In 2011, I wrote a 2-part series for the Journal of Craniofacial Surgery in which I collated all of the previously reported risk factors and found that there are three major categories- congenital muscular torticollis, prematurity, and developmental delay. Each of these seemingly unrelated conditions share one common thread- they all act to limit the ability of a newborn to actively move their head during the first several months of life. Because flattening is primarily caused by an infant's inability to actively alter the area of contact between their head and the flat mattress, the acquisition of independent active head motion marks the end of further flattening. This is why common recommendations are head repositioning (alter the area of head-bed contact) and physical therapy (stretch the neck and improve head-neck mobility). Torticollis is the biggest risk factor and develops in utero due to positioning and fetal constraint. Its earliest and most consistent manifestation is a strong and persistent head rotation preference. The other two factors are much less common but act to slow the acquisition of motor control and, ultimately, active head motion. The table above is from the 2011 article and summarizes all of the known risk factors for head flattening and groups them into these three major categories. The full article is accessible as a download in the link.
Commenti