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One less thing to worry about for infants with flat heads

September 24, 2009 |  4:01 am

The “Back to Sleep” campaign is credited with averting more than 2,000 cases of sudden infant death syndrome each year. But placing infants on their backs instead of their stomachs has caused the rate of deformational plagiocephaly to surge.


At Wake Forest University Medical Center’s North Carolina Institute for Cleft and Craniofacial Deformities, the increase has been “exponential,” according to staffers there. The number of infants who come to the clinic to be treated for deformational plagiocephaly – a fancy way of saying a flat or misshapen head – has grown to 2,000 per year.

The condition isn’t merely cosmetic. Babies can wind up with eyes, ears or teeth that are out of alignment; temporomandibular joint problems; delays in psychological and motor development; and ear infections.

Researchers at the North Carolina clinic wanted to determine whether a diagnosis of deformational plagiocephaly was associated with an increased risk for ear infections. The smushing of the malleable infant skull can shift and shorten the eustachian tube, which links the middle ear to the nasopharynx. If the tube is unable to drain mucus from the middle ear, bacteria can build up and cause ear infections.

The researchers included 1,112 patients who were treated at the clinic over a two-year period. The average age of babies on their first visit was 5.6 months, and most were treated with band helmets.

Overall, 559 patients – or 50.3% – had an ear infection by their first birthday, according to results published today in the Journal of Craniofacial Surgery. That’s about the same as for infants in general, according to data from the Centers for Disease Control and Prevention.

The researchers found that cases were more likely in babies with more severe deformation. For children with an “initial craniofacial asymmetry severity level” of 1 to 3 on a 5-point scale, 48.8% had at least one ear infection. For children with a severity score of 4 or 5, the incidence rose to 53.9%, according to the study. But the difference between the groups wasn’t statistically significant.

Overall, it would seem that parents coping with a diagnosis of deformational plagiocephaly could breathe a sigh of relief, safe in the knowledge that they need not worry about an increased risk of ear infections as well. But the researchers concluded that the loose correlation between degree of deformity and the rate of ear infections be investigated in future studies.

-- Karen Kaplan

Photo: This baby with deformational plagiocephaly isn't necessarily at increased risk for an ear infection. Credit: Cranial Technologies Inc. / Associated Press