Re: How effective is repositioning?/When to consider a helmet?

[Guest guest]

Hi Amy.

We were in a similar situation about four months ago. First of all, I'm Canadian

and we don't measure their heads the same way you guys do. My son was diagnosed

with plagio at around four months in the mild to moderate range. The

neurosurgeon I talked to referred us to a physiotherapist for his torticollis

and suggested repositioning first until about six months of age. We went to

physio and were given some exercises to strengthen one side of his neck that was

weaker than the other. So far we have been repoing for almost two months and it

seems to have made a great difference. It's a lot harder to see the flat spot

now.

At night we reposition him onto his side and during the day we keep him off his

back as much as possible. Just like you our son HATED tummy time with a passion.

He would scream as soon as we put him down. So we started doing the tummy time

on the bed or on the couch. I would get very animated and play with him the

whole time, tickle him etc. And now he tolerates it a lot better. He will stay

on his tummy on the floor for around five minutes at a time now. Another thing

that worked was constant positive reinforcement. Put him down on his tummy, when

he screams tell him it's okay in a really happy voice, pick him up for 30

seconds max to calm down and put him back down on his belly again with a happy

voice. It eventually works.

Good luck with the repositioning. Sometimes it is a pain in the rear end,

especially waking up occassionally in the middle of the night to make sure he's

still in that position but we have had some success with it.

Our follow up appointment with the neurosurgeon is in two weeks, so I'll let you

know how it goes. We're hoping he doesn't need the helmet, but whatever is best

for my son is what we'll do.

Good luck with the repo, keep it up,

Vickie

>

> Hi,

>

> My daughter is 4 months old and has plagiocephaly. We noticed the

flattening on the right side at 8 weeks and our pediatrician referred us to a

physical therapist to try repositioning techniques. Her initial measurement at

three months was 6 mm and when she was remeasured last week it was still 6mm, so

it has not gotten worse but not really better either. She really dislikes tummy

time, but we suffer through it 3 times a day for about 10 minutes, which seems

to be her max:-)I keep her off the back of her head as much as possible and

reposition her to her side throughout the night. The PT is sort of vague about

what the next step will be if she doesn't improve. If anyone would be willing to

share their expereinces I would really appreciate it! Since her case is in the

mild range would she be a canidate for a helmet or banding? Any suggestions on

how to make tummytime more enjoyable for her? I'm a new mom and don't know

anyone else who has dealt with this issue!

>

> Thanks,

> Amy

>

[Guest guest]

> >

> > Hi,

> >

> > My daughter is 4 months old and has plagiocephaly. We noticed the

flattening on the right side at 8 weeks and our pediatrician referred us to a

physical therapist to try repositioning techniques. Her initial measurement at

three months was 6 mm and when she was remeasured last week it was still 6mm, so

it has not gotten worse but not really better either. She really dislikes tummy

time, but we suffer through it 3 times a day for about 10 minutes, which seems

to be her max:-)I keep her off the back of her head as much as possible and

reposition her to her side throughout the night. The PT is sort of vague about

what the next step will be if she doesn't improve. If anyone would be willing to

share their expereinces I would really appreciate it! Since her case is in the

mild range would she be a canidate for a helmet or banding? Any suggestions on

how to make tummytime more enjoyable for her? I'm a new mom and don't know

anyone else who has dealt with this issue!

> >

> > Thanks,

> > Amy

> >

>

Vickie,

Thanks you so much for replying- that makes me feel like the repositioning

efforts may be successful. It has been 10 days since the last PT visit and I

think I may notice a slight change for the better already. I will keep trying

with the tummy time (i swear it feels like " tummy torture " sometimes:-)- I tried

your suggestions this afternoon and she seemed to do better with the shorter

period with a brief pick up and then back on her tummy. I would really

appreciate it if you would let me know what your doc says at the next

appointment. I also just want to do what's best for , but I do hope we

will not need to do a helmet if the repositioning can be successful.

