Plagiocephaly - would you/did you opt for the helmet?

[chocolatepie]

Saw pediatrician for his 4 month and she said his head isn't severely flat and she did not immediately suggest a helmet. She said if we worked at not laying him on his back other than sleep/car seat, it would round itself out by age 3 but may not be 100%. She said a helmet usually needs to be started between 4-6 months and can't be added later so I'm terrified that if we skip it and it doesn't round out, my kid will have a misshapen head for the rest of his life. 

She offered a referral to a specialist if we wanted their opinion and said she would not be offended at all if we opted for the helmet since it's faster working and guaranteed to fix it. I decided to at least have the expert look at it and offer their opinion but I know it's considered cosmetic and our choice.

Would you/did you opt for the helmet? Or did you just do positional changes and if so, did their head round out completely on it's own?

[dcn]

I would see what the specialist says.

We did not do a helmet for ds2 and his head did round out for the most part by the time he was 2/3 years old. I remember reading a study back when we were deciding that showed that there wasn’t a huge difference between kids who had the helmet vs those who did not - that those who did not have a helmet ended up with a round head anyway.

The doctors we saw didn’t think his flat spot was that significant though we did have the option if we wanted to. It was helpful to hear from them since they see so many cases and could give us an idea of what severity we were dealing with.

[sparty04]

Definitely go to the specialist.

We helmeted our two oldest kids. DS1 was borderline and they said we could go either way. His head has a great shape now and I’m glad we did it, even though it was annoying at the time. DS2’s head was flat as a board. It wasn’t even an option in my mind, and his head still isn’t as round as I’d like it, but I’m glad we tried.

Both kids got it between 6-7 months. I’d do it again in a heartbeat.

[shauni27]

We went through this and had the specialist suggested a helmet we would have absolutely done it. Around 4 or 5 months we were sent to the specialist from our pedi and they looked and did measurements over a 2 month period (I think?) and promised that we would mostly look normal within a year because they saw progress.

He is now 2.5 and has a totally fine head shape. I can try to find pictures if you want?

[HoneySpider]

DS2 had severe plagiocephaly and brachycephaly so it was a no-brainer for us to do it - he actually ended up having 2 helmets back to back, started around 5 months and had them on a total of about 6 months. The difference is vast and although his head still isn't "perfect" it at least looks normal now. Like pp, we would do it again in a heartbeat.

I would definitely go and get the evaluation, they can show you some pretty amazing images of the head along with measurements that might help you decide if you need it.

[waverly]

I would get the second opinion of the specialist and go from there. We didn't do it, but it wasn't something the pedi saw as a problem or recommended a specialist. He did have a flat spot on the back of his head, and it was there many years later. It might be rounder now, but he's got lots of hair, so I can't tell unless he goes for a shaved head lol.

[tennisgal]

I'd go to the orthotist and see what they say. They will do an evaluation and you can see where the numbers fall. The orthotist will be able to give you better estimates on whether or not to go ahead once they know what his numbers look like. They could also do an eval now and again in another month and see if things change.

[Susie]

My DS had torticollis, and it's only because his pedi caught it at 2m that it was treated before it caused plagiocephaly.  So we didn't need to do a helmet, but I was mentally preparing for the possibility depending on how PT went.  I would have done a helmet if it would have potentially helped him.  Like you said, you don't get this window back.

[ohgillian]

I did and I would again. I also think that many pedis under-address head shape. Especially with a boy who might be bald one day (LOL) I would look into it, but I helmeted my DD and it was incredible the change we saw.

[readyin07]

I would do your research and go see a well respected specialist. at 3ish months, my DS1's head looked flat. My pedi was the same like enhhhh maybe a little, but I probably wouldn't have worried about it you hadn't said anything, but he gave me his preferred provider. When I went to see the specialist, they did his measurements and he was perfectly fine. I even went back a second time (and the office was like an hour away!) because at 7 months it didn't seem improved to me. Again, normal numbers. Clearly I have issues, but it made me feel better.

[shauni27]

Feb 20, 2020 14:12:55 GMT -5 waverly said:

I would get the second opinion of the specialist and go from there. We didn't do it, but it wasn't something the pedi saw as a problem or recommended a specialist. He did have a flat spot on the back of his head, and it was there many years later. It might be rounder now, but he's got lots of hair, so I can't tell unless he goes for a shaved head lol.

