CNS Guidelines

The American Academy of Pediatrics has endorsed the Congress of Neurological Surgeons (CNS) publication titled Evidence-Based Guidelines for the Treatment of Pediatric Positional Plagiocephaly. A summary of the recommendations includes but is not limited to:

1. Pediatricians are able to make a definitive diagnosis of deformational plagiocephaly by physical examination alone in most cases.
2. Repositioning is an effective treatment for deformational plagiocephaly and is most relevant to young infants, usually four (4) months of age or younger.
3. Physical therapy may be required for some infants with neck muscle involvement.
4. Cranial remolding orthoses are recommended for infants at least four months of age with persistent moderate to severe plagiocephaly after a course of conservative treatment, e.g., repositioning, tummy time, physical therapy. Cranial remolding orthoses are also recommended for older infants with moderate to severe plagiocephaly when repositioning efforts are no longer effective.

The CNS publication also notes that infants with a more severe deformity yielded better clinical outcomes when orthotically managed at an earlier age.