Wednesday, October 23, 2013

Battling Brachycephaly: The Adventures of a Helmet Baby

As many of you know, a little over a week ago, we were finally given the go ahead to say goodbye to Brody's helmet forever! For as nervous as I was to remove this orthotic helmet that doubled as a safety device, Brody did wonderful during the transition. It only took him a couple goose eggs to learn that he can no longer bang his head against the wall/crib/high chair to make that "cool noise." I'm so excited to finally be able to kiss his adorable little face and head without fear of a busted nose or fat lip.

As popular as these helmets have gotten since the 1994 "Back to Sleep" campaign, I was somewhat surprised how ill-informed most people were about "helmet babies." Listening to other parent's responses when their own children asked them about Brody's helmet was pretty priceless sometimes.

"That baby just isn't learning as fast as other babies." 

"Oh, he just gets hurt a lot so his mommy has to make him wear a helmet."

Goodness. There were other times when people would really stare Brody down, but A.) who cares, and B.) he's adorable, so why wouldn't they want to check out his perfect little face? ;)

We made the decision to get Brody fitted for a helmet back on May 15 this year. His flat spot was very noticeable the second he was born and it just became most prominent over the next few months. I chalk it up to a combination of a very long, difficult birth, the use of forceps and the fact that he slept on his back for 10-12 hours straight through from the beginning. Regardless, it needed to be taken care of.

Brody was referred to the specialists at Mary Free Bed, and thankfully, they have an office with a STARband scanner right here in Holland. The staff was wonderful to work with and extremely helpful when it came to dealing with insurance and referrals.

Brody's official diagnosis was Brachycephaly with Plagiocephaly... which loosely translates to the back of his head was flat. (Learn about the different types here.) As you can see, the scan shows the shape of Brody's head on May 15 and October 10. (Imagine looking down on the top of his head and the dates are near his forehead.) Because we were diligent about not exceeding the hour Brody could go without his helmet every day, the sides of his head did not grow, only the front and back filled out.

We were most concerned with his Cephalic Ratio. Brody was originally over 96% (0.962) and "normal/ideal" was considered anything below 90%. His last scan put him right at 90% (0.901). There's still a small flat ridge towards the top of his head, but our Othotist assured me that there's a good chance it'll still fill out on it's own and wearing the helmet any longer wouldn't produce any more noticeable change.

For all you other parents of helmet babies who can't read this gibberish either, I tracked down an explanation:

  • Cephalic Ratio: Cranial Breadth/Cranial Length. An ideal ratio would be 0.78 or 78%
  • Radial Symmetry Index (RSI): From the front of the head, 15° segments are measured and added. The addition of the right side segments is subtracted to the addition of the left side segments. An ideal ratio would be left side – right side = 0
  • Oblique Cranial maximum and minimum: Ideally one is looking to have the maximum line vertical and the minimum line horizontal.
  • Oblique at 30 deg (US1 and US2): Length of diagonal taken at 30° on each side (30° corresponds to the corner of the eye). The subtraction of US1 and US2 gives an indication of the asymmetry of the head. An asymmetry bet. 0 and 10 mm is classified as mild, bet 10 and 16 mm medium and over 16mm severe.
  • Q1, Q2, Q3, Q4 volumes: Draws vertical and horizontal lines centered on middle point of head. Measures volume of each corner starting front left, then front right, back right and back left.
  • Anterior Symmetry Ratio: Looks at front of head and divides front left volume with front right volume. An ideal ratio would be 1.
  • Posterior Symmetry Ratio: Looks at back of head and divides back right volume with back left volume. An ideal ration would be 1.
  • Overall Symmetry Ratio: Divides left side with right side. An ideal ratio would be 1.
  • Upper facial left and upper facial right: Measures the length between the centre of the front to each left and right ear. This corresponds to a cranial bone and determines the position of the ear.
  • Upper Facial Symmetry Ratio: Divides Upper Facial Right with Upper Facial Left. An ideal ratio would be 1.

I loved Brody's little do rag for scans. LoL. He's so street.

Brody did phenomenal the entire helmet process. The initial transition phase takes 5 days to get his head accustomed to wearing the helmet. He never even knew he had it on. He even fell asleep with it on the very first day. It was only towards the end that he would reach up and occasionally tug at it. The helmet also turned into a little game. We would stick toys in the cutout area on top and he'd laugh and shake his head until they fell out. So adorable.

Unfortunately, I don't have any fantastic shots of the back of Brody's head before the helmet. I would definitely recommend investing in a helmet if your child is diagnosed with a form of Plagiocephaly. Because there isn't the awareness and a lack of literature, most believe this is simply a cosmetic issue with doctors playing the vanity card. Left untreated, Plagiocephaly can compromise the functions of the ears, eyes, and jaw along with elevated risk of cognitive and motor delays. I can honestly say the helmet was not nearly as scary as I had imagined and it has made a world of difference in just 19 weeks.

Now it's time to catch up on the millions of kisses his little face and head have been missing out on.
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