Infant Head Deformaties

Parents beware. For years moms and dads have been told to put their babies on their backs in their cribs to avoid sudden infant death syndrome. But now we are learning of some frightening side effects of doing just that.

Before little Paul Toner was old enough to wear his bicycle helmet, he donned a helmet of a different sort. First his parents noticed a small bump on Paul’s forehead when he was three months old, first on the front, then on the back.

The back of his head was sheared, it was flat; his head was resting on the pelvic bone. From birth it exaggerated, as he slept on his back, and he would always go to the flat spot because it was comfortable.

It's called deformational plagiocephaly, a fancy term for a misshapen head usually caused by infants' heads resting on the same spot. All the Toners were doing was following their pediatrician's instructions to lie Paul on his back when he slept, a very common practice that the American Academy of Pediatrics started recommending in 1992 to decrease the incidence of sudden infant death syndrome, or SIDS.

Babies have an enormous head per unit volume in size compared to us; they're not able to get their head and turn, lift their head out of the mattress. So they are probably suffocating in SIDS. And that's the theory behind it.

And the academy's recommendations have worked. National SIDS rates have gone down by more than forty percent, while positional head deformities went up, from one in 400 to one in 60.

For babies whose heads are misshapen from their sleeping position, the treatment is purely cosmetic. The greatest risk if not corrected by 24 to 28 months when the skull permanently fuses in place: the child's head may look somewhat asymmetrical.

After that point, changing the shape of the head generally requires surgery. If noticed early on, parents can often correct the problem by alternating the position of the child's head during sleep, which in most cases helps the head eventually round out to a normal appearance.

But the Toners were not willing to take the risk. Paul had two different helmets over the course of his treatment to accommodate his growing head, each costing $800, and they had to go back every three weeks to have the helmet adjusted.

As it stands now, some, but not all insurance companies, cover the costs of this kind of treatment.

Now at four and a half, Paul has no sign of his formerly flattened head and no recollection of his helmet-wearing days.