Positional Plagiocephaly

To: The American Academy of Pediatrics Task Force on Infant Positioning and
SIDS

John Kattwinkel, MD, Chairperson
John G. Brooks, MD
Maurice E. Keenan, MD
Michael Malloy, MD

And

To: The American Board of Pediatrics,

Prior to the 1992 Implementation of the Back to Sleep Campaign, it was estimated that 1 in 300 babies had varying degrees of cranial asymmetry {abnormal head shape}. As of today, it is estimated that 1 in 60 babies have a cephalic disorder, known as Positional Plagiocephaly. The numbers are increasing in epidemic proportions globally. We respect the American Academy of Pediatrics commitment towards the quality of health for our children. However, we as parents feel the Task Force on Infant Positioning and SIDS has not fulfilled its duties with educating the public or the medical establishment on the complexities of this campaign.

The American Academy of Pediatrics' stand has been a supine sleeping position to reduce the risk of Sudden Infant Death Syndrome. The AAP has only recently released a statement of the importance of "tummy time." The recommendations in this statement do not indicate an effective course of treatment - or serve as standard medical care - for Deformational or Positional Plagiocephaly.

Deformational and Positional Plagiocephaly is characterized as follows:

PLAGIOCEPHALY- significant flattening of the right or left skull, typically accompanied by ear misalignment and facial asymmetry

SCAPHOCEPHALY - Long and narrow head shape

BRACHYCEPHALY - shortening of the head due to flatness,increased head height, often accompanied by an under bite.


Suggested Manifestations of Cranial Asymmetry are as follows:

torticollis- Face turns to the right or left with a head tilt
Misaligned ears,
Nose pushed to one side,
Unilateral cheek prominence,
Bossing of the forehead,
One eye appearing larger than the other.

Head shape abnormalities are believed to cause:

Migraines,
Temporomandibular Joint {TMJ} Syndrome,
Eyesight problems, and
Severe Psychological Consequences

We as parents will continue to place our children in a supine sleeping position. We are asking the American Academy of Pediatrics to implement a policy requiring our children's doctors to carefully evaluate every child at birth for cranial abnormalities, and follow up at every well-baby checkup thereafter. We are asking the American Board of Pediatrics to offer various options for treatment when these abnormalities are present.

The phrase, "It will round out, is simply not true in most cases. Aggressive repositioning is not always successful. We as parents would like to be given a referral to an educated specialist, in a timely manner. The ideal timeframe for maximum correction is between 3 and 6 months. We as parents do not want babies with perfectly round heads. What we expect is recognition and response to the rise of documented disorders related to the Back to Sleep campaign.

Sincerely,

The Undersigned