The push to put babies to sleep on their back to reduce the risk of sudden infant death syndrome (SIDS) has been associated with a decrease in the incidence of SIDS but has led to an increase in the number of babies living with head shape abnormalities. However, positional skull deformities are generally benign, reversible head-shape anomalies that do not require surgical intervention, as opposed to craniosynostosis, which can result in neurological damage and progressive craniofacial distortion. Although associated with some risk of positional skull deformity, healthy young infants should be placed down for sleep on their backs.
Parents are naturally concerned if they observe asymmetry or unusual flat spots on their baby’s head and abnormalities in the face, and often seek advice from their paediatrician. These concerns are valid and assessments need to include not only the back, but forehead flattening, ear shift, and orbital or facial involvement.
This guide is designed to provide information about the causes, signs and treatment strategies for managing head shape deformities in infants. This includes educating parents on methods of proactively decreasing the likelihood of the development of occipital flattening, initiating appropriate management and making referrals when necessary.
Treatment interventions include repositioning, a developmental home program, paediatric physiotherapy for patients with torticollis and the use of a cranial remolding orthosis to improve symmetry and normal proportion.