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Objectives: Medical dictionaries and anthropologic sources de-fine brachycephaly as a cranial index (CI = width divided by length ×100%) greater than 81%.We examine the impact of supine sleeping on CI and compare orthotic treatment with repositioning.Study design: We compared the effect of repositioning versus helmet therapy on CI in 193 infants referred for abnormal head shape.Results: Eighty percent of the infants had a pretreatment CI >81%.Their initialmean CI atmean age 5.3 months was 89%, and after treatment, their mean CI was 87%(±2 SE = 0.9%) at mean age 9.0 months.For 92 infants with an initial CI at or above 90%, their initial mean CI of 96.1%was reduced to a mean of 91.9%.Conclusions: Post-treatment CI was 86%to 88%, CI in neonates delivered by cesarean section was 80%, and CI in supine-sleeping Asian children was 85%to 91%, versus 78%to 83%for prone-sleeping American children.Repositioning was less effective than cranial orthotic therapy in correcting severe brachycephaly.We recommend varying the head position when putting infants to sleep.
Objectives: Medical dictionaries and anthropologic sources de-fine brachycephaly as a cranial index (CI = width divided by length × 100%) greater than 81% .We examine the impact of supine sleeping on CI and compare orthotic treatment with repositioning. Study design: We compared the effect of repositioning versus helmet therapy on CI in 193 infants referred to for abnormal head shape. Results: Eighty percent of the infants had a pretreatment CI> 81%. Their initialmean CI atmean age 5.3 months was 89%, and after treatment, Their mean CI was 96.1% was reduced to a mean of 91.9%. Their mean CI was 87% (± 2 SE = 0.9%) at mean age 9.0 months. For 92 infants with an initial CI at or above 90% : Post-treatment CI was 86% to 88%, CI in neonates delivered by cesarean section was 80%, and CI in supine-sleeping Asian children was 85% to 91%, versus 78% to 83% for prone-sleeping American children .Repositioning less effective than cranial orthotic therapy in correcting severe brachycephaly. We recommend varying the head position when putting infants to sleep.