Evidence-Based Care of the Child With Deformational Plagiocephaly, Part II: Management

Abstract Non-synostotic deformational plagiocephaly (DP) is a common condition that affects as many as one in five infants in the first 2 months of life. The purpose of this article, the second in a two-part series, is to present a synthesis of the evidence related to management of deformational pla...

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Bibliographic Details
Published in:Journal of pediatric health care 2012-09, Vol.26 (5), p.320-331
Main Authors: Flannery, Amanda B. Kack, MS, RN, CNP, Looman, Wendy S., PhD, RN, CNP, Kemper, Kristin, MS, RN, CNP
Format: Article
Language:English
Subjects:
Advanced Practice Nursing
cranial asymmetry
Deformational plagiocephaly
Evidence-Based Medicine
evidence-based practice
Female
Head Protective Devices - utilization
Humans
Infant
infant care
Infant, Newborn
Interdisciplinary Communication
Male
Nursing
Parents
Patient Care Team
Patient Education as Topic
Pediatrics
Physical Therapy Modalities
Plagiocephaly, Nonsynostotic - diagnosis
Plagiocephaly, Nonsynostotic - therapy
Primary Health Care
Sleep
Supine Position
Time Factors
Torticollis - diagnosis
Torticollis - therapy
Treatment Outcome
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Summary:Abstract Non-synostotic deformational plagiocephaly (DP) is a common condition that affects as many as one in five infants in the first 2 months of life. The purpose of this article, the second in a two-part series, is to present a synthesis of the evidence related to management of deformational plagiocephaly and an evidence-based clinical decision tool for multidisciplinary management of DP. We systematically reviewed and graded the literature on management of DP from 2000 to 2011 based on level of evidence and quality. The evidence suggests that although many cases of DP will improve over time, conservative management strategies such as repositioning, physical therapy, and cranial molding devices can safely and effectively minimize the degree of skull asymmetry when implemented in the first year of life. Outcomes are best when the timing of diagnosis and severity of asymmetry guide decision making related to interventions and referrals for DP. Prevention and management of early signs of DP are best achieved in a primary care setting, with multidisciplinary management based on the needs of the child and the goals of the family.
ISSN:0891-5245
1532-656X
DOI:10.1016/j.pedhc.2011.10.002