The Back to Sleep Campaign, Positional Cranial Deformity, and the Foramen Magnum: New Lessons Learned from Old Pachacamac Crania

In 1992, the American Academy of Pediatrics discouraged prone sleeping positions because of its association with sudden infant death syndrome. The recommendations prompted the United States Public Health Service to begin the “Back to Sleep Campaign,” to promote the habitual practice of placing newborns to sleep in a supine or side‐lying positions. After the Back to Sleep Campaign was initiated, there was a sudden increase in the incidence of deformational plagiocephaly. Therefore, research is warranted regarding effects on the influence of extrinsic forces on the development of the cranium. This study utilized ‘traditional’ and geometric morphometric techniques to compare the foramen magnum size and shape of Peruvian crania from the Samuel George Morton Collection, largely from Pachacamac and likely to have undergone intentional cranial deformation, to those of craniofacially diverse cultures that were not reputed to practice intentional cranial deformation. The results demonstrate statistically significant differences in the sagittal dimension of the foramen magnum between groups. Likewise, geometric morphometric analysis revealed differences in foraminal shapes between groups. The results of this study suggest that extrinsic compressive forces likely alter the structure of the foramen magnum. These findings should be taken into consideration with regard to modern‐day newborn sleeping positions and positional cranial deformation. Support or Funding Information WV Research Challenge Fund [HEPC.dsr.14.13]