Thanks for the encouragement!

Amy

[Guest guest]

Hi Amy,

6 mm is generally considered mild, and most people won't band at that number,

but it really depends how your child looks. Also there is the cephalic index

which you might want to consider. This is the ratio of the head length front to

back, vs the width. Basically you want to see if the head is extra wide, and

flat across the back (probably not since you didn't mention this).

Also at 4 mo you still have time. You should push tummy time, but also look at

the repositioning tips in the files section. You want to keep the baby off the

flat spot and put pressure on the prominent area when she does rest on her head.

You can do things like put a sock filled with rice under one shoulder. It can be

sewn or velco-ed to pajamas etc.

Take pictures that show the plagio (usually from the top), and see if it is

getting better or worse every week or two.

-christine

sydney, 3 yrs, starband grad

>

> Hi,

>

> My daughter is 4 months old and has plagiocephaly. We noticed the

flattening on the right side at 8 weeks and our pediatrician referred us to a

physical therapist to try repositioning techniques. Her initial measurement at

three months was 6 mm and when she was remeasured last week it was still 6mm, so

it has not gotten worse but not really better either. She really dislikes tummy

time, but we suffer through it 3 times a day for about 10 minutes, which seems

to be her max:-)I keep her off the back of her head as much as possible and

reposition her to her side throughout the night. The PT is sort of vague about

what the next step will be if she doesn't improve. If anyone would be willing to

share their expereinces I would really appreciate it! Since her case is in the

mild range would she be a canidate for a helmet or banding? Any suggestions on

how to make tummytime more enjoyable for her? I'm a new mom and don't know

anyone else who has dealt with this issue!

>

> Thanks,

> Amy

>

[Guest guest]

> >

> > Hi,

> >

> > My daughter is 4 months old and has plagiocephaly. We noticed the

flattening on the right side at 8 weeks and our pediatrician referred us to a

physical therapist to try repositioning techniques. Her initial measurement at

three months was 6 mm and when she was remeasured last week it was still 6mm, so

it has not gotten worse but not really better either. She really dislikes tummy

time, but we suffer through it 3 times a day for about 10 minutes, which seems

to be her max:-)I keep her off the back of her head as much as possible and

reposition her to her side throughout the night. The PT is sort of vague about

what the next step will be if she doesn't improve. If anyone would be willing to

share their expereinces I would really appreciate it! Since her case is in the

mild range would she be a canidate for a helmet or banding? Any suggestions on

how to make tummytime more enjoyable for her? I'm a new mom and don't know

anyone else who has dealt with this issue!

> >

> > Thanks,

> > Amy

> >

>

Thanks so much . She does have some flattening on the back of her head

which is also a concern. Again the PT says it is mild but still significant. I

had never considered sewing the rice sock to the pajamas- I will definitely

asked the PT if she thinks that would help! I will also take some pics as you

suggested so we can track it more accurately. Thank you for taking the time to

respond!

Amy

[Guest guest]

> >

> > Hi,

> >

> > My daughter is 4 months old and has plagiocephaly. We noticed the

flattening on the right side at 8 weeks and our pediatrician referred us to a

physical therapist to try repositioning techniques. Her initial measurement at

three months was 6 mm and when she was remeasured last week it was still 6mm, so

it has not gotten worse but not really better either. She really dislikes tummy

time, but we suffer through it 3 times a day for about 10 minutes, which seems

to be her max:-)I keep her off the back of her head as much as possible and

reposition her to her side throughout the night. The PT is sort of vague about

what the next step will be if she doesn't improve. If anyone would be willing to

share their expereinces I would really appreciate it! Since her case is in the

mild range would she be a canidate for a helmet or banding? Any suggestions on

how to make tummytime more enjoyable for her? I'm a new mom and don't know

anyone else who has dealt with this issue!

