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The AAP now recommends frequent rotation of a child’s head, as well as supervised tummy time. By 1996, several studies documented the relationship between back sleeping and plagiocephaly.

After the American Academy of Pediatrics (AAP) 1992 recommendation to have infants sleep only on their backs to reduce the risk of SIDS, craniofacial centers began to see a dramatic increase in plagiocephaly. Prior to 1992, the risk factors associated with plagiocephaly were considered to be a restrictive uterine environment and congenital muscular torticollis. This can result in a long and narrow head shape. Preemies will often spend extended time in the Neonatal Intensive Care Unit (NICU) on a respirator with the head in a fixed position. Premature infants are also more likely to be physically delayed, preventing normal movement of the head. Premature delivery makes the already soft cranium susceptible to molding forces. Torticollis may be obvious or subtle.įirmness of infant cranial bones increases nearly 5-10 fold during the last ten weeks of pregnancy. This can result in plagiocephaly as the tightness causes the head to be held in a single position. In CMT, one or more of the neck muscles develops a tightness, causing the head to tilt and/or turn. Congenital Muscular Torticollis (Wryneck):.A breech orientation can lead to an abnormal head shape when the infant’s head becomes wedged under the mother’s ribs. The constraint may be caused by several sources: multiple births (twins or triplets), small pelvis, small or abnormal formed uterus or if there is a lack of amniotic fluid. In this case, the infant does not have room to move or becomes stuck in one position. One of the leading risk factors in the development of plagiocephaly is a restrictive intrauterine environment. To see facial asymmetry, hold a child up to a mirror. Gently placing your fingers in the child’s ears will help you “feel” the ear shift. To evaluate your infant’s head shape, view the head from various angles: from the top, the sides, the back and face-on. The head shape is either too flat (brachycephaly), too narrow (scaphycephaly) or too asymmetric (plagiocephaly).