Improving head shapes on neworns

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Hello! this is the first time I am posting :eek: I am a student at Orvis School of Nursing at UNR. I have been assigned to find out information on any subject in nursing that was interesting to me!

Here is my question to all you experts......I read an article Evaluating head shaping in infants. There were a few ideas on how this should be done. Head- molding helmet therapy, surgical intervention etc. I was wondering if any of you have any experience with this. As a young mother my daugther had a pretty bumpy head and my grandmother told me to sit and rub her head...after all whatelse did I have to do..her words.....So if you could please give me some information on techniques that have worked for you or the parents you have worked with it would be very interesting and helpful as I am going into a ob rotation in a few weeks!

Thank you

Laura

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Specializes in ER, Tele, L&D. ICU.

I just gave him adequate amounts of "tummy-time". From the time he was first born I allowed him supervised time on his tummy to check out his new view. I don't know any science behind it, but he has a beautiful, perfectly round head-he never had any balding near the back of his head or mis-shaping.

Good Luck in your study:nurse:

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Specializes in Peds - playing with the kids.

weird that you should bring this up...our local news station had a story last night about "flat head syndrome" which is what the babies are getting now from sleeping on their backs.

one of the docs that works out of my hospital designed a special mattress that has been helping with this. don't remember the name of it...but you could probably find the article at local10.com.

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Specializes in Postpartum, Lactation.

I personally, and without any real evidence, think that flat head syndrome comes from letting babies stay in their infant carrier all the live long day. Some people barely ever take their kids out of them. They let them sleep in the carrier most of the time, rather than transfer the baby to her crib after a trip to the grocery. And as such, I warn my parents not to let their babies stay in the carrier too much. There just isn't enough padding. I'm completely convinced that infant carriers, NOT "back to sleep" are the culprit.

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I personally, and without any real evidence, think that flat head syndrome comes from letting babies stay in their infant carrier all the live long day. Some people barely ever take their kids out of them. They let them sleep in the carrier most of the time, rather than transfer the baby to her crib after a trip to the grocery. And as such, I warn my parents not to let their babies stay in the carrier too much. There just isn't enough padding. I'm completely convinced that infant carriers, NOT "back to sleep" are the culprit.

I too have no real evidence but have seen this alot. Babies rarely held and left to sit in their infant carrier/seat or swing . .. one family had the baby sleep in the swing all night, every night the whole first year of her life. Another placed the baby in a infant seat and placed in front of the tv. :(

I think putting baby in a front pack and taking a walk, picking the baby up alot and holding her, giving the baby some tummy time, etc., will do wonders . . ...

steph

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Specializes in NICU.

I also see lots of kids either in infant seats, swings, or bouncy seats all day long. Parents are so afraid to put them on their tummies - even with the baby awake and parents right next to them - that they don't try it until the baby is six months old, and by then the position is so foreign that the baby screams and cries.

My nephew spent a lot of time during the day in different positions - his problem actually was Back To Sleep. He started sleeping through the night at about three months of age and he always slept in the exact same position - on his back, arms over his head, with his head tilted to the right. By the time he was six months old, his head was flatter than a pancake, balding, slanted, and his ears were uneven. He wound up with a helmet (Doc-band) until he was a year old. It helped a lot, but he should have worn it a few months longer than he did - head is still a little funny shaped.

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Look up plagiocephaly. Good luck!

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I was wondering if any of you have any information on positional plagiocephaly. In the literature that I have recently read it talks alot about the impact of American Academy of Pediatrics' Back to Sleep Campaign and positional plagiocephaly. Clearly. if this has a positive impact on SIDs as is intended we can not deny the importance. But, what is to be done, if anything, about postional plagiocephaly resulting from this recommandation?

Your comments would be greatly appreciated.

Laura

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One additional question on the subject of head shaping.

What emotional effects if any do you think infants and toddlers incur from the use of helmets?

Laura

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Specializes in Postpartum, Lactation.

See my above post. I am serious. I refuse to believe that "Back to Sleep" is the culprit here. There are many, many kids who are put "Back to Sleep" and do not get positional plagiocephaly. I will continue to blame infant carriers.

I don't have any experience to base an opinion about emotional effects upon.

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Specializes in NICU.
One additional question on the subject of head shaping.

What emotional effects if any do you think infants and toddlers incur from the use of helmets?

Laura

First of all, if you Google positional plagiocephaly, you'll get mountains of information about it. Rather than us trying to type everything out here, it's best for you to just go to all those websites and read for yourself. There is way too much to print here. There are even places that will custom paint these helmets to make them look cute!

But basically, yes, the Back to Sleep program seems to be the #1 culprit when it comes to plagiocephaly. HOWEVER, the increased use of bouncy seats, swings, and corificeats is also to blame. Many parents let their babies sleep in these seats all day long, with pressure against the back of the baby's head, then they lay them down on their backs to sleep at night. Is it any wonder that positional plagiocephaly has become a problem???

As far as emotional effects, I can tell you that I've never seen any. There would be MUCH more of a problem if the baby had a misshapen head and the parents DIDN'T agree to using a helmet. That child would go through life with a misshapen head, so there would probably be teasing and self-esteem issues to deal with. Not to mention anger! Can you imagine a 30-something man who has thinning hair, whose odd head shape is becoming more and more obvious each day? Picture a bride on her wedding day, worried that she has to cock her head a certain way in each and every picture, so that the pictures don't highlight the fact that her ears are horribly uneven. If these people knew that their parents refused to get them a corrective helmet when they were babies, and that this COULD have been prevented - do you think they're going to be happy? No way.

Most of the parents I've seen who refused helmets didn't see the big picture. They thought it would emotionally scar the baby to go through the casting procedure. Or they worried what people would think if they saw them with a baby who had a helmet. They were embarrassed. They didn't want to deal with the stigma of having a child that was different.

My nephew had a helmet. Of course his parents were a little embarrassed about people seeing it - because strangers often stare and can be very rude - but they kept that thing on him. Sometimes if they were running to the mall or grocery store with him, they'd take it off for that hour or two, just because they didn't have time to deal with questions and annoying stares. But as for the kid, he could have cared less that he had a helmet on. He hated wearing hats, but he didn't mind the helmet. It was cute - he likes to tug his hair when he's sleepy, but he couldn't with the helmet on, so he figured out how to undo and redo the Velcro latch instead. He'd just play with that, and we'd know he was tired.

As a matter of fact, we missed that thing when he was through with it. He had just started walking at that time, and it was nice that he had some head protection! Once it was off, he was bumping his head like crazy and we'd cringe everytime!

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I see babies in their homes all day long. I have to say that the babies that have more of an attachment parenting experience have better shaped heads. These babes are held or worn in a sling or carrier, they breastfeed (so no laying in the carrier with a propped bottle), and many breastfed babes I see are co-sleeping so they tend to be switching position in the night to bf on either side. The opposite end of the spectrum are the babes who never get out of the corificeat or swing. Feedings are propped and they sleep in the crib on their backs (which is a fine thing, but will someone hold them eventually, please!!)

So, I guess what I'm saying is that back to sleep may be part of the culprit, but inattentive parents (or those who just don't know better) also play a large part.

I encourage supervised tummy time from the very first post-partum visit. Just to get them used to the idea.

Natalie

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