Health> Vol.5 No.6B, June 2013

A pilot study, a specially designed pillow may prevent developmental plagiocephaly by reducing pressure from the infant head

DownloadDownload as PDF (Size:142KB)  HTML    PP. 32-37  
Author(s)    Leave a comment

ABSTRACT

Developmental plagiocephaly (DP) has been an increasing problem since the successful “back to sleep campaign”. The referrals for DP have increased by >400% during the years 2004 to 2008. Many infants spend less time in the prone position nowadays and some of the risk factors for DP are as follows: less than 3 times per day for the tummy time, torticollis and slow achievement of motor milestones. There is a need for better information to the parents but also for other strategies to prevent DP. The aim of this study was to investigate the effect of a special pillow and thus to reduce pressure on the infant head. Method: infants aged zero to two months were included in the study. They were randomized to either intervention group or control group. Head shape was investigated on two occasions, on the second occasion motor development, mobility and muscle function of the neck were also investigated. The parents were asked about tummy time and sleep position. All infants were investigated by the same physical therapist, blinded to group belonging. Result: seven infants had CVAI >3.5 on the last assessment, five of these had not used any method to reduce pressure. Fishers exact test showed a tendency where infants with reduced pressure on the head had less DP (P 0.08). Paired t test showed significant decrease in CVAI for the infants who had had reduced pressure on the head (P 0.01). Among these infants the CVAI was zero for 47% in the last assessment. For the infants who had not had a reduction of pressure on the head, there was no indication of a decrease of CVAI (P 0.45), and only 12% of these infants had a CVAI that was zero in the last assessment. Conclusion: this pilot study shows that a specially designed pillow may prevent DP in young infants. However, a larger sample is needed to confirm or disprove this. The study is planned to go on until there are 200 participants.

Cite this paper

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.

