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What is "repositioning"?
"Techniques to encourage
your child to alter the resting position of his/her head."
Why is "repositioning"
important?
"Careful attention to
repositioning while your child is awake can prevent or reduce
positional cranial deformities."
From the American Academy of Pediatrics:
"To prevent the [deformational plagiocephaly],
parents should be counseled during the newborn period (by 2 to 4
weeks of age) when the skull is maximally deformable. Parents
should be instructed to lay the infant down to sleep in the
supine position, alternating positions (i.e., left and right
occiputs). When awake and being observed, the infant should
spend time in the prone position. The infant should spend
minimal time in car seats (when not a passenger in a vehicle) or
other seating that maintains supine positioning....
Once deformational plagiocephaly is
diagnosed, parents should be made aware of the condition and the
mechanical adjustments that can be instituted. In general, most
infants improve if the appropriate measures are conducted for a
2- to 3-month period. These include positioning the infant so
that the rounded side of the head is placed dependent against
the mattress.
Additionally, the position of the crib in
the room may be changed to require the child to look away from
the flattened side to see the parents and others in his or her
room..."
Source: Persing J, James H, Swanson J,
Kattwinkel J. Prevention and management of positional skull
deformities in infants. American Academy of Pediatrics
Committee on Practice and Ambulatory Medicine, Section on
Plastic Surgery and Section on Neurological Surgery. Pediatrics
2003 Jul;112(1 Pt 1):199-202.
Key points:
- Infants should always be placed on their
backs to sleep. However to avoid positional plagiocephaly:
- change the child's sleeping position by placing
the child's head at opposite ends of the crib on alternate
nights
- turn the crib around every few days --
babies will turn their head away from the wall
- change the position of toys (for mobiles)
and other objects to encourage head movement
- Include supervised "tummy
time" in your child's day. In addition
to removing pressure on the back/side of the head, playing on
his/her tummy is good for development.
- Alternate the arm in which the infant is
held for bottle and/or breast feeding.
- During diaper changes, alternate the side
from which you approach the infants. This will encourage the
child to turn his/her head to look at the caregiver.
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