mimos® baby pillow  but also include some tummy time or position your infant when awake on his/her belly. This will help prevent Flat Head Syndrome.

Reference:

Ohman, A. (2013) A pilot study, a specially designed pillow may prevent Developmental Plagiocephaly by reducing pressure from the infant head. Health, 5, 32-37. doi: 10.4236/health.2013.56A2006. Retrieved on 11 September 2013 from http://file.scirp.org/Html/6-8202140_33167.htm