Infant flat skulls can be avoided: U.S. doctors

"CBI" wrote in message
...

"JG" wrote in message
t...

If a child sleeps *much*
better on his/her stomach (falls asleep faster, stays asleep
longer), it
makes much better sense, IMO, to let him/her do so.

At least (s)he will be a well rested corpse.

Why are you so averse to letting parents make a rational decision based
on *their* situation? A sleep-deprived child can adversely affect an
entire family; his/her problem usually has a domino effect.

There's a trade-off to be made in the case of kids whose heads
become
pronouncably misshapen: Are the costs (financial and other) of
having
the deformity corrected worth the benefit (very, very small) of
forcing
an infant to sleep on his/her back? Likewise (alternatively), are
the
costs of *not* correcting a noticable deformity (teasing,
ridiculing,
name-calling, ...[= bullying, these days]) worth it?

You tell us. What is the cost of correcting these deformities caused
by BTS?

Sorry, I don't have a plastic surgeon on call. I'm sure you could get a
ballpark figure by doing a Gooogle search, however.

Compare that to the number of lives saved. How many of these kids are
noticibly deformed by the time they get to school age? How much
teasing
/life is worthwhile?

That's for the individual (or, in this case, his/her parents) to decide
now, isn't it?

"Doomsday," IMO, is already upon us (the US). The point of my
posting
the article (along with my comments) was not to lament the creation
of a
society with weird-shaped-head kids (hell, some of the kids whom I
tutor
have deformities/conditions that they'd undoubtedly trade for a
flattened head in a heartbeat), but to deplore the existence of a
society in which parents apparently can't discern and resolve
problems
for themselves.

Why do you assume this?

I'd say "up to 48%" of kids having misshapen heads, even if the
deformities aren't permanent, speaks for itself. The simple measures
suggested in the article (prone while awake/observed, rotating 180
degrees in the crib) are, IMO, common sense--yet apparently almost half
of "Back to Sleep" parents haven't employed them (or asked their kid's
caregiver to employ them). OTOH, maybe they ARE aware of them, and
simply think Jr.'s misshapen head is endearing, right? Uh-huh. Yeah...

Maybe they can and they just don't come tot he same
conclusions as you.

Yup. Gee, and to think there are some parents who just can't cope with
having kids, so they come to the conclusion that they'll simply off
them.

"CBI" wrote in message
...

"JG" wrote in message
t...

With all the concern
about "bullying" these days, I'd advise parents, especially those
reluctant to encourage their kids to defend themselves, to try to
have
their kids look as "normal" as possible.

Interesting parenting advice. Would you have them keep their mouths
shut and
go along as much as possible as well?

You bet, if they (the kids) are unwilling and/or unable to defend
themselves against the responses (consequences) their words or actions,
like their appearance, might provoke. Growing up, you must surely have
known one or two kids who'd throw stones (literally or figuratively) and
immediately retreat behind their mom or dad. What'd you think of them?

"JG" wrote in message
t...
"Elizabeth Reid" wrote in message
om...

...It should be *ZERO*. How in the world could an otherwise competent
parent .....

JG - the fallacy of your whinings is showing through.

First you whine about the AAP treating parents like idiots.
Then you whine that some of them are idiots.

Maybe there is some connection?
Perhaps the AAP is not being so unreasonable after all?

--
CBI, MD

"CBI" wrote in message
...

"JG" wrote in message
t...

"Elizabeth Reid" wrote in message
om...

...It should be *ZERO*. How in the world could an otherwise
competent
parent .....

JG - the fallacy of your whinings is showing through.

First you whine about the AAP treating parents like idiots.
Then you whine that some of them are idiots.

Maybe there is some connection?
Perhaps the AAP is not being so unreasonable after all?

Many parents ARE idiots (incompetent). I believe the number, and
percent, of
"idiot parents" is increasing. A few reasons are obvious: Many
parents these days have (or had) less-than-ideal (and/or often absent)
parents
themselves ... A crappy (*overall*) public education system that turns
out future parents (and some teenagers who are *already* parents!) who
can't think (but who *think* they can think and who feel good about
themselves!) ... A culture (read: media) that continues to endorse and
encourage/promote self-centeredness--ME first, kid second ...
Politicians (and bureaucrats), intent on keeping their jobs, giving (or
trying to) all things to all people (even those who
neither need nor want to partake of gubmnt's largesse!), and have
thereby instilled a sense of both dependency and entitlement among much
of
the populace (why think for yourself when there's someone--some
bureaucrat--all too ready and willing to do it for you?) ... A federal
gubmnt that's made a habit of bailing out/subsidizing all sorts of
entities, including other gubmnts (e.g., cities) and corporations (e.g.,
Amtrak) as well as individuals (e.g., farmers) who DO screw up ... In
short, can you honestly deny that personal responsibility is a waning
virtue? But I digress...

As I've asserted before (previous threads), it's simply not possible to
educate a lot of idiots (the "uneducable"), no matter how hard one might
try. You can lead a horse (parent) to water...

