Thirteen years ago, the NICHD (National Institute of Child Health and Human Development) in conjunction with the AAP (American Academy of Pediatrics), SIDS Alliance, and the Association of SIDS and Infant Mortality Programs launched the â€œBack to Sleepâ€ program. In its thirteen years, SIDS related deaths have decreased by more than 50%. This is a remarkable success rate.
In 1990 the SIDS related death rate per 1000 live births was 1.30. One year after the launch of â€œBack to Sleepâ€ 1994, the rate was 1.17; by 2002 the rate was 0.56. While SIDS continues to affect 0.7 in 1000 live births/year, it is clear that the â€œBack to Sleepâ€ campaign is a success.
As with any action there is an equal and opposite reaction, Positional Plagiocephaly, commonly known as Infant Flathead Syndrome (IFS). IFS affects 1 in 8 infants, or 125/1000 infants. This occurrence has in recent years caused great alarm in the Pediatric community as well as great concern to new parents.
IFS is largely caused by an infant sleeping in a single position during the first four months when its head is still soft and forming. After four months, an infants neck muscles are generally strong enough for self repositioning, greatly reducing the need for manual repositioning. IFS can also be caused by, although, much rarer situations, congenital torticollis or craniostenosis. Congenital torticollis, or wry neck, is a condition in which the head is tilted toward one side, and the chin is elevated and turned toward the opposite side. Craniostenosis is the skull deformity caused by the premature closure of the cranial sutures.
IFS usually dissapears on its own several months after a baby begins to sit up. However, some parents and pediatricians are opting for helmets much earlier. Helmets are worn 23 hours a day and reshape the heads by repositioning custom inserts in the helmets. These helmets generally cost $3,000.00 each and usually are not covered by insurance. Why take this action when nature will in most cases correct this. According to â€œPediatrics,â€, Vol 105, No. 2 February 2000, â€œLong-Term Developmental Outcomes in Patients With Deformational Plagiocephalyâ€, â€œConclusions. Infants with deformational plagiocephaly comprise a high-risk group for developmental difficulties presenting as subtle problems of cerebral dysfunction during the school-age years. There is a need for additional research on the long-term development problems in infants with deformational plagiocephalyâ€. Other risk factors are permanent cranial deformation, mandibular and maxillary deformation, facial deformation. These conditions usually are evident only after 12 months in which case mechanical means (helmets) do not work.
IFS can usually be prevented by following some very simple guidelines. Birth â€“ 6 months. Manually reposition infants head approxiamately every two hours infant is sleeping or in down position prior to infants neck strong enough to move on its own (generally four months). AAP reccomends placing infants on their stomach when they are AWAKE AND SUPERVISED . Some activist group are trying to launch a campaign of â€œStomach to Play and Back to Sleepâ€. There is one FDA approved device that is available to help, it is called NightFormâ„¢. While there are ten basic positions to choose from, a infant may prefer only one or two to fall asleep in. This is ok, after the infant has fallen asleep, you may reposition the sleeping infant and track the positional change on a chart. Manual repositioning is generally only needed for the first six months. After which sleeping habits, and neck strenghtening are enough to allow the head to form naturally.
If you suspect your infant, or one you know, may be affected, research this subject using the key phrases and websites provided as well as asking their pediatrician how they can prevent this.
Web Sites: WebMD, NightForm, Pediatrics, pedns.wustl.edu, SIDS.org, nichd.nih.org
Keywords/Phrases: SIDS, Back to Sleep infant program, Positional Plagiocephaly, torticollis, craniostenosis, wry neck.
Copyright © 2010 John Wolf
"Back to Sleep", Combating SIDS
Copyright © 2010 John Wolf
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