Slightly flat-headed babies are a small price to pay for the 55
percent drop in Sudden Infant Death Syndrome since 1992, when the
American Academy of Pediatrics first recommended that babies be put
to sleep on their backs.
The recommendation, followed by the ‘‘Back to Sleep’’ campaign
that added warnings against soft mattresses, pillows, quilts,
comforters, sheepskins and fluffy crib bumpers, sleeping in the
same bed with parents or an older sibling and overheating, is
credited with saving thousands of babies from SIDS, the sudden,
unexplained death of a healthy infant.
We still don’t know what causes SIDS, but breathing carbon
dioxide back in after expelling breath into a pillow or blanket is
partly to blame, and every couple of years, the pediatricians
update their position statement on SIDS to re-emphasize the
importance of laying babies on their backs for every sleep period,
including naps.
Just last month, in updating a position statement on SIDS, the
AAP stressed that side-sleeping is not good enough, since it is
unstable and increases the chances of infants rolling onto their
stomachs while sleeping, and they added the recommendation that
babies be given pacifiers at nap time and bedtime throughout the
first year of life.
The only drawback to all this emphasis on the supine sleep
position is some flattening of the head, called ‘‘positional
plagiocephaly,’’ and a slight delay in the development of neck and
shoulder muscles because the baby is not as apt to push up and look
around when she first wakes up. Both can usually be remedied by
repositioning therapy that involves turning the baby’s head from
one side to the other during sleep so that she does not always rest
on the flat spot, changing visual stimuli so the baby isn’t always
looking in the same direction when she is awake and tummy time
whenever the baby’s not sleepy, says Dr. John Honeycutt, a
pediatric neurosurgeon at Cook Children’s Hospital.
‘‘Starting in 1992, we saw a huge increase in plagiocephaly and
a big decrease in SIDS,’’ Honeycutt said when he spoke recently at
Cook Children’s. The presentation was to help pediatricians and
family doctors distinguish between cosmetic problems caused by
external pressure on the head and true malformation of the
skull.