The AAP apparently believes *all* parents are idiots, and thus
recommends pediatricians treat them as such (e.g., by asking MYOB
questions such as whether there are any guns in the house). As far as
head-flattening is concerned, if it's to the point where it's noticeable
(i.e., of medical concern) you'll have a hard time convincing me that
the parents themselves don't/haven't noticed it and taken some "common
sense"--intuitive--measures (such as those recommended in the article)
to alleviate/correct it.

If a pediatrician wants to cover his/her ass (against "failure to warn"
lawsuits), I'd suggest he/she simply put all his/her (i.e., the AAP's)
"advice" in a "new parent" booklet that can be given to all
new/expectant moms. Hand out an addendum regarding the importance of
repositioning infants to avoid smushed heads, if you wish.

"JG" wrote in message
t...
"CBI" wrote in message
...

"JG" wrote in message
t...

If a child sleeps *much*
better on his/her stomach (falls asleep faster, stays asleep
longer), it
makes much better sense, IMO, to let him/her do so.

At least (s)he will be a well rested corpse.

Why are you so averse to letting parents make a rational decision based
on *their* situation? A sleep-deprived child can adversely affect an
entire family; his/her problem usually has a domino effect.

Never said I was. Why do you assume that parents aren't? Maybe some value
the decreased risk over a little extra sleep. Truth be told there are very
few kids who, if put down supine right from birth, will not sleep just fine.
There is nothing int he back to sleep program that suggests parents should
force the issue. All they are told to due is to put them down face up. There
is no direction to keep checking them and flipping the kid over. We've
discussed this before yet to keep raising the same old crap over and over
again.



You tell us. What is the cost of correcting these deformities caused
by BTS?

Sorry, I don't have a plastic surgeon on call. I'm sure you could get a
ballpark figure by doing a Gooogle search, however.

For one surgery? - Sure.

The relevant figure would be to determine how many surgeries are being
caused by the campaign. I'm betting it is low. SInce you are the one
claiming it is not worth it then I am sure you won't mind digging out those
figures.



I'd say "up to 48%" of kids having misshapen heads, even if the
deformities aren't permanent, speaks for itself.

What does it say? To me it says that a lot parents have been appropriately
counselled to try to turn the kid but not to get worked up about some mild
asymmetry.

As I pointed out in my other post - the real joke here is that for ages you
have been screaming about how the advice the AAP gives should be obvious to
any idiot. Now you are claiming that 48% of parents are idiots. You can't
have it both ways. If so many parents are so stupid then the AAP is
justified in giving such obvious advice.


The simple measures
suggested in the article (prone while awake/observed, rotating 180
degrees in the crib) are, IMO, common sense--yet apparently almost half
of "Back to Sleep" parents haven't employed them (or asked their kid's
caregiver to employ them). OTOH, maybe they ARE aware of them, and
simply think Jr.'s misshapen head is endearing, right? Uh-huh. Yeah...

No - maybe they are employing them but they don't work 100%. I hear about
kids that prefer to sleep with their heads to one side all the time but you
and Roger are the only two parents I have ever heard claim their kids would
not sleep well supine. Perhaps that is because I counsel my patients from
early on and so the kids become accustomed to supine sleeping from early on
whereas you and Rog never really bought into the whole concept (and probably
took a perverse pleasure in not following the standard advice).

Remember, you still have not shown that there is a significant problem. The
48% figure indicates nothing since that does not tell us how many of these
kids will even have a noticeable asymmetry when older, much less undergo
surgery or teasing. Before you lambaste 48% of the parents for their poor
choices/parenting you need to show that they are doing something wrong.



Maybe they can and they just don't come tot he same
conclusions as you.

Yup. Gee, and to think there are some parents who just can't cope with
having kids, so they come to the conclusion that they'll simply off
them.

I'm not sure I see the connection. Surely you abnit that it is possible for
a well adjusted, sane intelligent parent to come to different conclusions
than you did?

--
CBI, MD

On Wed, 9 Jul 2003 00:05:34 -0400, "CBI" wrote:

No - maybe they are employing them but they don't work 100%. I hear about
kids that prefer to sleep with their heads to one side all the time but you
and Roger are the only two parents I have ever heard claim their kids would
not sleep well supine. Perhaps that is because I counsel my patients from
early on and so the kids become accustomed to supine sleeping from early on
whereas you and Rog never really bought into the whole concept (and probably
took a perverse pleasure in not following the standard advice).

I'd say I see about one family a year where the infant is put to sleep
prone because of a dramatic difference in quality of sleep. I
appropriately counsel the parents, who are generally well aware of the
risk, and they make the decision, sometimes with great difficulty, to
continue to allow the patient to sleep prone. The vast, vast majority
of infants, on the other hand, who have any preference, hate being
prone, and in fact many infants have to be coached to tolerate "tummy
time."

PF

On Tue, 08 Jul 2003 18:22:47 GMT, "JG" wrote:

"PF Riley" wrote in message
...

I'd say 48% sounds about right in my experience. What you fail to
realize is that for most of them, the deformity resolves with time.
Back to Sleep started in full force around 1994. Do you know many
9-year-olds with misshapen heads?

