Guidelines for the treatment of positional plagiocephaly have recently been published after systematic reviews of evidence related to four main topics. Key points are as follows:
- Physical examination is recommended for diagnosis of plagiocephaly with imaging necessary only rarely (Level III)
- Physical therapy is recommended rather than positioning pillows (which cause a less safe sleeping environment), and more effective than repositioning education based on evidence from 1 Class-1 study.
- Helmet therapy is recommended for infants with persistent moderate to severe plagiocephaly despite conservative therapy (Level II).
- Helmet therapy is recommended for infants presenting at an advanced age with moderate to severe plagiocephaly (Level II).
These guidelines catalog the current state of the scientific literature regarding plagiocephaly, but also highlight the lack of high-grade evidence to guide clinical practice.