To helmet or not to helmet - plagiocephaly in 8 month old
April 26, 2016 12:30 PM   Subscribe

So my dear sweet 8 month old has moderate positional plagiocephaly, and the specialist we saw yesterday suggested getting at least a consultation for helmet therapy.

The specialist said he was 'in the middle' of the range, and that at 8 months old his head shape is basically set, but that a helmet may help to round it out a bit. She basically said it was up to us, there is no neurological or other health issues to be concerned about, and that the shift to his ears is very slight. Sounds almost like a cosmetic thing but he does have a visible flat spot on the back of his head. We're scheduling an appointment with the orthotics specialist but I was hoping some MeFites might be able to share their experiences with plagiocephaly and what questions you may have gone through when deciding whether or not to helmet. My main concerns are heat (hot summer weather and a bulky helmet probably don't go well together), and comfort (what if he absolutely HATES it? He is a super happy baby and I don't want to make him miserable).

Anon because a part of me feels horrible for having done this to him in the first place. Follow up questions can go to

Thank you!
posted by anonymous to Health & Fitness (8 answers total) 1 user marked this as a favorite
My baby had torticollis from being stuck breech and her head was also light-moderate, but I thought it was really bad. We waited a long time and had several consultations and got her a doc band when she was about 12 months old -- do not wait this long, their heads grow more slowly the older they get and you'll have to keep it on longer! She had it for about 5 months before we decided it was good enough and took it off -- it definitely made a difference in her head shape. She had a little bump out on one side that went away after having the doc band. She still maintained a tiny bit of a flat spot, but is almost 3 now with curly hair and you can't see it at all (I'm the only one who ever notices, her dad thinks it's gone). We started it in June and while, yes, she definitely got hot and sweaty at first, she also adjusted to it pretty easily, even when she was outside playing. We did keep her well hydrated, as recommended by the company we bought it from. She didn't mind having it on at all, I don't think she even noticed, and she had no problems sleeping with it on (and she slept butt up in the air right on her face). We called it her hat, and she would go and get it for us to put on after her bath or anytime we took it off to air her out for a bit, so obviously she didn't mind it. I still don't know if it would've gone away on its own or not, but it was mostly covered by insurance, so I'm glad we tried it and her head looks great now. If we run into this problem with baby #2, I will push to get the helmet much earlier.

I'm happy to answer any additional questions if you want to MeMail me - we got a doc band from Cranial Technologies. It was about 2 years ago, so my memory may be a bit fuzzy on specifics.
posted by echo0720 at 12:41 PM on April 26, 2016

I thought it sounded like an uncomfortable hassle for uncertain cosmetic benefit, so I didn't worry about doing a consult when my son got about the same recommendation at about the same age. He's six now and his head looks perfectly normal to me, even when he has super-short hair. But I'm not sure I (or anyone else for that matter) would notice if it weren't.

Or: a vote for not worrying about it if you don't want to. If you generally trust your doctor's judgment, you can also trust her decision to leave it up to you to mean that either option is fine.
posted by cogitron at 12:57 PM on April 26, 2016

Ours had a cranial band from approx ~5 mo to ~8mo. Prior to that physical therapy for torticollis (there's a simple stretch you can do at home if this at all a factor).

Comfort wasn't an issue for the baby. We had the band from Dec - March so I can't comment on heat.

Daily baths and cleaning of the helmet was important (rubbing alcohol in a spray bottle). There were fittings every two weeks.

There was some improvement -- my main concern was ear/eye alignment and that was fixed. The consultant with the company that did the cranial band provided a detailed scan that showed the severity of issue (head shape and standard deviations) and that helped us make a decision, that and our pediatrician's opinion that she thought it was worth it, especially as we were able to do it relatively early.

I think it's very much a case-by-case basis.
posted by typecloud at 1:01 PM on April 26, 2016

We've had several friends who had to do the helmets with their babies, and the babies really don't notice or mind after the first couple of days. In the worst of the summer humidity, our closest friends let their baby take a couple hours off if we were all going to the zoo or some other outdoor activity, but otherwise it just didn't bother him.

