Unsafe sleep practices, including placing infants in a non supine (on side or on stomach) sleep position, bed sharing, and using soft bedding in the sleep environment (e.g., blankets, pillows, and soft objects) are modifiable risk factors for sleep-related infant deaths.
In one study, low educational status accounted for 27% of risk factors in deformational plagiocephaly. Providing parents with relevant information/education and preventive measures are simple, economical, and effective options for preventing positional skull deformities. (Linz, 2017)
Cultural disparities in minority populations also play a factor in safe to sleep practices.
According to the National Library of Medicine, research found, "African-American mothers say that they are generally aware of the Safe to Sleep® recommendations, even though the majority of mothers do not follow them. The reasons they give for not following them are that they are not comfortable doing so, they feel they are unable to do so, or find it unnecessary."
Finally, in those with diagnosed positional or deformational plagiocephaly, helme therapy is not an option the cost-prohibitive $2000 prevents many lower income families from affording this corrective measure. As insurance does not yet widely cover this option, many of the families go without.
Linz C, Kunz F, Bohm H, Schweitzer T. Positional skull deformities- etiology, prevention, diagnosis, and treatment. Dtsch Arztebl Int. 2017; 114: 535-42.