This--for us we figured he would have hair there and honestly, once he got hair you could not tell that it was not as round as other babies.

Also, our specialist said that this is extremely common now for babies to have slightly flatter heads--that with babies sleeping on their backs, we as a species will evolve into just having flatter heads a bit (not totally flat, but not fully round). So by the time our (slightly) flat-headed kiddos start going bald, it will not be abnormal if their head is slightly flat--millions of others will be that  way too.

[awkwardpenguin]

We opted for no evaluation and no helmet. DD had mild to moderate plagiocephaly. I would have done it for severe plagiocephaly or if it affected her face shape, but the research on the effectiveness of helmets is not strong. There's even an RCT that was limited to infants with moderate and severe plagiocephaly and showed the same outcomes for the helmet vs. no helmet groups.

www.ncbi.nlm.nih.gov/pmc/articles/PMC4006966/

Helmets change head shape faster, but time and repositioning changes head shape just as much.

[loira]

My DD had a really noticeable flat spot at the back of her head by 4 months. It didn't affect the shape of her face at all, so we were advised by our family doctor not to go the helmet route, just try to do lots of tummy time etc. I pushed for a pediatrician at 7 months because it hadn't rounded out at all IMO, but she said the same thing as our GP. I found doctors here to be way less likely to recommend helmets. Anyway despite all my worry, by 2 it had rounded out considerably, and now at 4 you can't tell at all. Yes, she has long hair, but it's also fine and straight so if her head was super flat it would still be noticeable and it's not.

That being said, if a specialist had recommended it, or if it had been changing the shape of her face, I definitely would have pushed for it.

[kershnic]

Our pedi and another doctor we know personally both showed us the research that shows little to no difference between helmet and no helmet kids. We decided not to pursue it. I don't remember exactly how they described it, but her flatness was on the more significant side of moderate, but was symmetrical. Her head rounded out significantly with time and some re-positioning effort. It's still not quite as round as her sister's, but I can only tell at all if I'm looking for it when her hair is soaking wet. Pedi strongly believed we would have had the same outcome with helmet. Obviously we'll never know for sure, but it seemed like a pretty annoying placebo to us.  She's in kindergarten and I have zero regrets.

[lagom]

I saw Susie mentioned it too, but one of my twins has a flat spot and had torticollis. A pediatric PT was extremely useful by showing me stretching and holds and for providing peace of mind.
Our ped was not supportive but we saw an orthotist anyway and had measurements done 3 weeks apart. We did not see much change but he was borderline and they did not suggest a helmet.
I can still see the spot daily at 13 months but knowing that it is not severe helps me accept it.

[sapphireblue]

We got the helmet when my son was 5 1/2 months old. He had a super noticeable flat spot. The specialist had these graphs of his head shape and where it was severely off from the standard.

If I had read these studies other posters have cited, I might not have done it but I wasn't aware at the time and we had to move quickly apparently. They said we were really at the end of the window of when it's good to do the helmet.

Anyway, the helmet wasn't a big deal and he wore it for a few months, maybe 3-4. Hardly anyone even asked about it and he didn't really seem to mind it.

[lifetaketwo]

We just got a helmet 2 weeks ago. DS head is very misshapen, but no flat spots. His forehead sticks further out on one side, and the slope on his right side is completely different than his left. Until he started flipping to his belly to sleep he only slept turned to the left. It didn’t matter what we did. They didn’t find any muscular issues, so he apparently just had a weird preference. We actually noticed that it started getting better just before the helmet arrived, and it really made us second guess. He’s tolerating really well though, so we’ll give it some time and see. I really hate it, but everyone else finds it adorable

[cherryvalance]

My son had torticollis when he was born, which eventually lead to a flat spot on one side of his head. We did PT when he was about 6 through 13 weeks old. The PT pushed a helmet hard, but my pediatrician didn't feel it was necessary (and my son did have some face symmetry issues at first from it). Ultinately, we decided not to do it and see how it was with time.

Hes 2.5 now and I don't really notice the spot at all, even when his hair is cropped short. His face is perfectly fine.