(I can't really speak to how to decide if it's necessary, but really the babies aren't very bothered by them.)
posted by Eyebrows McGee at 2:20 PM on April 26, 2016

When I noticed this in my 6-month old baby, the pediatrician said she was about a 3 on a scale of 10 and recommended we get a helmet. We took her to a craniosacral therapist instead who specializes in kids and infants, and after 3 sessions the torticollis was completely gone. She's 10 now and doing great.

Would highly recommend it - even if you are a bit of a skeptic like me, it's well worth a try to avoid the helmet if you can. Good luck!
posted by widdershins at 2:30 PM on April 26, 2016 [1 favorite]

We saw a head shape clinic when my baby was about 7 months old and we chose not to go with the recommended helmet because we live a 4 hour drive away from the clinic and we didn't want to have to do that drive every 2 weeks for fittings. I don't think it really mattered in the end whether we did the helmet or not. I did however make sure to religiously follow the clinic's recommendations for physio (neck stretches) and positioning (tilt crib; use carrier instead of stroller; tummy time, etc.).
We also did craniosacral therapy as an alternative and I noticed a *huge* difference in his general happiness after CST. Even though I still think it's woo ... but it was woo that worked, somehow.
posted by bluebelle at 6:57 PM on April 26, 2016

Hey, I felt the guilt, too. Hell, I cried more over my baby's flat head than the much more serious genetic disorder he partially inherited from me because OH, HOW I FELT I COULD HAVE PREVENTED IT (you know, if I never slept myself and constantly repositioned his head while he napped on his back in his crib).

Anyway, his geneticist saw his head every couple weeks at his metabolic clinic appointments and said in a sing-song voice, "Somebody's getting a helmet!" On the other hand, his pediatrician said that the meta-analysis of the medical literature showed no discernible difference in head appearance between babies who wore helmets and babies who didn't 5 years down the road. She was so reassuring and said that since our kid had normal head range of movement and just a flat spot on the side/back of the head, she would never refer him for a cosmetic issue when we already had our hands full with the life-threatening stuff.

His head looked a lot less flat a year later, and now there's no way you could even tell.

I know it's hard, but try your best to throw out the guilt. You cannot force your baby to sleep perfectly on it's currently malleable skull. No one can. It's a largely unanticipated result of "back to sleep" safe sleeping, and it happens sometimes.
posted by Maarika at 8:33 PM on April 26, 2016

Different cultures, different situations, different people, but from a UK perspective: our first born had it; it was pretty noticeable (one of his grandparents used to ask all the time about it, winding my partner up a treat). Lots of stress and upset and googling (as you do with a first born), so by the time we saw the paediatrician we were prepared for the worst. I think he may have been about 9-12 months by the time we saw him.

He was incredibly nice, diagnosed the underlying reason (strained neck issue from early on, meaning it was easier for him to lie on one side), said that baby's heads grow and reshape lots over time, pointed out that despite the fact lots of men have close cropped hair now due to fashion, you never see anybody with a noticeably deformed head shape and basically (in a very nice way!) said that we should relax and not worry about it, and maybe just try and reposition him if we wanted to when he slept, but not to get too obsessive about it. I think he may also have gently implied there was an interest in manufacturers overstating the issue and getting parents wound up.

First born is now 8, with a full head of hair. Now, even when his hair is wet and plastered to his skull, you can't notice it (you could when he was having a bath at, say, 4, but not in any way that ever looked shocking). If you run his hands through his head, you can tell if you're looking for it. I strongly suspect that will change again, but even if it doesn't, he's absolutely 100% fine - it's completely unnoticeable to anybody, he's not getting bullied or teased or self-conscious about it.

I remember how stressful it was, and how we felt we had to do all we could to prevent him being 'deformed', but now, with hindsight, I'm really glad that he didn't spend his early years (and all those photographs) in a helmet.

(Our second one, however, probably should still have a helmet to this day, the number of times he's smashed his head open on tables, banged his head on things, fallen over, been hit on the head etc. There's lots of other things you get to worry about is I guess my point there.)
posted by Hartster at 2:56 AM on April 27, 2016

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