References

[1] Clarren, SK. (1981) Plagiocephaly and torticollis: Etiology, natural history and helm treatment. Journal of Pediatrics, 98, 92-95. doi:10.1016/S0022-3476(81)80549-5
[2] Littlefield, T.R., Kelly, K.M., Pomatto, J.K. and Beals, S.P. (2002) Multiple-birth infants at higher risk for development of deformational plagiocephaly: II. is one twin at greater risk? Pediatrics, 109, 19-25. doi:10.1542/peds.109.1.19
[3] McKinney, C.M., Cunningham, M.L., Holt, V.L., Leroux, B. and Starr, J.R. (2009) Case-control study of infant, maternal and perinatal characteristics associated with deformational plagiocephaly. Paediatric and Perinatal Epidemiology, 23, 332-345. doi:10.1111/j.1365-3016.2009.01038.x
[4] Hutchison, B.L., Thompson, J.M. and Mitchell, E.A. (2003) Determinants of nonsynostotic plagiocephaly: A case-control study. Pediatrics, 112, e316. doi:10.1542/peds.112.4.e316
[5] Hutchison, B.L., Hutchison, L.A.D., Thompson, J.M.D. and Mitchell, E.A. (2004) Plagiocephaly and brachycephaly in the first two years of life: A prospective cohort study. Pediatrics, 114, 970-980.
[6] Van Vlimmeren, L.A., van der Graaf, Y., Boere-Boonekamp, M.M., L’Hoir, M.P., Helders, P.J. and Engelbert, R.H.H. (2007) Risk factors for deformational plagiocephaly at birth and at seven weeks of age: A prospective cohort study. Pediatrics, 119, e408-e418. doi:10.1542/peds.2006-2012
[7] Oh, A.K., Hoy, E.A. and Rogers, G.F. (2009) Predictors of severity in deformational plagiocephaly. Journal of Craniofacial Surgery, 20, 685-689. doi:10.1097/SCS.0b013e318193d6e5
[8] Brofin, D.R. (2001) Misshapen heads in babies: Position or pathology? The Ochsner Journal, 3, 191-199.
[9] Robinson, S. and Proctor, M. (2009) Diagnosis and management of deformational plagiocephaly. A review. Journal of Neurosurgery: Pediatrics, 3, 284-295. doi:10.3171/2009.1.PEDS08330
[10] Peitsch, W.K., Keefer, C.H., LaBrie, R.A. and Mulliken, J.B. (2002) Incidence of cranial asymmetry in healthy newborns. Pediatrics, 110, e72. doi:10.1542/peds.110.6.e72
[11] Joganic, J.L., Lynch, J.M., Littlefield, T.R. and Verrelli, B.C. (2009) Risk factors associated with deformational plagiocephaly. Pediatrics, 124, e1126-e1133. doi:10.1542/peds.2008-2969
[12] Hutchison, B.L., Stewart, A.W. and Mitchell, E.A. (2009) Characteristics, head shape measurements and developmental delay in 287 consecutive infants attending a plagiocephaly clinic. Acta Pædiatrica, 98, 1494-1499. doi:10.1111/j.1651-2227.2009.01356.x
[13] Golden, K.A., Beals, S.P., Littlefield, T.R. and Pomatto, J.K. (1999) Sternocleidomastoid imbalance versus congenital muscular torticollis: their relationship to positional plagiocephaly. The Cleft Palate-Craniofacial Journal, 36, 256-261. doi:10.1597/1545-1569(1999)036<0256:SIVCMT>2.3.CO;2
[14] Rogers, G.F., Oh, A.K. and Mulliken, J.B. (2009) The role of congenital muscular torticollis in the development of deformational plagiocephaly. Plastic and Reconstructive Surgery, 123, 643-652. doi:10.1097/PRS.0b013e318196b9be
[15] Bialocerkowski, A.E., Vladusic, S.L. and Wei, C. (2008) Prevalence, risk factors and natural history of positional plagiocephaly: A systematic review. Developmental Medicine & Child Neurology, 50, 577-586. doi:10.1111/j.1469-8749.2008.03029.x
[16] Persing, J., James, H., Swanson, J. and Kattwinkel, J. (2003) American Academy of Pediatrics Committee on Practice and Ambulatory Medicine, Section on Plastic Surgery and Section on Neurological Surgery. Prevention and management of positional skull deformities in infants. Pediatrics, 112, 199-202. doi:10.1542/peds.112.1.199
[17] Argenta, L.C., David, L.R., Wilson, J.A. and Bell, W.O. (1996) An increase in infant cranial deformity with supine sleeping position. Journal of Craniofacial Surgery, 7, 5-11. doi:10.1097/00001665-199601000-00005
[18] Kane, A.A., Mitchell, L.E., Craven, K.P. and Marsch, J.L. (1996) Observations on a recent increase in plagiocephaly without synostosis. Pediatrics, 97, 877-885.
[19] White, N., Warner, R.M., Noons, P., McAlister, E.M., Solanki, G., Nishikawa, H. and Dover, M.S. (2010) Chaning referral patterns to a designated craniofacial centre over a four-year period. Journal of Plastic, Reconstructive & Aesthetic Surgery, 63, 921-925. doi:10.1016/j.bjps.2009.05.007
[20] Wennergren, G. (2004) Prevention of sudden infant death syndrome. Pediatric Pulmonology, 37, 110-111. doi:10.1002/ppul.70072
[21] Majnemer, A. and Barr, R.G. (2005) Influence of supine sleep positioning on early motor milestones aquistion. Developmental Medicine & Child Neurology, 47, 370- 376. doi:10.1017/S0012162205000733
