Flat spot on head

[army_mom]

DD always sleeps with her head to the right. She always has (she's almost 5 months) and she is starting to get a flat spot and a bald spot. I want to try to get her to sleep on the other side but she automatically turns her head when I lay her down. I'm not sure what is safe to put in her crib to help keep her on the other side. She is quite the little wiggle worm in her crib and is all over the place so I'm not sure what to do!

Anyone's DC every have a side preference and what did you do to keep them rotating sides so a flat spot didn't develop?

TIA!

[Tondi G]

You can try putting her on her side.... when she is totally asleep you can go in and attempt to shift her head to the other side. You should attempt to have as much upright or tummy time as possible.... get her out of the bouncy seat and swing.... maybe exersaucer when you need to put her down to make dinner etc. Have you had your ped look at it? Sometimes there is a neck issue with plagio called torticollis which requires stretching and exercises to help loosen up their tight neck muscles.

this could help you but if she is moving all over at night it might not work

http://www.infantheadbed.com/?gclid=...FRk_awodynVSLA

This is the helmet that my friends son wore to correct his plagio

http://www.cranialtech.com/

Here are some sites to check out...

http://www.flatheadsyndrome.info/

http://www.plagiocephaly.info/

http://www.torticolliskids.org/

[WatchingThemGrow]

great references!!!

We also reversed the way we put DD on the changing table, moved her to the other side in the crib (so she'd look into the room using the other side of her head) and other positional things.

[brittone2]

You've gotten some great references. You might consider consulting w/ your ped and or contacting early intervention. Disclaimer: no one can diagnose your child via the internet. However, what you are describing could be consistent with what someone would see in the case of plagiocephaly and or torticollis. Sometimes things like torticollis or plagiocephaly can resolve on their own, but at the same time, ideally you want to have them treated before it starts to impact gross motor milestones (like rolling and sitting).

Some kids have *just* plagiocephaly (flattening), and some have *just* torticollis (tight neck muscle(s)). And often, the two can go together (the tight neck muscle leads to flattening in one area because that area of the head gets the most pressure for the largest number of hours).

If the child has torticollis (tight neck muscle(s)), it can definitely impact gross motor milestones. IME, there are many peds that are not great at detecting torticollis. If you are dealing w/ plagio plus tort and an obvious preference for one side, hopefully your ped will be willing to take it seriously. If not, you can self-refer to EI. Babies are excellent at compensating, so while it may not look like their head is rotated and/or tilted from the tight neck muscle, unless you know how to isolate specific joint movements...it may not *look* like it is affecting them.

The upside of tort is that in most cases it resolves very well with some positioning, and gentle stretching and strengthening exercises that a physical therapist would teach you. The key is to do them consistently, every day, several times a day (try to do 1-2 of the stretches or exercises with each diaper change for example)

In the meantime, try to position her so that everything *interesting* (if she wants to watch siblings, if she wants to stare at the TV if you have it on, etc.) is to her non-preferred side. If she's watching you in the kitchen and you have her in some sort of seat, etc. then position her so that in order to look at you she needs to turn her head the opposite way. That said, babies are excellent at compensating and will often rotate their shoulders or entire trunk to turn their body so that they don't have to stretch the tight neck muscle. You can even modify feeding her by bottle or breast so that she's turning toward the non preferred side. Encourage some tummy time after each diaper change to at least alleviate some of the pressure on her head and strengthen her neck muscles. Depending on which side is affected (which muscle(s) is tight), the PT can give you more specific exercises, positioning strategies, and stretching to help.

I would encourage getting it looked at sooner rather than later, since you are already getting close to the time when she might start sitting up, rolling, etc. (it is hard to roll to both sides if you can't turn your head fully, and it is hard to balance in sitting if your head is tilted).

[KpbS]

I agree w/ suggestions of the PP--change up the changing table, place her at the other side of the crib, see if you can borrow a bumbo seat, etc.

You are almost to point where many babies start sitting up and rolling over (once she can roll she may prefer her stomach for sleeping) and both of these help tremendously w/ the flatness. Will she tolerate tummy time?

I would make an appt. w/ the ped just to get her/his opinion. Some like get the ball rolling sooner than others IME and it is good to have a reference pt. to compare when you go in for your 6 mo. checkup.

Both of my babies had plagio but theirs started very early on but improved significantly at 7-8 mo. onwards. No torticollis.

[KrisM]

DD did this and had torticolis. We increased tummy time, held her face down supported by our arm, and would hold her so that she had to look left to see everyone in the room. We did see a ped. PT about it and these ideas came from her. The PT had us doing some stretches as well, but I'm not describing them online .

