title: Positional plagiocephaly reduces parental adherence to SIDS Guidelines and inundates the health system.
abstract: This study sought to better understand parent, grandparent and clinician views of prevention, treatment and costs of plagiocephaly.
  
  
  
  A qualitative study was conducted using focus groups and semi-structured interviews. A grounded theory approach was taken to build theories from the qualitative data collected. A subjectivist epistemological orientation was taken under the paradigm of positivism.
  
  
  
  Ninety-one parents, 6 grandparents and 24 clinicians were recruited from the community as well as primary and tertiary care clinics. Plagiocephaly worried most parents because it could permanently affect their child's 'looks' and some thought it would affect a child's development. Parents were 'willing to do anything' to prevent plagiocephaly including using products or sleeping positions that are contraindicated under sudden infant death syndrome guidelines. Parents found the care pathway convoluted and inconsistent messages were given from different health providers. For clinicians, the high prevalence of flat head is 'clogging up their patient pool', taking up time they used to spend with children with more severe conditions.
  
  
  
  There is a need to re-emphasize sudden infant death syndrome guidelines for families when they present with an infant with plagiocephaly. Stronger messaging regarding the lack of safety of current pillows marketed to prevent flat head may be useful to decrease their use. Increasing education for all health professionals including general practitioners, allied health and complementary health providers and standardizing assessment and referral criteria may allow the majority of diagnosis and treatment of positional plagiocephaly to occur at points of first contact (e.g. general practitioners, community nurse) and may prevent further burden on the health care system.
authors: University of Sydney, George Institute for Global Health, University of Toronto: Edward Ford Building, Sydney, NSW, Australia. Alexandra.Martiniuk@sydney.edu.au.
authors: A
authors: A
authors: Martiniuk
authors: Edward Ford Building, University of Sydney, Sydney, NSW, Australia.
authors: J
authors: J
authors: Jacob
authors: Edward Ford Building, University of Sydney, Sydney, NSW, Australia.
authors: N
authors: N
authors: Faruqui
authors: Basic Physician Trainee, John Hunter Hospital, Newcastle, NSW, Australia.
authors: W
authors: W
authors: Yu
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002658:Developmental Disabilities / Q000209:etiology; D005260:Female; D017144:Focus Groups; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000379:methods; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D059041:Plagiocephaly / Q000523:psychology / Q000628:therapy*; D011187:Posture; D017410:Practice Guidelines as Topic; D036301:Qualitative Research; D013398:Sudden Infant Death / Q000517:prevention & control*; D055815:Young Adult
keywords: SIDS; brachycephaly; clinicians; parents; positional plagiocephaly