Since the start of the "Back to Sleep" campaign, many physicians have begun to notice a sharp rise in the number of babies diagnosed with positional plagiocephaly -- a reshaping of the skull that can result when an infant spends too much time in the same position.
"Many families have the crib up against one wall, and the child goes to sleep always looking in the same direction," says John Graham, M.D., director of clinical genetics and dysmorphology at Cedars-Sinai Medical Center in Los Angeles. "Soon, he can start to develop a flat spot on the back side of his head."
Plagiocephaly is often associated with a shortening of the neck muscles on one side (torticollis), which causes the baby's head to tilt and turn, making it difficult for him to try new positions. Though it's a fairly benign condition, plagiocephaly can lead to distortion of the face and skull, which can only be corrected with surgery if left untreated. But if caught before 4 months, when the head bones begin to fuse, the condition is often easily managed. What to do:
MAKE A POSITIVE I.D. When the baby is about two months old, look at his head from the top, says Dr. Graham. If you see a flat spot developing in the back on one side, consult your pediatrician.
TURN HIS OTHER CHEEK Once plagiocephaly is identified, your doctor will probably ask you to encourage Baby to rest on the opposite back side of his head. How? Try moving the crib around the room. If he usually turns his head to the right, put the most interesting objects on the left so he'll want to turn his head. You can also use a wedge-shaped infant sleep positioner to vary the placement of his head.
STRETCH HIM OUTWhile your baby is on his back, place one hand on his shoulder and the other on the side of his head. While he's looking forward, gently press down toward the opposite shoulder (check with your M.D. first). Hold as long as the baby will tolerate (it may be uncomfortable), working up to one minute. Repeat on the other side. Next, turn Baby's head so his chin is over his shoulder and he's looking to the side. Hold and repeat.
DON'T FORGET TUMMY TIME The importance of putting babies to sleep on their backs cannot be overemphasized, says John Kattwinkel, M.D., chair of the American Academy of Pediatrics' Task Force on Infant Sleep Position. But when they are awake and observed, babies need "tummy time" to develop motor skills, he says.
If, by four months of age, there isn't significant improvement, your M.D. may suggest that you consult a craniofacial clinic, which can fit babies with an orthotic helmet to help remold their skulls. To locate one, contact the American Cleft Palate and Craniofacial Association.