Introduction
The Back-to-Sleep campaign, which began in the United State in 1992, is known as a groundbreaking event that lowered the rate of sudden infant death syndrome.
However, since the campaign spread negative perceptions of the prone position, parents have started to maintain their babies in the supine position while the babies are awake or babies are older than 2 months. Also, previous studies revealed that the campaign increased the incidence rates of brachycephaly and plagiocephaly; particularly, the incidence rate of plagiocephaly in the US was one out of 300 prior to 1992 but dramatic increase of up to 600% for plagiocephaly was reported.
This study is aimed to confirm the incidence of reversed sequence of prone-to-supine and supine-to-prone rolling in Korean infants and to investigate the caregivers' awareness of developmental milestones for rolling. Through a comparison between the two groups, deformational plagiocephaly (DP) and normocephaly, in which the developmental order of rolling was different, we investigated the cause of the different developmental sequence and whether there was a relationship with the incidence of skull deformities.
Method
A questionnaire survey was conducted among total of 120 persons, who visited our clinic from January 2018 to May 2018 (Fig. 1). Of the children surveyed, most visited the hospital for confirmation of the plagiocephaly.
Group of children with plagiocephaly is mentioned as ‘Group P’ and that of children with normocephaly is mentioned as ‘Group N’. Group of children flipped supine-to-prone firstly is mentioned as ‘Group STP’, and the opposite is mentioned as ‘Group PTS’.
Statistical analysis was performed using SPSS, and paired t-test and chi-square test were used for comparison of parameters with differences between groups.
Result
According to Table 1, the order of rolling-over in the development of Korean children is totally reversed, and pandemic misperception of development is present. Table 2 shows the comparison between Group P and Group N. The proportion of caregivers who answered that the child rolled over supine-to-prone first showed statistically significant differences between the two groups. According to table 3, the proportion of caregivers who answered that the child with DP showed statistically significant differences between two groups. Also, caregiver perception of the rolling-over order showed significant difference between the two groups.
Conclusion
In this study, the reversal of the order of rolling is confirmed to be associated with an increase in the prevalence of plagiocephaly. The pandemic phenomenon of reversed sequence of gross motor development in Korea stems from a lack of awareness in caregivers. So, it is necessary to advertise that the prone position should be recommended during hours when infants are awake and supervised. |
