What is flat head syndrome?

What is flat head syndrome?. The ‘Back to Sleep’ campaign, begun in the early Nineties, has been credited with reducing cot deaths by a huge number. However, it has led to a rather bizarre, non-harmful side effect in some babies. Grainne Rothery reports.

One notable side effect of the highly successful ‘Back to Sleep’ campaign – which recommends that parents lie their babies on their backs to sleep in order to reduce the risk of cot death – has been an increase in the incidence of positional plagio­cephaly, or flat head syndrome.

The condition – where the back or side of the baby’s head appears to be flattened – is caused by the baby resting its head for long periods against flat surfaces, including cot mattresses. Because babies’ skulls are made up of several different plates that are not yet cemented together, they are much more susceptible to external pressures and are therefore prone to the condition.

As far as the medical profession is concerned, flat head syndrome is primarily cosmetic and almost alw­ays a temporary problem that will sort itself out. The overriding advice is that babies should always be put sleeping on their backs and that the reduced risk of cot death is far more important than the cosmetic problem of flat head syndrome. However, parents are advised to consult a doctor for diagnosis and advice.

In general, the problem can be easily prevented and treated by putting babies on their tummies for short periods when they are being supervised, says Dr John Murphy, consultant paediatrician at Holles Street. “Plagiocephaly is very much predicated on the back­to-sleep position,” he explains. “One thing that perhaps hasn’t been emphasised enough is giving the babies tummy time.

“Tummy time really means to lie the baby on his tummy for a few minutes under supervision when he’s being changed or fed and is wide awake,” he says.

“That tends to strengthen the neck muscles and I think would help prevent many of the cases. There’s now good evidence to show that this is helpful.”

Other tips for helping to correct the problem, accord­ing to Murphy, include feeding the baby on the oppo­site arm to encourage him to turn away from the flat­tened side. “And you can talk a bit more from that side and make things a bit more interesting on the side you want to get him to turn to,” he adds. “That increases the rotation of the neck.”

While treatment for the condition is also available with specially customised orthotic helmets – usually costing several thousand euro and worn by the baby for 23 hours a day – doctors are sceptical.

“It’s not really a medical intervention and most doc­tors wouldn’t recommend them,” says Murphy. “Hel­mets may restrict the head and body movements of a baby and that would be a cause of concern. The whole business of being ‘back to sleep’ is that the baby is in a position where he’s unrestricted and not likely to get into difficulty.”

Elsewhere, Irish brand Clevamama’s memory-foam pillow is being marketed as a way of helping to sig­nificantly reduce flat head syndrome: tests carried out at Trinity College Dublin’s Centre for Bioengineering found that the pillow can reduce pressure on the baby’s skull by almost 50pc, while allowing the baby’s head to rest in a position that does not restrict the airways.

Clevamama developed the memory foam especially for babies as it is lighter and more breathable than the standard version but offers the same benefits, says Martina Delaney, founder of Handybaby.com, which sells the Clevamama range.

If you would like to find out more about the memory-foam pillow, go to www.handybaby.com.

Tips for avoiding and treating flat head syndrome

Place your baby on his tummy to play
Change the position of the baby’s cot or alternate which end of the cot you place him in
Place toys, mobiles or a light on the side you
want your baby to turn towards
Switch the side you hold your baby for feeding
Where possible, carry your baby or use a sling rather than a buggy.
Back to sleep

In its fact sheet on positional plagiocephaly, the Rotunda Hospital says that the incidence of cot death has fallen by almost 40pc since the Back to Sleep campaign was introduced in the early Nineties. In the UK, meanwhile, the campaign – which was fronted by Anne Diamond, and which also recommended not smoking anywhere near babies, not overheating them, and going to the doctor if they have coughs or colds – resulted in the number of cot deaths dropping from 2,500 to 300 a year.( @ Independent News )