I know a couple of teenagers with rather severe craniofacial
abnormalities, but not because of supine sleeping. What I have
difficulty understanding is why the parents of the 48% with misshapen
heads either didn't notice the problem developing (!) or didn't take
corrective action (e.g., the suggestions in the article) sooner...

And yet again we revisit a common theme from you, JG. Either by
arrogance or ignorance (or both?) you seem to way overestimate the
average intelligence and common sense of the American public. As CBI
has pointed out, your problem in this case is not with the AAP
dispensing the advice, but with your perception that it shouldn't be
necessary.

I would say about half of the families to whom I point out the typical
occipital flattening and even occasional rhomboidal deformity
(unilateral occipital with contralateral frontal flattening) of
positional plagiocephaly during the 4 month check-up genuinely had not
noticed it themselves. How, then, would you expect these parents to
have begun taking corrective action?

PF

Ha, my baby started getting the flattened head and we were alarmed as son as
we noticed - at about 3 months. We got a positioner and put him on his side
to sleep.

I daresay most intelligent folks will figure it out - that is, if they are
not overwhelmed by life (too many children, work, etc.) to notice

L.

P.S. I find the lot of you rather arrogant ans silly. I do not know a single
"doctor" that has TIME TO WRITE silly accusations. " And yet again we
revisit a common theme from you, JG. Either by
arrogance or ignorance (or both?)" To what parents are you dispensing
advice ? People in the grocery line in front of you ?

This is a very strange group.

"PF Riley" wrote in message
...
On Tue, 08 Jul 2003 18:22:47 GMT, "JG" wrote:

"PF Riley" wrote in message
...

I'd say 48% sounds about right in my experience. What you fail to
realize is that for most of them, the deformity resolves with time.
Back to Sleep started in full force around 1994. Do you know many
9-year-olds with misshapen heads?

I know a couple of teenagers with rather severe craniofacial
abnormalities, but not because of supine sleeping. What I have
difficulty understanding is why the parents of the 48% with misshapen
heads either didn't notice the problem developing (!) or didn't take
corrective action (e.g., the suggestions in the article) sooner...

And yet again we revisit a common theme from you, JG. Either by
arrogance or ignorance (or both?) you seem to way overestimate the
average intelligence and common sense of the American public. As CBI
has pointed out, your problem in this case is not with the AAP
dispensing the advice, but with your perception that it shouldn't be
necessary.

I would say about half of the families to whom I point out the typical
occipital flattening and even occasional rhomboidal deformity
(unilateral occipital with contralateral frontal flattening) of
positional plagiocephaly during the 4 month check-up genuinely had not
noticed it themselves. How, then, would you expect these parents to
have begun taking corrective action?

PF

"JG" wrote
I'd say "up to 48%" of kids having misshapen heads, even if the
deformities aren't permanent, speaks for itself.

Yes. Plus delayed development, less sound sleep, less sleep for
the moms, etc. The BS campaign was a bad idea.

"Roger Schlafly" wrote in message
...
"JG" wrote
Another article for the "Well, DUH!" file. Amazing how some people
manage to walk without someone else (a physician?) telling them

It seems obvious, but a lot of people have trouble distinguishing
the good pediatrician advice from the ungrounded goofy opinions.

Can you tell me what about advice that prevents kids from dying from SIDS is
"goofy?"

Am J Epidemiol. 2003 Mar 1;157(5):446-55. Related Articles, Links


Infant sleeping position and the risk of sudden infant death syndrome in
California, 1997-2000.

Li DK, Petitti DB, Willinger M, McMahon R, Odouli R, Vu H, Hoffman HJ.

Division of Research, Kaiser Foundation Research Institute, Kaiser
Permanente, Oakland, CA 94612, USA.

To assess the association between infant sleeping position and risk of
sudden infant death syndrome (SIDS) in an ethnically diverse US population,
the authors conducted a population-based case-control study in 11 counties
in California from May 1997 through April 2000. The authors conducted
in-person interviews with the mothers of 185 SIDS cases and 312 randomly
selected race/ethnicity- and age-matched controls to collect information on
sleeping positions. Infants who had last been put down to sleep in the prone
or side position were at greater risk of SIDS than were infants who had last
been put down on their backs (adjusted odds ratio (AOR) = 2.6 (95%
confidence interval (CI): 1.5, 4.5) and AOR = 2.0 (95% CI: 1.2, 3.4) for the
prone and side positions, respectively). The risk of SIDS was especially
high for an unstable side position in which an infant was placed on its side
and found prone (AOR = 8.7, 95% CI: 3.3, 22.7). Infants who were usually
placed on their backs to sleep but had last been put down in the prone or
side position (an unaccustomed position) had a significantly high risk of
SIDS (AOR = 8.2 (95% CI: 2.6, 26.0) and AOR = 6.9 (95% CI: 2.3, 20.6) for
the prone and side positions, respectively). Infants placed in an
unaccustomed prone or side sleeping position had a higher risk of SIDS than
infants who were always placed prone or on the side.

PMID: 12615609 [PubMed - indexed for MEDLINE]

There are other drawbacks to putting babies on their backs. Nowadays,
a lot of babies never even learn to crawl.

Better learning to walk in the wrong way (without crawling first) than being
in a coffin.