Please help... need advice... do I wait or persue helmet, neuro appt., etc...

[Guest guest]

At 2 months old, my son went to CHOP Philly for surgery on his belly while there

they thought his fontenelle had shut and they sent him for a CT. Ends up it

wasn't fused but very small. Now at his 4 month check up the pedi noticed his

head is flat on the back right side. She said they are not correlated and to

wait until 6 months to see if it clears up on its own, if not, she will send me

to " plastics " for a helmet. He currently is not showing signs of torticolis. She

also said that they won't helmet infants before 6 months which from my online

research seems rather inaccurate.

So I'm wondering 1. could his fontenelle have closed since his 2 mo. cat scan

and in turn its causing the flat head? 2. If its just positional plagiocephaly

should I really wait another two months to have him evaluated at 6 mo. old? How

commonly does it totally clear up on its own?

[Guest guest]

there is not a person on this board that will tell you it clears up on it's own. It does not. Even with aggresive repositioning they only thing you can hope for is it not getting worse.

A consult / second opinion never hurt anyone. The best I can say is go with your gut, as mine have never steered me wrong.

I cannot speak to if the bones have closed after time or not as I do not know the answer.

Please help... need advice... do I wait or persue helmet, neuro appt., etc...

At 2 months old, my son went to CHOP Philly for surgery on his belly while there they thought his fontenelle had shut and they sent him for a CT. Ends up it wasn't fused but very small. Now at his 4 month check up the pedi noticed his head is flat on the back right side. She said they are not correlated and to wait until 6 months to see if it clears up on its own, if not, she will send me to "plastics" for a helmet. He currently is not showing signs of torticolis. She also said that they won't helmet infants before 6 months which from my online research seems rather inaccurate. So I'm wondering 1. could his fontenelle have closed since his 2 mo. cat scan and in turn its causing the flat head? 2. If its just positional plagiocephaly should I really wait another two months to have him evaluated at 6 mo. old? How commonly does it totally clear up on its own?

[Guest guest]

Thank you for your response! That is good to know. We have an appointment today

for a scan through orthoamerica (starband, i think). She said if its very mild

she may recommend waiting. If not she would recommend giving the scans to the

pedi and telling her I want to start treatment now vs at 6 months.

>

>

>

> there is not a person on this board that will tell you it clears up on it's

own. It does not. Even with aggresive repositioning they only thing you can hope

for is it not getting worse. 

>

> A consult / second opinion never hurt anyone. The best I can say is go with

your gut, as mine have never steered me wrong.

>

> I cannot speak to if the bones have closed after time or not as I do not

know the answer.

>

>

> Please help... need advice... do I wait or persue helmet,

neuro appt., etc...

>

>  

>

>

>

>

> At 2 months old, my son went to CHOP Philly for surgery on his belly while

there they thought his fontenelle had shut and they sent him for a CT. Ends up

it wasn't fused but very small. Now at his 4 month check up the pedi noticed his

head is flat on the back right side. She said they are not correlated and to

wait until 6 months to see if it clears up on its own, if not, she will send me

to " plastics " for a helmet. He currently is not showing signs of torticolis. She

also said that they won't helmet infants before 6 months which from my online

research seems rather inaccurate.

>

> So I'm wondering 1. could his fontenelle have closed since his 2 mo. cat scan

and in turn its causing the flat head? 2. If its just positional plagiocephaly

should I really wait another two months to have him evaluated at 6 mo. old? How

commonly does it totally clear up on its own?

>

[Guest guest]

Fontanelles ( " soft spots " ) close normally over the first couple years

of life, and the more they do, the less effect helmets or

repositioning have on existing plagiocephaly. That's why early

treatment works best. When a fontanelle closes, what's left is a

suture, like a little bit of flexible gristle between the skull

plates. Sutures should not close in babies; that's craniosynostosis.

When a suture closes (and there are degrees of this), what's left is

a single bone, which doesn't broaden in the fused spots anymore. When

a fontanelle closes, the skull surface still gains in area, but the

new growth can't follow the contours of brain and helmet as easily,

because it has to adhere to the suture. However, since

circumferential growth diminishes along with the fontanelles, it's

the lack of growth that is usually blamed.

As long as there is normal growth in your baby's future, a helmet

should still work. Six months is still nice and early, IMO. But if

you want to argue, dig into the reason for the policy. If they don't

want to remodel a skull that is excessively pliable, and therefore

prone to regression, the small fontanelles would seem to counter that

reasoning.

--

Thad Launderville

town, VT

Clara almost 3, had a STARband for plagio

On Mar 1, 2011, at 9:41 AM, Kennedy wrote:

> 1. could his fontenelle have closed since his 2 mo. cat scan and in

> turn its causing the flat head?