J was born in July and all was well. A week before his two month pediatrician appointment my mom asked me if I'd noticed the flat spot on Julian's head. I brushed her off (and admittedly was annoyed that she even mentioned it - my child was perfect in my mind and I thought she didn't know what she was talking about). I took a good look at the back of his head and realized that it was a tad flat but figured it would work out on its own. Fast forward a week to his pediatrician appointment. I didn't mention the flat spot (since I didn't think it was an "issue"), but sure enough, the pediatrician did. She said it was a little concerning, and asked me if he looked both left and right or if he favored one side. I hadn't noticed. But from that moment forward, I realized that he ONLY looked to the left. He was always favoring the left side and I couldn't get him to look all the way to the right. Sigh. Why is it that we don't notice things until someone points them out and then that is all we notice? How was it possible that I hadn't realized that he was doing this? Well the pediatrician gave us some simple exercises to do daily and said we'd reevaluate his head at his 4 month well visit.
2 months later and I knew that his head hadn't improved. If anything, the flat spot was getting worse and his forehead was bulging out on one side a bit (that sounds worse that it was...it looked like he had a bump on his forehead., ok, so maybe it was bad). So I wasn't exactly surprised when our pediatrician referred us to Children's Healthcare of Atlanta to see an orthotist for his plagiocephaly (fancy name for flat head syndrome) to see if Julian was a good fit for Cranial Remolding.
We went to CHOA a week later for Julian's initial scans which measure the diagonal length difference of his head as well as his ear position. The normal range for the diagonal length is 0-6mm. His measurement was 13.6mm which put him in the "moderate to severe" category. We also learned that his ears were very asymmetrical, with one being further forward than the other. (Again, how had I not noticed this?!?) So they recommended we order a helmet and go forward with the cranial remolding. We were told that we could wait and see if the flat spot corrected itself as he started sleeping on his stomach and spending less time on his back, but that they see the best results the earlier you begin and his time in the helmet should be minimized the earlier we begin. I hesitated for a moment (to cry), but Mr. Cob and I decided to go ahead and proceed. CHOA uses the Star Band brand of helmets, so we were able to choose a fun design for his helmet. We decided that Julian's big brother would think the spaceships were neat so we went with the outer space themed helmet.
|About to get scanned!|
We go every 2 weeks for adjustments. They make sure he doesn't have any "hot spots" and that his skin is not getting irritated from the helmet. It keeps his head pretty hot and sweaty so we've had some issues with rashes, but it's nothing a little diaper cream won't fix. They also told us to rub his head down in coconut oil to prevent any yeast infections from growing, so he often smells of coconut, which is better than the sweaty smell (and the diaper cream smell for that matter). I'm told that we should be thankful that he's not wearing the helmet in the summer, because then he'd always be sweating and no amount of cleaning gets rid of that smell! We clean the helmet every night with rubbing alcohol or his baby shampoo and a toothbrush (we were told we could try witchhazel which might help the smell even more, but haven't tried it yet). It's a pain, but it's become part of our nightly routine. I won't miss it when we're done though.
|Hot spot - time for adjustments!|
|6 week scans - IMPROVEMENT!|
So that's half the story. The other half is the torticollis, which often accompanies plagiocephaly but doesn't always and can occur without the flat head. Torticollis "is a condition in which an infant's neck muscle is shortened causing the neck to twist." More on torticollis here. So we were referred to physical therapy to help stretch Julian's neck and correct his head tilt. (Again, I never noticed the head tilt, but the physical therapist assured me his head tilted. Great.). So we were given 3 different stretch exercises to do with Julian 3 times a day - we fit this in in the morning before school/work, right when we got home from school and right before bed. We were very strict about doing the exercises each day and within a week noticed a difference. Within a month we could tell he was looking both ways and moving his neck with more ease. At his follow up PT appointment a month ago, we were told his neck was doing great and that we didn't need to keep doing the exercises. So thankfully that corrected quickly.