Positional plagiocephaly: pathogenesis, diagnosis, and management.

Positional plagiocephaly is a deformation resulting from intrauterine constraint or postnatal positioning leading to asymmetrical cranial growth. There has been a steady increase in referrals for positional plagiocephaly following the release of the American Academy of Pediatrics recommendation of supine infant sleeping position to prevent Sudden Infant Death Syndrome (SIDS) in 1992, largely because of poor parent education on the risks of prolonged occipital pressures. While this deformity is fairly easy to manage when diagnosed early, treatment can become more difficult and complicated with prolonged course. Because of this, it is essential that primary care physicians and parents be educated on recognition of positional plagiocephaly, prevention strategies, and treatment options. In milder cases, where diagnosis is made early, the deformation can be managed by stretching exercises and regular prone positioning, while in more severe cases molding helmets may be needed. Following appropriate treatment, success rates for acceptable cranial shape may be as high as 92%.