No Dogs Allowed

Here's Bubba, as we see him every day. Yes, our little guy wears a helmet. He has a flat spot on the posterior side of his head.

It developed slowly over the first couple months of life outside the womb, as we were instructed by our pediatrician and the American Academy of Pediatrics to always position him on his back when sleeping to prevent SIDS. What we were not told was that the "Back is Best" campaign was the result of misinterpretation in the slight rise of SIDS deaths over the past decade which were primarily due to outside factors such as smoking, etc, and not because babies were positioned on their sides or tummies.  So, yes, Drew developed into a back sleeper and when he was eventually positioned on his side, between towels, pool noodles under his sheets, etc., he could not get to sleep and would immediately fight to get back to laying on his back.

Couple this with severe colic and spending hours bouncing in our arms every night for the first couple of months of his life and his case doesn't get any better. After the 3-4 hours of blood-curdling screams, I slept with him in my arms on the couch for eight weeks. Eventually I had to go back to work and needed to get some sleep so we tried him in his crib to no avail. He would, however, sometimes sleep if he was in the swing. This... again... did not help the case of developing a flat head.  

Why am I telling you all of this? Perhaps it's some sort of therapy, but I also want others to learn from our situation.


When Drew was about five months old, a student's parent, who is an OT, overheard me telling a friend at work about his constant spitting up and irritability. Her response was, "how much tummy time does he get?" To which I replied, "Not much because he immediately spits up and freaks out." Apparently this was not the correct response. What I also didn't know at the time, and was then informed, was that tummy time is incredibly important for babies to not only maintain a beautifully round head :) but also to develop the esophageal sphincter that aids in digestion and keeps down milk--especially breast milk, which tends to be a bit thinner and sloshes around more than formula.  It was a catch22. He needed more tummy time to help aid in his digestion, but he already had reflux so bad that it was extremely difficult to keep him on his tummy. The result--more time laying on his back and flattening his head.

At about six months, our pediatrician told us that most babies start to move around more and spend less time laying down, so his head would probably start to even out on his own. I wasn't so sure. Sage was an early mover but Drew...not so much. He was quite content sitting in one spot and playing with his toys. All we had going for us to help reshape his head was gravity, which eventually aids in dropping and pushing the brain towards the posterior of the skull, thus rounding out their head.

I waited two more weeks and got a referral to a pediatric neurologist. That appointment led us to an orthotist (a medical professional that provides bracing for the body) at John Stoddard Cancer Center. They both agreed that Drew had moderate plagiocephaly, and that it would probably not correct itself. (Plagiocephaly occurs in 1 of 60 births since the "Back is Best" campaign.) It was our choice whether we wanted to help correct it, because it--in no way--effects his development, and would solely be for cosmetic reasons.

We learned that society views "beauty" in symmetry, which apparently means that the optimal head measurement is when the width of the head equals the depth--makes sense--a ratio of 100%. Drew's was 75%--whoa. The growth plates on the top of his head were also starting to form a point at the top of his skull and also push forward into his forehead so that his face appeared quite round. This means that he specifically has brachiocephalic plagiocephaly--the hardest to correct because there isn't another place on his skull that can fill in the void. His head simply has to grow into it. A baby's growth plates in the skull usually fuse by 14-18 months, at which time the cranial band will have no more effect.

This information, along with the fact that he is male and would probably have to deal with hair loss at some point in his life, encouraged us to opt for cranial band therapy, a.k.a. the helmet. 

Every three-four weeks, Sage, Drew, and I take a trip over to see his orthotist. Sage knows exactly where to park, what doors to open, which elevator to take, what buttons to push, and which hallway to go down until she pushes the handicap button and enters the office. Promptly, she sets down her backpack, goes to the water cooler to fill up a Dixie cup, says hi to the administrative assistant, searches for her favorite Elmo toy, and walks straight through the waiting room and into the examination room. She searches through the diaper bag for her measuring tape and snack and gets ready for the doctor to "measure Drew's head because it's flat".

It's become a part of our everyday life. He wears it 23 hours a day and doesn't seem to mind. He's had it since mid-July and we probably have at least another couple of months to go. Some day he will thank us for the silly looking helmet with the "no dogs allowed" sign.

 

                    July 18th                                                                 September 15th