Tuesday, October 26, 2021

Infant plagiocephaly: everything new is well forgotten old.

There was a time when absolutely all babies used to sleep on their backs. Placing babies on their backs started most likely when people did not know how to write. It was a tradition. Why do traditions exist? Supposedly, only for one reason: to change them. Placing babies to sleep on the back did not escape the challenge of time, and several decades ago, someone brilliant decided that the best position for babies to sleep was on their bellies. That was a change, revolutionary in its courage and boldness. It was not as revolutionary as the polio vaccine, but something new challenged a tradition. Two generations of pediatricians knew only one infant sleeping position - on the belly. 


It turned out that our grandparents and great grandparents, and before them, Moses, Sarah, and Abraham were correct in placing their babies for sleep on the backs. Maybe they have known something we discovered only in the 1990s - belly sleeping was often responsible for sudden infant death. Thousands of infants died because the "progressive" doctors changed the old habit by placing babies to sleep on their bellies. However, following the discovery that sleeping on the backs was much safer, pediatricians started the "back to sleep" campaign, and in a mere decade, it almost succeeded. Nowadays, most nurses and doctors do their best to change the habits of their patient's parents, who inherited them from their parents. This change led to the rediscovery of a disease called "infant plagiocephaly."


Plagiocephaly is the flattening of the baby's naturally soft skull caused by the pressure of sleeping in one position combined with a low amount of vitamin D in the mother's diet during her pregnancy, making babies skull even more pliable. When babies slept on their bellies, their heads were randomly turned to one side, avoiding constant pressure on one side and an asymmetrical flattening of the face. Since the "back to sleep" campaign required placing babies on their backs, many babies developed flattened backs of their heads. 


This disease epidemic caused enormous alarm among pediatricians. A new industry arose to deal with it when companies began manufacturing infant helmets. Hundreds of scientific articles discussed the origin of this new disease and ways to treat it. Many doctors earned their professorship publishing them. Pediatric neurosurgeons developed surgical procedures for correcting anesthetically molded infant's skulls shapes. 


We could have avoided all of this if the same pediatricians had asked their grandmothers about plagiocephaly or read seemingly ancient textbooks of pediatrics written when their grandparents were young. They would have made an astonishing discovery that infant plagiocephaly is as old as the world. They would have learned that plagiocephaly was very common and did not alarm pediatricians back then because they knew that the head deformity would disappear once babies began to roll and sit. The pressure of the rapidly growing brain on still moldable skull bones would gradually make the head round again. And that using helmets is a waste of money because helmets work no better than time itself.