A Health Brief in the August issue of AAP News highlighted a recent study from the Netherlands on helmet vs. “natural” therapy for positional plagiocephaly and brachycephaly (http://aapnews.aappublications.org/content/35/8/2.1.full.pdf+html). This study by R.M. van Wijk, et al. in the British Medical Journal (2014;348:g2741) reports on data collected from 29 pediatric physical therapy practices and finds no difference in head shape outcomes at 24 months among those assigned to helmet therapy vs. those assigned to no treatment at all.
Although timely and intriguing given the prevalence of positional head shape deformity in the wake of the Back to Sleep campaign (renamed the Safe to Sleep campaign), the study suffers from important and critical weaknesses that must be understood by our general pediatric providers.
First, subject numbers were particularly small (with 42 patients per group), and infants with “severe” deformities were excluded. Also excluded were infants with torticollis and other developmental...
