Prevention and management of positional skull deformities in infants

James Laughlin, Thomas G. Luerssen, Mark S. Dias, Lawrence Hammer, Oscar Brown, Edward Curry, Herschel Lessin, Chadwick Rodgers, Geoffrey Simon, Xylina Bean, Joseph Piatt, Philipp Aldana, John Ragheb, Michael Partington, David Gruber

Research output: Contribution to journalArticlepeer-review

97 Scopus citations


Positional skull deformities may be present at birth or may develop during the first few months of life. Since the early 1990s, US pediatricians have seen an increase in the number of children with cranial asymmetry, particularly unilateral flattening of the occiput, likely attributable to parents following the American Academy of Pediatrics "Back to Sleep" positioning recommendations aimed at decreasing the risk of sudden infant death syndrome. Positional skull deformities are generally benign, reversible head-shape anomalies that do not require surgical intervention, as opposed to craniosynostosis, which can result in neurologic damage and progressive craniofacial distortion. Although associated with some risk of positional skull deformity, healthy young infants should be placed down for sleep on their backs. The practice of putting infants to sleep on their backs has been associated with a drastic decrease in the incidence of sudden infant death syndrome. Pediatricians need to be able to properly differentiate infants with benign skull deformities from those with craniosynostosis, educate parents on methods of proactively decreasing the likelihood of the development of occipital flattening, initiate appropriate management, and make referrals when necessary. This report provides guidance for the prevention, diagnosis, and management of positional skull deformity in an otherwise normal infant without evidence of associated anomalies, syndromes, or spinal disease.

Original languageEnglish (US)
Pages (from-to)1236-1241
Number of pages6
Issue number6
StatePublished - Dec 2011
Externally publishedYes


  • Back to sleep
  • Cranial asymmetry
  • Infant
  • Positional skull deformity
  • SIDS
  • Sleep positioning
  • Tummy time

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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