INTERVIEW WITH AN EXPERT
Sr David Verde, Infocefalia coordinator.
Fecha de publicación: 21/09/2010
Infancia Segura: What are cranial deformities?
R: Cranial deformities are an alteration in the growth of the baby's head due to external pressures, the tenderness of the skull and its rapid growth.
These deformities started to appear after the campaign "back to sleep" started in 1992 by the American Association of Pediatrics to reduce the occurrence of Sudden Death Syndrome. The result in this direction has been very positive, having significantly reduced its incidence.
In other cultures, the incidence of such deformities is very different. In Africa, for example, this problem is unknown because mothers always carry their babies in arms or hanging from the chest. In Asia and especially China almost the entire population is affected of brachicephaly as the popular belief that babies after should remain immobile during the first month of life. In the southern provinces of China is considered that girls are more attractive with brachicephaly, so parents make sure of getting a flat skull during the first months of life to help their daughters to marry on the best families.
Although most pediatricians think these deformities correct themselves, this is not entirely true because it depends on many factors such as hours of sleep, severity of the deformity, metabolism, psychomotor activity, etc. Given the lack of studies in this area I believe the only way is prevention.
IS:What is the incidence of these deformities?
R: According to the head of pediatric neurosurgery at the hospital in San Juan de Dios in Barcelona Dr. Costa Clara (interviewed in 2008) the incidence of such deformities has increased exponentially recent years. Furthermore during 2010 many pediatricians have reported to us that approximately 50% of babies who attend their consultations have some type of deformity demanding special measures to correct them. It is evident that we are facing a real epidemic.
IS: How to diagnose these deformities?
R: The diagnosis of such deformities is simple since x-rays, ultrasound, or any neurological examination are not necessary. We simply face a deformation of the bony plates of the skull due to the head own weight. Further scanning might be necessary if we suspect a premature welding of the skull plates. Depending on the degree of deformity and the age of the baby is possible to make a simple and rapid diagnosis. The problem, however, is that as this is a very recent problem diagnosis protocols available are scarce and somewhat confusing.
In the first phase is important to separate those cases of premature closure of cranial sutures because these babies skull present similar shapes to positional deformities and their treatment is completely different and who need urgent surgery to reopen the sutures and release the brain growth. Keep in mind that in case of doubt, the patient should be sent to a pediatric neurosurgeon.
IS: There is some risk to the health of the baby?
R: Obviously there are various types of risks, including physical, aesthetic and psychological-emotional. Plagiocephaly or asymmetric cranial deformities are those that involve greater physical risk. When the baby tends to turn her head to one side more than another it is flattened on that side resulting in a bulge on the face which means the whole skull is out of shape. The result is that one eye can be located later than the other which leads to vision problems. The lower teeth might not match th upper counterparts and teeth wear problems can occur. Another potential effect is adult cervical pain.
If the deformity is visible under the hair affected children may suffer from teasing at school and growing self-consciousness and self-esteem problems.
IS: How can we prevent deformities?
R: Although it is easy to understand how to prevent cranial deformities is difficult to carry out appropriate measures. Firstly we cannot let the baby's head always withstand pressure at the same point, so the baby position must be changed regularly and make sure that does not tend to rotate the head always on the same side. There have been established a series of "preventive" measures including regularly changing the baby on its side, avoid using pushchairs to sleep, soothe or feed him, carry the baby on a kangaroo pack or placed facing down when awake, and so on. Today it is very difficult to carry out such measures in a strict and correct way because the parents work and the babies spend most of their time with third party caregivers who invariably pay less attention to them and tend to make them sleep as much as possible. To solve this problem was created Mimos Pillow where the baby’s head can rest and be protected.
IS: That led to the birth of Infocefalia?
R: The natural history of the birth of INFOCEFALIA can be summarized as follows. My son Leo was born with a head well round and completely normal but gradually we saw that the right side was flattening. Although our pediatrician recommended monitoring progress our concern was higher each passing day. Due to the lack of serious and reliable information (checking on the Internet) we started to search for clinical studies and expert opinion and prepare to carry out a prevention campaign with the intention of bring up to all parents this issue and how can these deformities be prevented.
We are invited to numerous pediatric conferences where we explain preventive measures and diagnostic protocol to pediatric doctors. We also give talks at health centers when we are requested.
At the same time we have designed the Mimos pillow to reduce pressure on the baby's head and redistribute it to prevent the deformity, and in case deformity, will help its correction when use with other methods, all indicated and always supervised by the pediatrician.
Prof. Dr. Manuel Repetto - Dra. Marta Castells Cuixart - D. Ramón Sánchez Ocaña - Dr. Eduard Estivill - Prof. Dr. Ignacio Gómez de Terreros Sánchez - D. Elisard Soler - Prof. Dr. Julio Ardura Fernández - Profesor Manuel Cruz Hernández - Profesor. Dr. Jesús Costa Vila - Sr. D. Gerard Bosch - Dr. Pablo Umbert Millet - Mª Angeles Miranda - Prof. Dr. Serafin Málaga Guerrero - D. Jesús Repetto - David Verde - Sr. Daniel Klumpp - Sr. Moises Garcia - Dra. Roser de Castellar Sansó