Madam, The Healthcare Section of the Ross Gazette on February 22nd 2012 contains an article on the "Flat Head Syndrome" which causes me concern.

Skull deformities are commonplace in the newborn and result from the moulding of the soft skull bones during the baby's passage down the birth canal. They resolve quickly and spontaneously and no treatment is necessary beyond reassurance of the parents.

This situation must be distinguished from the condition of craniostenosis where one or more of the joints of the skull (sutures) join up before they should resulting in deformities of the head. The facial skeleton is not infrequently involved and serious problems – although relatively rare – can be associated with these conditions. They should be recognised by health professionals at routine post-natal follow-ups and referred to the GP initially.

There is no doubt that misshapen skulls do occur in babies who spend prolonged periods lying in a favourite position. These too resolve spontaneously and do not require encasement in a custom-made highly expensive helmet which is worn for prolonged periods every day until the baby is a year old. During that time, the baby's head grows naturally by an average of 12cms round. The wearing of a helmet could interfere with this growth and be dangerous in its own right.

These may be unintended consequences but are the risks associated with unnecessary interference with natural processes, particularly when there is no proof of benefit, justified if the only indication is cosmetic perfection?

Babies with funny shaped heads can and should only be properly assessed by appropriately qualified and experienced medical specialists.

Ian P Cast FCRS

Consultant Neurosurgeon (retd.)

Aston Crews, Ross