Neuroprotective Core Measure 3: Positioning &amp; Handling — A Look at Preventing Positional Plagiocephaly

Danner-Bowman, Kesia; Cardin, Ashlea D.

doi:10.1053/j.nainr.2015.06.009

Cited by 6 publications

(6 citation statements)

References 12 publications

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“…Previous studies have shown the capability of NUs to reduce the prevalence of PHDs through a variety of methods, such as positioning and environmental changes, or through cranial devices. 13,[22][23][24] Despite this, there are currently no national guidelines focused specifically on PHD prevention or management, with the frameworks previously mentioned focused more on mimicking the womb environment. Recent national benchmarking activities with physiotherapists from other NUs within Australia, revealed that PHD prevention and management were not generally key priorities within their workplaces, and none were aware of the current prevalence within their units.…”

Section: Discussionmentioning

confidence: 99%

“…8,12 In fact, some PHDs may be avoidable altogether with strong positioning programmes and, when detected early, may be corrected with simple low-cost strategies. A study from Danner-Bowman & Cardin 13 demonstrated that the implementation of positioning guidelines (e.g. regular re-positioning, undertaking cares from both sides of the cot, supervised prone 'tummy' time) in a Neonatal Intensive Care Unit reduced both the number of babies discharged with a PHD, as well as the severity of the PHD.…”

Section: What This Paper Addsmentioning

confidence: 99%

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Period prevalence of positional head deformations and implications for practice in a large tertiary neonatal unit

Hepnar,

Ngenda,

Cottrell

et al. 2023

J Paediatrics Child Health

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AimTo establish the prevalence of positional head deformations (PHDs) within a neonatal unit (NU) setting, and to evaluate the subsequent impact that PHDs have on NU graduates and their families.MethodsA prospective audit was conducted over a six‐week period within a tertiary NU (Brisbane, Australia). Eligible babies were measured weekly using a craniometer where presence, type and severity of PHD were determined. Univariate analysis was undertaken to establish differences in clinical characteristics between babies with, and without, the presence of PHD.A study‐specific survey was completed by a separate set of families returning for outpatient follow‐up services who represented similar clinical characteristics and risk factors for PHD.ResultsFifty‐three babies were eligible for inclusion in the audit. PHDs were identified in 66% (n = 35) of the cohort, the most common being scaphocephaly (52.8%, n = 28). Within that, 46% (n = 13) were classed as mild, 25% (n = 7) were moderate and 29% (n = 8) were severe. Moderate correlation (r = 0.55) was found between severity of scaphocephaly, and length of time spent in an isolette. Of the 10 (66% response from 15 families) surveys completed, 80% of respondents perceived that their child's PHD had impacted their life.ConclusionsTwo‐thirds of babies developed a PHD during their neonatal admission. Most families surveyed perceived this condition to have an impact on their lives beyond the confines of the nursery. Further research is needed to identify preventative interventions to decrease the prevalence and severity of this common condition.

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Section: Discussionmentioning

confidence: 99%

Section: What This Paper Addsmentioning

confidence: 99%

Period prevalence of positional head deformations and implications for practice in a large tertiary neonatal unit

Hepnar,

Ngenda,

Cottrell

et al. 2023

J Paediatrics Child Health

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“…PHD is a common problem in the first six months of life and is present in 20–46% of live births [ 3 ]. The earlier the discovery of PHD, the better is the effect of the intervention and the lower is its cost [ 4 ]. After six months of age, the growth rate of the infant’s skull decreases, while the hardness of the skull and the free movement of the head increases; therefore, PHD generally does not continue to progress; however, treatment difficulty also increases compared to that before six months of age [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of cranial type characteristics in term infants: a multi-center study