> >

> > Thanks,

> > Amy

> >

>

Thanks so much . She does have some flattening on the back of her head

that the PT is also concerned about. It is mild as well but still a concern. I

will definitely start taking pictures to track the changes. The idea about

sewing the rice sock to the sleep sack is great!

Amy

[Guest guest]

I agree that 6mm is usually not enough to band. What I think would help in

addition to the tummy time and keeping her off her back is making sure that when

she IS laying down, that there is pressure being applied to the part sticking

out, and space is left under the flat part (so that it can fill in). This can be

achieved by putting a rolled up receiving blanket against the side of her head

that has the flat spot. To be honest, this would probably work BETTER than just

keeping her off her back, because this type of repositioning is working like a

helmet by applying pressure to the part that sicks out and leaving room for the

flat area to fill in. When you keep a baby off their back, the head won't get

worse, which is good, but it also won't get much better either, since the head

continues to grow evenly around. The flat area won't just grow faster to

compensate. So the flat spot will remain, but maybe look less noticeable as time

goes by. Applying pressure to the part that sticks out (the non-flat side) will

slow growth there, giving the flat area time to catch up and fill in. Did I

explain that well? I hope this helps you.

[Guest guest]

>

> I agree that 6mm is usually not enough to band. What I think would help in

addition to the tummy time and keeping her off her back is making sure that when

she IS laying down, that there is pressure being applied to the part sticking

out, and space is left under the flat part (so that it can fill in). This can be

achieved by putting a rolled up receiving blanket against the side of her head

that has the flat spot. To be honest, this would probably work BETTER than just

keeping her off her back, because this type of repositioning is working like a

helmet by applying pressure to the part that sicks out and leaving room for the

flat area to fill in. When you keep a baby off their back, the head won't get

worse, which is good, but it also won't get much better either, since the head

continues to grow evenly around. The flat area won't just grow faster to

compensate. So the flat spot will remain, but maybe look less noticeable as time

goes by. Applying pressure to the part that sticks out (the non-flat side) will

slow growth there, giving the flat area time to catch up and fill in. Did I

explain that well? I hope this helps you.

>

Thanks - yes that is very helpful! When she is laying down it is on the

right side of her head to apply pressure to that area. I swear I can see some

change already. I was so excited today because she is tolerating tummy time much

better- it seems to get less upsetting for her as she gets stronger neck

muscles. Hopefully, she will continue to improve!

Amy

[Guest guest]

> > I agree that 6mm is usually not enough to band. What I think would help in

addition to the tummy time and keeping her off her back is making sure that when

she IS laying down, that there is pressure being applied to the part sticking

out, and space is left under the flat part (so that it can fill in). This can be

achieved by putting a rolled up receiving blanket against the side of her head

that has the flat spot. To be honest, this would probably work BETTER than just

keeping her off her back, because this type of repositioning is working like a

helmet by applying pressure to the part that sicks out and leaving room for the

flat area to fill in. When you keep a baby off their back, the head won't get

worse, which is good, but it also won't get much better either, since the head

continues to grow evenly around. The flat area won't just grow faster to

compensate. So the flat spot will remain, but maybe look less noticeable as time

goes by. Applying pressure to the part that sticks out (the non-flat side) will

slow growth there, giving the flat area time to catch up and fill in. Did I

explain that well? I hope this helps you.

> >

> Thanks - yes that is very helpful! When she is laying down it is on the

right side of her head to apply pressure to that area. I swear I can see some

change already. I was so excited today because she is tolerating tummy time much

better- it seems to get less upsetting for her as she gets stronger neck

muscles. Hopefully, she will continue to improve!

> Amy

>

I've heard success stories with people who have done this, to the point where

their heads look totally normal again just with repositioning. Unfortunately

this didn't work for my son. They think his case started in-utero, making it

even harder to correct. So far his head is looking good, but we need to get a

2nd helmet. I'm glad things are going well for you! Good luck!