A randomized controlled trial of positioning treatments in infants with positional head shape deformities

Abstract

Background: Randomized controlled trials of treatment for deformational plagiocephaly and brachycephaly have been lacking in the literature.

Methods: Infants (n = 126) presenting to a plagiocephaly clinic were randomized to either positioning strategies or to positioning plus the use of a Safe T Sleep™ positioning wrap. Head shape was measured using a digital photographic technique, and neck function was assessed. They were followed up at home 3, 6 and 12 months later.

Results: There was no difference in head shape outcomes for the two treatment groups after 12 months of follow-up, with 42% of infants having head shapes in the normal range by that time. Eighty per cent of children showed good improvement. Those that had poor improvement were more likely to have both plagiocephaly and brachycephaly and to have presented later to clinic.

Conclusions: Most infants improved over the 12-month study period, although the use of a sleep positioning wrap did not increase the rate of improvement.