Deformational brachycephaly in supine-sleeping infants.
OBJECTIVE
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.


METHODS
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.
Graham
John M
JM
Medical Genetics Institute, Ahmanson Department of Pediatrics, Steven Spielberg Pediatric Research Center, Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Kreutzman
Jeannie
J
Earl
Dawn
D
Halberg
Andy
A
Samayoa
Carlos
C
Guo
Xiuqing
X
D005260:Female; D006260:Head Protective Devices; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D049068:Plagiocephaly, Nonsynostotic / Q000503:physiopathology / Q000628:therapy*; D012886:Skull / Q000002:abnormalities*; D012890:Sleep / Q000502:physiology; D016683:Supine Position / Q000502:physiology*; D016896:Treatment Outcome