11/04/2022
Positional molding (plagiocephaly and brachycephaly) is quite common being encountered in roughly 30% of infants in the United States. While certainly concerning to parents and even distressing in some instances it is a Cosmetic issue and does not affect brain development.
Treatment early on primarily consists of recognition of the condition, repositioning therapies and the use of tummy time. Physical therapy may also be prescribed in severe cases and/or for those children also with torticolis (a tight neck).
Helmets are a form of treatment that is typically reserved for severe cases where repositioning, tummy time and physical therapy have failed to correct the head shape. Helmeting is not started before 6-7 months of age in most cases as many cases will resolve without the need for a helmet.
There has been an increasing interest in the use of positioning pillows which can be purchased from many sources without a prescription. These pillows have been historically recommended against by the American Association of Pediatrics as well as the AANS/CNS Joint Section on Pediatric Neurosurgery. Recently, the FDA came out with a strong statement supporting this stance and have recommended against the use of positioning pillows:
https://www.fda.gov/medical-devices/safety-communications/do-not-use-infant-head-shaping-pillows-prevent-or-treat-any-medical-condition-fda-safety
If you are worried about your child’s head shape, please discuss your concerns with your child’s pediatrician and consider evaluation by an expert (Pediatric Neurosurgeon).
The FDA recommends that parents, caregivers, and health care providers not to use infant head shaping pillows to prevent or treat any medical condition.
