Science1 publisher2 min readPublished
Picene skulls from Iron Age Italy hold the country's earliest known cases of infant flat head syndrome
Padua-led researchers found flat head syndrome in 11 of 26 Picene skulls from 9th-8th century BC Italy, the country's earliest known cases. The condition predates 1990s back-sleeping advice, though one small cemetery cannot show how much that advice adds to modern cases.
The Scientist · Science desk
What happened
- CT scans ruled out a rare birth defect that makes the sutures of the skull fuse early.
- The skulls lacked the pitting and rear hollow left by deliberate head binding, a practice not documented in Iron Age Italy.
- Some individuals had lopsided neck vertebrae and collarbones, possible signs of wryneck, a condition often seen alongside flat head syndrome.
- The authors suggest that flattening low on the back of some skulls came from infants lying on pillows, which modern doctors tend to discourage.
Compiled by The ScientistSomething wrong?How this is made
Why it matters
- constraint Explanations of flat head syndrome can no longer treat 1990s back-sleeping advice as its only origin, since Iron Age infants developed the same flattening without it.
- capability Checking burial position, fragment fit, binding marks and CT scans gives excavators a way to tell infant flattening apart from burial warping in damaged skulls.
- precedent Expect infant-care practices to be argued from skull shape at other sites, following the authors' reading of low rear flattening as a sign of pillows.
The best control in the study came from Picene burial custom. The individuals buried at Matelica, in central Italy, all lay on their right sides, yet flattening turned up on both sides of the head [1][11]. That matters because flattening clustered on the right [10], the same side the bodies rested on, so pressure in the grave was the obvious rival explanation. A flat spot on the left sat on the side facing up [11]. The broken fragments also fit neatly back together. The authors take that to mean the skulls were shaped in infancy, not by soil weight [12].
The sample is filtered by survival. Excavations since the 1990s have yielded 26 individuals with preserved or restored skulls [9]. Of those, seven male and four female individuals had flattened heads, 11 in all, or 42 percent [1]. "Skulls are rarely completely preserved," Beck De Lotto said [7]. Soil weight and moisture can also change a buried head's shape, he said, "making this condition difficult to recognize confidently" [8]. The reported figures do not show whether the surviving skulls are typical of everyone buried in the two cemeteries [9].
Modern figures measure something else. Flat head syndrome is seen in up to 47 percent of babies aged 7 to 12 weeks [6], an upper estimate for infants under three months old. The Matelica share counts flattening that formed in infancy and stayed in the skull until death [12].
Flattened skulls have usually been blamed on the 1990s Back to Sleep campaign, which told parents to lay babies on their backs to reduce the risk of sudden infant death [3]. "The presence of plagiocephaly in ancient individuals shows that this is not exclusively a modern condition," Beck De Lotto said [4]. The evidence supports that sentence as written, and I would stop there. A cemetery from nearly 3,000 years ago shows that other pressures could flatten an infant's head [1]. Splitting modern cases between back-sleeping and those other pressures would take infant data from before and after the campaign [3].
The pillow suggestion rests on indirect evidence [16]. No pillows survive from the Picene. The supporting image is a later Etruscan or Roman-era terracotta figurine of a tightly swaddled baby with its head propped on a pillow [17]. "Rather than being alarming, I think this makes the condition particularly interesting from a bioarchaeological perspective," Beck De Lotto said [5].
What to watch
- Results from other Iron Age Italian cemeteries tested the same way, which would show whether Matelica's 42 percent is local or typical and whether the earliest date for Italy holds.
- Picene-era evidence of infant bedding, which would test a pillow explanation that currently leans on a later Etruscan or Roman-era figurine.