DAVID

From reading on the net, I was still worried it could have been craniosynostosis. But because his ear was forward on the bulging side, I started thinking it might be plagiocephaly.  At his 2 month old doctor's appointment, I mentioned it to the pediatrician who thought it was plagio too, but sent me for skull x-rays to be on the safe side.  The sutures were open, so we were relieved to be faced with plagio and not cranio.

My husband and I had decided we were going to try repositioning first since David was so young.  We told ourselves we would reconsider our treatment at 4 months old and decide if we were going to ask for a helmet or not at that point.  So I read everything I could find on plagio and on repositioning and we started.  Within a week or two we saw progress, I didn't know if it was real or I was dreaming it.  A lot of our friends and family noticed an improvement too.  Of course, I was observing his head all the time, once in a while I would think: "Wow, it has improve a lot! Repositioning is working!" , but then a lot of time I would doubt myself and think maybe we should have gone for the helmet right away!

When David approached the four month mark, my husband and I started discussing what we would do.  In the back of my mind, I was still a bit worried about cranio since the ridges on the coronal sutures were still there, and they were not improving.   We had seen some good improvement with repositioning but there was still room for more improvement...  We really didn't know if we wanted the helmet or not.  We decided we were going to ask for a referral to a neurosurgeon and discuss this with him.  Our pediatrician was very good about this, when we told him about our worries, he is the one who suggested the neurosurgeon!  On our way home, we called for an appointment with the neurosurgeon, and were told we couldn't be seen until the next month...  We were a bit disappointed, but then, we though it would give us a chance to try repositioning for longer to see if we would still see more improvement. 

Finally, when David turned 5 months old, we met with the neurosurgeon.  Before the meeting, dh and I had decided that we had seen more improvement in the last month, and even if there was to be no more improvement from now on, we were satisfied with the shape of David's head.  Therefore, we were not going to ask for a helmet.  By looking at the x-rays, the neurosurgeon said he could clearly see that the sutures were open.  So that was our first piece of good news.  He then told us he could see lots of improvement in David's plagio as compare to the x-rays taken at 2 months old.  It was really nice to hear it confirmed by a specialist!!  I hadn't dreamed the improvement, it was there!  He also said he would have diagnosed David's plagio as moderate at 2 months old, but was now only mild!!  That was great news to us.  He thought David might have had a mild case of torticollis (but not a head tilt) that could have contributed to his plagio and referred us to a physical therapist.  We met with the pt the following week, and David received a complete physical exam.  The pt concluded he had no tort, he had full range of motion, and that he was doing great in all other aspect of his development and had no delays (he was even advance on some aspects).  So that was our third piece of good news in a week!

Repositioning David

At night, we used a side positioner so David slept on alternative sides between the time he diagnosed at 2 months and 6 months old.  Now, we have stop using the positioner because he is too old, and he often sleep on his tummy, or he sleeps on his side.  I usually put his favorite stuffed toy in his field of vision so that he can see it when he is lying on the side we want him to be.

During the daytime, if David is in his car seat , we have used a rolled towel to force him to look the other way.   Since we didn't want him to develop a flat spot on the other side, we also alternate the use of the rolled towel with some bubble styrofoam, the kind they sell to put under your bed sheets (we cut a square piece of it and put it in the head region of his car seat covered by a receiving blanket).  When we used that we let him choose his own position.  Finally, we got the Boppy "Noggin nest" that we also use in the car seat, that we used for a long time, but he just outgrew it now.  We just try to vary our way of positioning him, so David doesn't get tired of it, and also that no other flat spot developed.  He really use to favor one side when we started the repositioning, but now doesn't seem to have a preference if we let him choose.

We rarely lay him flat on his back during the day, we never did it when we started repositioning..  Sometimes I end up just holding him more, and he does lots of tummy time.  He used to hate it when we started it, but just loves it now.  We he was younger and not as heavy I carried him in a frontal pouch.  Recently, we started doing a little bit of activities while he lays on his back, but now he never stays in the same position anymore, and rolls constantly from his front to his back (and vice versa), and since his flat spot is better he doesn't choose to rest on it.  We also alternate our ways of doing tummy time, by sometimes doing it directly on the floor on a receiving blanket, sometimes using a boppy pillow, and we also bought the "Tummy mat" from Boppy that David loves playing with.  Sometimes, we do also tummy time in my bed while I have things to do in the bedroom.  Once again,  we change it as much as we can, change the toys we use, change the orientation so he has something new to look at.  He now really enjoys tummy time and plays for good periods of time in that position (he even likes to watch his baby Einstein video on his tummy now).  When we started tummy time, he use to  fuss a lot, and I would get down on the floor with him and cheer him and play with him.  Now, he is quite independent.

David also loves his exersaucer and we give him some time in that too.  David has started sitting up and it is so much easier to reposition him.  Even in his high chair, he doesn't rest in head, but prefers to lean forward (we don't put the tray on yet)...  I still hold him a lot and even carry him sometimes for part of the way if we go somewhere and he is his stroller for a long time so that he doesn't rest on his back for too long.  But there also, he has started to sit straight now, and doesn't rest his head most of the time.  Also, if I know that one day he spent more time on his back than usual, because we drove more, or of where we were, then I'm more careful the next couple of days in reducing the amount of time he spends on his back to compensate.

We also change David diaper from the side, and also do it so that to look at us, he is not resting on the flat spot.

That is mainly what we do...  It was not always easy, but it got much easier as David grew older...  It was definitively worth   it for us : )

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©Craniosynostosis And Positional Plagiocephaly Support, Inc.2001