Wang

Chen

et al. 2021

BMC Pediatr

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Background Positional head deformity (PHD) is defined as a change in the shape of an infant’s skull due to an external force. In certain cases, it can lead to cosmetic deformities or even neurological issues due to its impact on the developing nervous system. Therefore, we conducted this study to investigate the incidence and characteristics of PHD in term infants in China and preliminarily establish a localized diagnostic reference standard. Methods Overall, 4456 term infants from three medical institutions in Chongqing were and divided and analyzed according to their age. Cranial vault asymmetry (CVA) and cephalic index (CI) were calculated in all infants. The current international diagnostic criteria were used to understand PHD incidence and analyze the CVA and CI distribution. Results According to the current international standards, the total detection rate of PHD in Chongqing’s term infants was 81.5%, with brachycephaly alone being the most frequent (39.4%), followed by brachycephaly with plagiocephaly (34.8%) and plagiocephaly alone (6.2%). The detection rates of dolichocephaly were low: alone, 0.9% and combined with plagiocephaly, 0.2%. According to age, plagiocephaly (44.5%) and brachycephaly (82.0%) were the most frequent in the 2-3-month group. The 75th/90th/97th and 3rd/10th/25th/75th/90th/97th percentiles of CVA and CIs were 0.4/0.7/1.0 and 76.4/78.8/82.3/91.1/94.6/99.2%, respectively. Conclusions According to the current international standards, the PHD detection rate among term infants in Chongqing was high. Therefore, a new diagnostic standard for Chinese infants was proposed where CVA ≥ 0.4 cm indicates plagiocephaly, CI ≥ 91% indicates brachycephaly, and CI ≤ 82% indicates dolichocephaly.

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“…The earlier the discovery of PHD, the better the effect of the intervention and the lower the cost. Especially in the PHD of 3-month-olds, the best correction effect can be achieved simply by adjusting the sleeping posture (4). After 6 months of age, the growth rate of the baby's skull decreases, the hardness of the skull and the free movement of the head increases; therefore, PHD generally does not continue to progress; however, treatment di culty also greatly increases compared to that before 6 months of age (5).…”

Section: Introductionmentioning

confidence: 99%

Analysis of Cranial Type Characteristics in Term Infants: A Multi-center Study

Wang¹,

Hu²,

Chen

et al. 2020

Preprint

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Background: Positional head deformity (PHD) is defined as a change in the shape of a baby's skull due to external force. In certain cases, it can lead to cosmetic deformities or even neurological issues due to its impact on the developing nervous system. We therefore conducted this study to investigate the incidence and characteristics of PHD in term infants in China and preliminarily establish a localized diagnostic reference standard. Methods: Overall, 4456 term infants from three medical institutions in Chongqing were recruited and divided according to age groups. Cranial vault asymmetry (CVA) and cephalic index (CI) were calculated in all infants. The current international diagnostic criteria were used to understand PHD incidence and analyze their CVA and CI distribution. Results: According to the current international standards, the total detection rate of PHD in Chongqing’s term infants was 81.5%, with brachycephaly alone being the most frequent (39.4%), followed by brachycephaly with plagiocephaly (34.8%), and plagiocephaly alone (6.2%). The detection rates of dolichocephaly were low: alone, 0.9% and combined with plagiocephaly, 0.2%. According to age, plagiocephaly (44.5%) and brachycephaly (82.0%) were most frequent in the 2-3-month group. The 75th/90th/97th percentiles and 3rd/10th/25th/75th/90th/97th percentiles of CVA and CIs were 0.4/0.7/1.0 and 76.4/78.8/82.3/91.1/94.6/99.2%, respectively. Conclusion: According to the current international standards, the PHD detection rate among term infants in Chongqing was high. Therefore, a new diagnostic standard for Chinese infants was proposed. CVA ≥0.4 cm indicates plagiocephaly. CI ≥91% indicates brachycephaly. CI ≤82% indicates dolichocephaly.

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Neuroprotective Core Measure 3: Positioning & Handling — A Look at Preventing Positional Plagiocephaly

Cited by 6 publications

References 12 publications

Period prevalence of positional head deformations and implications for practice in a large tertiary neonatal unit

Period prevalence of positional head deformations and implications for practice in a large tertiary neonatal unit

Analysis of cranial type characteristics in term infants: a multi-center study

Analysis of Cranial Type Characteristics in Term Infants: A Multi-center Study

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