7 Months & Deciding To Let Nature Take It's Course

First I want to thank everyone who responded to my post about Bucket's head for all of the love and support. Since my last post I've had the opportunity to talk to a few moms whose babies had similar heads and who decided not to helmet. They generously sent me photos of their children as they grew up. By 2 years, you could barely tell that the child's head was anything other than "normal", and by 5 years there was no difference at all. Between the support from our friends and family, these mom's experiences, and the lack of any real evidence that the helmets make a difference at the age of 2 we decided to forgo the helmet and let Bucket's head develop as it will.

That being said, "develop as it will" is coupled with mission "Keep Bucket off his head whenever he is not sleeping". I may not be getting paid, but I suddenly have a new full time job. We decided to invest in a jumparoo a.k.a. "the circle of neglect":

Fortunately, Bucket loves it. He has a good position for prime Kitty-watching, lots of things to chew on (that the cat can't reach and eat), and has a great time bouncing up and down.

Also fortunately, Bucket is a great sitter. He still sucks on his stomach, but kid's got some wicked core strength. He still topples backwards when excited so I need to keep an eye on him, but it's a huge advantage.

We also spend much more time in the ergo. This keeps him off his head and allows him to nap (meaning a full 45-90 min of sleep also off of his head. He's comfy in the front carry, but he gets in the way. The back carry is more convenient, but both he and I are too short for the carrier so I'm looking for alternatives.

Hikin' with L on Baba's Day

Luxuriating post-back carry with me.

The rest of the time, I'm holding, bouncing, or playing with him. We also try to time all car rides with naps so we bang out car seat time and nap time into one on-his-head time.

Its a lot of work, but every day actually gets easier. Even more encouraging, we're already seeing a difference in his head shape. Compare:

to:

I'm amazed at what a difference this sort of repositional work makes. The rate of improvement is also very encouraging to keep going, even when it's a real pain in the ass. It has also occurred to me that the entire keep-Bucket-off-his-head mission is possible because I don't work outside of the home. If he were in daycare, he'd be in a helmet. Both because the $3,000 price tag would be more affordable with two incomes, but also because we could not ask a daycare provider to keep him off his head in the same way I am able to. So, I guess you could say I'm earning us $3,000 by being home so we don't have to put him in a helmet (or something like that).

This was a hard choice for me to make (easier for L for a variety of reasons), but I now feel strongly that we made the right choice by our kid.

Yes, yes she does.

The shape of a head

Bucket has a flat head. It started when he was engaged in my pelvis, but it got much worse around 8 weeks when his head grew much faster than the rest of himself. Knowing that we had to keep him off of his head and that tummy time was excruciating, we went to a bunch of extra measures to keep him off of his head. Then, at the 4 month dr apt, our pediatrician mentioned that he had a flat head, but that it would round as he got older. A bigger concern was teaching him how to roll and we were encouraged to leave him on the floor (tummy or back) to encourage movement he could not do when in arms.The added floor time did help him learn to move, but made the head issues worse. Again, the pediatrician advised us to work on tummy time and reassured us it would round as he got older. 

Visiting my aunt, a pediatrician, this past week produced a very different response. She said she would have recommended aggressive positioning and PT at 4 months and would have him evaluated for a helmet to correct the deformity immediately. 

Cue: Kelly freaking out.

Well, not entirely. I'm totally aware of his head. We've been trying to work on it, but it's not working. I've looked into helmets and know they would round his head out after a few weeks. Caught between the two extremes of it'll-work-itself-out and helmet-now! we decided to see a pediatric neurologist.

Bucket has a "moderate" head deformity. It is symmetrically flat in the back and causes no misshaping in the face. The skull is wider above the ears than a "normal" head, but not too bad, especially considering he seems to have inherited the round face from his dad's Swedish side of the family. The neuro said that a helmet would correct the flatness, but wasn't "necessary" and that it would round out and be covered with hair, over time. It will not round to "normal", but it won't be particularly noticeable. Most importantly, the flatness won't cause any developmental problems, it's simply the way his head is growing. That being said, a helmet would correct the problem and he gave us a prescription in case we want to go that route. 

As a parent, I'm really torn. On the one hand, Bucket has a round face inherited from his father's side, and my mom has a flat patch on her head. Not to mention that I have random strangers come up to me to tell me how beautiful my child is. Hell, even the neurologist said, "you should have more kids, you and your husband make beautiful babies". It's not like I hear a lot of "tsk, he'd be adorable if only it weren't for his head..." Plus, since the back-to-sleep campaign, flat heads have been on the rise and are much more common these days. On the other hand, I wonder if this is something 30- year old Bucket would want us to correct when we can. What if it does't round or he goes bald? Is it worth putting him in an orthotic for 8-12 weeks when he won't even know its on his head so that his head will look more "normal"?

To be honest, we wouldn't even be having a debate if his palgiocephaly was asymmetrical (on the side, or distorting his facial features). But because it's even across the back, it just makes his already large head perhaps slightly more prominent. (body is 22% for age, head is 87% for age).

We still have to talk to the insurance company and see what/if a helmet would be covered. Because it is considered a "cosmetic" deformity, many insurance companies don't cover the costs. At about $3,000, they aren't cheap. How much is the shape of his head worth? Then again, what about just accepting him for how he develops? Who is to say that his head won't look basically normal in 2 years time?

At the end of the day, I'm most relieved that we have a beautiful, happy, healthy baby who will not face any neurological or developmental repercussions from having a flat head. I'm blogging about this, and will continue to do so, no matter what we decide. If we decide to helmet, I hope this will be a resource for parents who may face the same dilemma. If we decide not to helmet, I hope to chronicle how Bucket's head develops independent of an orthotic - and maybe give more confidence to others that the body can indeed work itself out.