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



 
 
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  #11  
Old July 9th 03, 06:42 AM
PF Riley
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Default Infant flat skulls can be avoided: U.S. doctors

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
  #12  
Old July 9th 03, 07:02 AM
PF Riley
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Default Infant flat skulls can be avoided: U.S. doctors

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
  #13  
Old July 9th 03, 01:14 PM
Elizabeth Reid
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Default Infant flat skulls can be avoided: U.S. doctors

"Jeff Utz" wrote in message ...
"Elizabeth Reid" wrote in message
om...


Millions spent on
hat redesign, plunging us into an economic crisis?


Hat redesign? If hats were flexible enough to fit around a kid's ears if he
pulls it a little to far, I am sure they will conform to the shape of the
skull well enough.

But it does sound like a good niche market.


Uh, Jeff? These were deliberately silly examples intended to
illustrate my belief that head-flattening is not a major crisis.
I understand that hat redesign will not be necessary. You may
want to turn your sarcasm meter up a notch or two.

Beth
  #14  
Old July 9th 03, 01:25 PM
Tsu Dho Nimh
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Default Infant flat skulls can be avoided: U.S. doctors

"Roger Schlafly" wrote:

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


Can you show evidence of the supposed delays in development, and
less sound sleep?

Tsu

--
To doubt everything or to believe everything
are two equally convenient solutions; both
dispense with the necessity of reflection.
- Jules Henri Poincaré
  #15  
Old July 9th 03, 01:28 PM
Tsu Dho Nimh
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Default Infant flat skulls can be avoided: U.S. doctors

"Jeff Utz" wrote:


Really? How is one going to tease a kid for a flat head when that part of
the body is covered by hair and not visible from the front?


When he goes totally bald at 70, of course. Or shaves his head
and becomes a pro athlete or rap musician.




Tsu

--
To doubt everything or to believe everything
are two equally convenient solutions; both
dispense with the necessity of reflection.
- Jules Henri Poincaré
  #16  
Old July 9th 03, 01:59 PM
Jeff Utz
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Default Infant flat skulls can be avoided: U.S. doctors


"Roger Schlafly" wrote in message
. ..
"Jeff Utz" wrote
Gee, so whom should one believe for expert advice on the care of

children?

Not someone who thinks that deformed heads, poor sleep, and delayed
development are all ok.


When did anyone say that poor sleep, delayed development or deformed heads
are ok?

How about dead babies? Are they ok?

Jeff


  #17  
Old July 9th 03, 05:43 PM
Roger Schlafly
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Default Infant flat skulls can be avoided: U.S. doctors

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


Can you show evidence of the supposed delays in development, and
less sound sleep?


Try this:

The pattern of early motor development is affected by sleep position.
(Stomach sleepers) attain several motor milestones earlier than (back
sleepers).
http://www.kids-md.com/Tipsheets/21_.../crawling.html



  #18  
Old July 9th 03, 10:08 PM
CBI
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Default Infant flat skulls can be avoided: U.S. doctors

"Roger Schlafly" wrote in message
. ..
"Tsu Dho Nimh" wrote
Yes. Plus delayed development, less sound sleep, less sleep for
the moms, etc. The BS campaign was a bad idea.


Can you show evidence of the supposed delays in development, and
less sound sleep?


Try this:

The pattern of early motor development is affected by sleep position.
(Stomach sleepers) attain several motor milestones earlier than (back
sleepers).
http://www.kids-md.com/Tipsheets/21_.../crawling.html


OK - they walk a little later. That is not quite the same thing as any
meaningful delay. As we have pointed out before - the kid who were born as
the campaign took effect are now 9. Do you have any evidence of long term
motor or cognitive defects?

The sleep problems are rare and those parents do have a legitimate choice.
Still not a common problem.

Your whole argument is sound and fury signifying nothing.

--
CBI, MD


  #19  
Old July 10th 03, 01:23 AM
Jeff Utz
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Default Infant flat skulls can be avoided: U.S. doctors


"Roger Schlafly" wrote in message
et...
"JG" wrote
It seems obvious, but a lot of people have trouble distinguishing
the good pediatrician advice from the ungrounded goofy opinions.

Apparently: "Up to 48 percent of infants develop the deformity." This
certainly doesn't bode well for our country's future, does it?


My kid always slept face down. She slept much better that way.
The Back to Sleep campaign never made much sense to me, as
they didn't even seem to look at problems like misshapen heades.


I don't know who they are, but the American Academy of Pediatrics seems to
take the problem seriously (Pediatrics is one of the journals published by
the Academy):

Pediatrics. 2003 Jul;112(1 Pt 1):199-202. Related Articles, Links


Prevention and management of positional skull deformities in infants.

Persing J, James H, Swanson J, Kattwinkel J; American Academy of Pediatrics
Committee on Practice and Ambulatory Medicine, Section on Plastic Surgery
and Section on Neurological Surgery.

Cranial asymmetry may be present at birth or may develop during the first
few months of life. Over the past several years, pediatricians have seen an
increase in the number of children with cranial asymmetry, particularly
unilateral flattening of the occiput. This increase likely is attributable
to parents following the American Academy of Pediatrics "Back to Sleep"
positioning recommendations aimed at decreasing the risk of sudden infant
death syndrome. Although associated with some risk of deformational
plagiocephaly, healthy young infants should be placed down for sleep on
their backs. This practice has been associated with a dramatic decrease in
the incidence of sudden infant death syndrome. Pediatricians need to be able
to properly diagnose skull deformities, educate parents on methods to
proactively decrease the likelihood of the development of occipital
flattening, initiate appropriate management, and make referrals when
necessary. This report provides guidelines for the prevention, diagnosis,
and management of positional skull deformity in an otherwise normal infant
without evidence of associated anomalies, syndromes, or spinal disease.

PMID: 12837890 [PubMed - in process]

It seems Roger is making things up. Again.

All the best,

Jeff


  #20  
Old July 10th 03, 01:34 AM
Jeff Utz
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Default Infant flat skulls can be avoided: U.S. doctors


"Roger Schlafly" wrote in message
. ..
"Elizabeth Reid" wrote
I tend to agree that the risk for a healthy term infant who has
no other risk factors is pretty low. I also agree that if a child
sleeps much better on his stomach, it may be worth considering. I
had a co-worker whose child would literally only sleep thirty minutes
at a strtech if put on his back. In that situation, I'd put a child
on his stomach too.


Tell the pediatricians. The AAP seems to lack common sense in
this area.


The NIH did: http://www.nichd.nih.gov/sids/sids_qa.htm: "Health
professionals need to consider the potential benefit when taking into
account each baby's circumstances." Sounds like the real professionals in
health have already addressed the issue.

All the best,

Jeff


 




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