[22] Mildered, J., Beard, K., Dallwitz, Z. and Unwin, J. (1995) Play position is influenced by knowledge of SIDS sleep position recommendations. Journal of Paediatrics and Child Health, 31, 499-502. doi:10.1111/j.1440-1754.1995.tb00871.x
[23] Ohman, A., Nilsson, S., Lagerkvist, A.-L. and Beckung, E. (2009) Are infants with torticollis at risk for having a delay in achieving early motor milestones compared with a control group of healthy infants? Developmental Medicine & Child Neurology, 51, 545-550. doi:10.1111/j.1469-8749.2008.03195.x
[24] Lauritzen, C. and Tarnow, P. (1999) Assymetric skull? Early correct diagnosis is a must! Positional skull deformities can be avoided. Lakartidningen, 96, 1447-1453.
[25] Hauck, F.R., Herman, S.M., Donovan, M., Ivasu, S., Merrick Moore, C., Donoghue, E., Kirschner, R.H. and Willinger, M. (2003) Sleep environment and the risk of sudden infant death syndrome in a urban population: The Chigago infant morality study. Pediatrics, 111, 1207-1214.
[26] van Sleuwen, B.E., L’Hoir, M.P., Engelberts, A.C., Westers, P. and Schulpen, T.W. (2003) Infant care practise related to cot death in Turkish and Moroccan families in the Netherlands. Archives of Disease in Childhood, 88, 784- 788. doi:10.1136/adc.88.9.784
[27] Scheers, N.J., Dayton, C.M. and Kemp, J.S. (1998) Sudden infant death with external airways covered case-comparision study of 206 deaths in the Untied States. Archives of Pediatrics & Adolescent Medicine, 152, 540-547.
[28] Carpenter, R.G. and Shaddick, C.W. (1965) Role of infection, suffocation and bottle-feeding in cot death. Ananalysis of some factors in the histories of 110 cases and their controls. British Journal of Preventive & Social Medicine, 19, 1-7.
[29] McGarvey, C., McDonnell, M., Chong, A., O’Regan, M. and Matthews, T. (2003) Factors relating to the infant’s last sleep environment in sudden infant death syndrome in the Republic of Ireland. Archives of Disease in Childhood, 88, 1058-1064.
[30] Thompson, J.M., Thach, B.T., Becroft, D.M. and Mitchell, E.A. (2006) New Zealand Cot Death Study Group. Sudden infant death syndrome: risk factors for infants found face down differ from other SIDS cases. Journal of Pediatrics, 149, 630-633. doi:10.1016/j.jpeds.2006.07.041
[31] Persson, K. and Stromberg, B. (1995) Structured observation of motor performance (SOMP-I) applied to neonatally healthy fullterm infants at the ages of 0 - 10 months. Early Human Development, 40, 127-143. doi:10.1016/0378-3782(94)01598-J
[32] Ohman, A. and Beckung, E. (2008) Reference values for range of motion and muscle function in the neck—in infants. Pediatric Physical Therapy, 20, 53-58. doi:10.1097/PEP.0b013e31815ebb27
[33] Ohman, A., Nilsson, S. and Beckung, E. (2009) Validity and reliability of the Muscle Function Scale, aimed to assess the lateral flexors of the neck in infants. Physiotherapy: Theory and Practice, 25, 129-137. doi:10.1080/09593980802686904
[34] Loveday, B.P. and de Chalain, T.B. (2001) Active counterpositioning or orthotic device to treat positional plagiocephaly? Journal of Craniofacial Surgery, 12, 308- 313. doi:10.1097/00001665-200107000-00003
[35] Jonsell, R. (1999) Infants should sleep in supine position. The risk of skull deformities can be prevented. Lakartidningen, 96, 1404-1405.
[36] Cavalier, A., Picot, M.C., Artiaga, C., Mazurier, E., Amilhau, M.O., Froye, E., Captier, G. and Picaud, J.C. (2011) Prevention of deformational plagiocephaly in neonates. Early Human Development, 87, 537-543. doi:10.1016/j.earlhumdev.2011.04.007
[37] Knudsen, B., Christensen, K., Baagøe, S., Hoppe, P., Juhl, C., Buus, L. and Linding Jakobsen, T. (2011) Positional plagiocephaly in infants can be prevented. Ugeskrift for Laeger, 173, 644-648.
[38] American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome (2005) The changing concept of sudden infant death syndrome: Diagnostic coding shifts, controversies regarding the sleeping environment, and new variables to consider in reducing risk. Pediatrics, 116, 1245-1255. doi:10.1542/peds.2005-1499
[39] Nield, L.S., Brunner, M.D. and Kamat, D. (2007) The infant with a misshapen head. Pediatrics, 46, 292-298.
[40] Robertson, R. (2011) Supine infant positioning—Yes, but there’s more to it. The Journal of Family Practice, 60, 605-608.
[41] Miller, L.C., Johnson, A., Duggan, L. and Behm, M. (2011) Consequences of the “back to sleep” program in infants. Journal of Pediatric Nursing, 26, 364-368. doi:10.1016/j.pedn.2009.10.004

comments powered by Disqus

Copyright © 2014 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.