The early 1990s brought parents the ability to sleep more soundly and worry less about Sudden Infant Death Syndrome (SIDS). Researchers compiled sleep data from multiple cultures and discovered that infant sleep position is strongly related to SIDS, leading to the recommendation that babies be placed on their backs to sleep.
This spurred the start of the Back to Sleep campaign, in which the medical community, commercial retailers, and parents came together to fight SIDS. Despite the promise of good health and a long life that defeating SIDS seemed to offer, the battle didn’t end with back sleep. An unexpected complication of the Back to Sleep campaign was waiting to rear its ugly head.
In this article, we’ll examine the relationship of this unprecedented health campaign and the prevalence of Flat Head Syndrome in infancy. The two are closely related, but luckily, largely preventable.
Asian and African families in some subcultures have tended to place their children to sleep on their backs as a matter of cultural preference. Extraordinarily low rates of SIDS in these populations encouraged a Western medical debate on the topic of infant sleep positions. For years, Western medicine, including the United States, had argued in favor of side sleep or stomach sleep. They now had to consider – were they wrong?
The American Academy of Pediatrics was the first to say, without question, that the prevailing school of thought was erroneous. In 1994, they began working with toy manufacturers, infant product companies, and other groups to educate parents regarding the potentially deadly consequences of side and stomach sleep.
The campaign fought to encourage placing children to sleep in the supine position, and hence was termed the Back to Sleep campaign. It was an incredibly successful initiative. Within 10 years, SIDS rates dropped by 40%. At the same time, one side effect of this change in sleeping positions was being noted, gradually at first. As a consequence of increased time spent on their backs, more children were developing positional cephalic deformities.
At first, the medical community wasn’t sure how to respond to the rise in cephalic deformities. Many cases of positional plagiocephaly, brachycephaly and scaphocephaly were misdiagnosed as craniosynstoses, and underwent surgical repair. More critical physicians assumed that there weren’t likely to be long term consequences, and chose to wait and see what consequences emerged, if any.
Mixed medical opinions left the insurance industry struggling to come tot erms with how to handle billing practices regarding positional cephalic disorder treatments, and the industry split on the issue. Some insurers paid everything for fear of the potential cost of leaving these conditions untreated, others paid nothing, citing a lack of scientific evidence for long term complications.
Current medical literature suggest that positional cephalic disorders can present some long term complications if left untreated, including developmental delays – specifically in children suffering from positional plagiocephaly. There is a chance that children who develop positional cephalic disorders may be more likely to experience motor skills and developmental delays, and that the occurrence of positional cephalic deformities is the result of a pre-existing condition.
Positional cephalic deformities are relatively easy to prevent, but education is necessary. Parents need to be informed about tummy time, repositioning, neck strengthening activities, safe sleep positioners, and other techniques that can be used to reduce the occurrence of these conditions. It is possible to prevent SIDS while preventing cranial deformation, and the medical community needs to speak up to the general public on this topic.