Positional plagiocephaly: an analysis of the literature on the effectiveness of current guidelines

Neurosurg Focus. 2013 Oct;35(4):E1. doi: 10.3171/2013.8.FOCUS13261.


Object: Positional plagiocephaly (PP) has been on the rise in recent years. In this review, the authors' aim was to assess the effectiveness of current recommendations to parents on this exceedingly common problem through a comprehensive literature search. Additionally, the current treatment options and the most recent studies on PP are reviewed.

Methods: A search of the existing literature was conducted to obtain all relevant studies on guidelines, recommendations, parental and clinician practices, and epidemiological aspects.

Results: Although the incidence and risk factors for PP have been well delineated, there continues to be debates on its management and association with developmental delays. Current guidelines and recommendations on prevention set by the American Association of Pediatrics may not be easily followed by both parents and clinicians. There is also evidence that certain populations, including those with lower education, socioeconomic status, and in particular geographic regions may be more affected by the condition. Additionally, the marketing and financial aspects of PP treatments exist and should be addressed.

Conclusions: Better awareness and education are necessary to inform the population as a whole, although certain populations should be given special attention. Additionally, current guidelines and recommendations can be modified to foster a better grasp of the condition by both parents and clinicians. Adjusting current recommendations, introducing initiatives, and offering elaborate educational campaigns would help deliver these aims. Educating parents on PP as early as possible through clearer guidelines and close monitoring is central to preventing and managing this common condition.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Child
  • Child, Preschool
  • Environment
  • Guidelines as Topic*
  • Humans
  • Infant
  • Infant, Newborn
  • Orthotic Devices
  • Plagiocephaly, Nonsynostotic / prevention & control
  • Plagiocephaly, Nonsynostotic / therapy*
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Socioeconomic Factors