[shawnandangel]

DD started getting a flat spot on her head. I went to Toys R Us and bought a crib mirror for 12.99. I put the crib mirror in the crib on the side I wanted her head to face. It worked wonders. She immediately started looking at that side of the crib, and thus turning her head. I'm happy to report her head is round again!
http://www.toysrus.com/product/index...ductId=3371229

[SammyeGail]

I have twin boys who are 3.5 now. By 2 months Noah (they were 6 weeks premature) had a completely flathead in the back, I felt terrible. Jonas was my high-maintance infant while Noah was my very calm infant, can't say that about him now, lol.

I went to Pottery Barn and got the Boppy Noggin Nest asap, didn't want to wait on mail order. Back then there was this one or denim (???).

http://www.boppy.com/shop/index.php?...roducts_id=104

We went to pedi and he said it would go away within 2 months. He also recommended getting a twin size memory foam matress cover, cut it to size about 2 inches shorter all around the crib matress and use that. We did this for both twins. Our sheets didn't fit, the only ones that did were Pottery Barn, so we had to get new sheets. I used spair memory foam and put it in the swing, etc.

2 months later its no better so we get a referral for a corrective helmet, he wore it from 6 to 9 months. What a major difference!! His case was considered severe.

In the meantime Jonas had developed a flat spot on one side. While we were in for an adjustment for Noah they did a quick scan of Jonas and he fell in the moderate/severe range. Noah was protected while I held him, but Jonas' spot came from the nook of my arm : ).

So Jonas gets a helmet at 9 months but it didn't go well. You can't wear it with a fever, (2 ear infections and 2-3 viruses) or if any red spots show up, we had to go to Atlanta 3 hours away for adjustments. Jo would have sweat pouring down his neck, he hated it. He probably only wore it about 40% of the time but he did self correct. He still has a small flat spot, but only I notice it when washing his hair.

I am very sure Noah would not have self corrected. He was pulling apart the velcro and pushing up the helmet so he said he was finished at 9 months, lol. They wanted him in it another month, but he made alot of progress and looked great. Still a flat spot and its never improved.

I think its hereditary in Noah's case. I have a flat head in back, my neice had a flat head but is now 14 and has a load of hair. Jonas might have had mild torticollis. I looked back at all his old baby pics and he was mainly looking one way. I did the exercises I saw online.

Lots of great advice you were given, this is such an awesome board!! I read once to put a rolled up recieving blanket under them once they are asleep so they are on the side you want them on, but it never worked for us for either DS. They would just shift over to get back into their comfy position.

Good luck!!

Samantha
Mommy to 3.5 twin boys
Noah, my little firecracker
Jonas, my sweetheart with autism

[KHF]

A big to all of the above advice. My DD also had to wear a helmet for plagiocephaly from 6-9 months old. She was diagnosed with torticollis very early (one month). She had it from birth. DD always looked to the right and tilted her head to the left. She had the most common form, congenital muscular torticollis.

Her pediatrician gave me a sheet of exercises to do, but I was never trained by a PT in them. When your infant is screaming at you when you do the exercises, it's hard to know how much to push. In retrospect, I wish I had demanded a referral to the PT much earlier. I know we could have avoided the helmet had we done that.

As it was, she ended up with a helmet at 6 months. It was not fun, but she only had to wear it for 3 months and her head is perfect now. Her plagio was considered moderate to severe. It was affecting her forehead (one side was pushed further out), her eyes were starting to look assymetrical and one of her ears was a full inch closer to her face than the other one.

We are now armed with the information to use with our new baby and have been actively keeping his time in swings and bouncers limited. We also make sure he holds his head up in the car seat, by propping it up with rolled up blankets and make sure he rotates the side of his head he's laying on. We also use an egg crate cut to crib size in his crib. I know it's not recommended, but we are relatively certain that DD's Colgate mattress had a lot to do with the flattening of her head. We religiously put her on her back and the mattress just had no give to it. DS also sleeps on his back, but the thin egg crate layer helps to take some pressure off of his head. It's all in what you're comfortable with. I'm more comfortable adding a padded layer than I am putting him on his stomach to sleep.

Thankfully, he hasn't shown the signs of torticollis, and with our preventive measures, it doesn't look like we'll be repeat customers at the plagio clinic.

Make sure you stay on top of the situation though. The best time for helmet treatment is between 6-12 months. After 12 months, the success rate goes down dramatically and they'll have to wear it much longer. Sometimes a small flat spot will correct itself, but if you wait too long in a "wait and see" pattern, you can lose your window of opportunity to correct it.

[justincase]

Another big ... You have gotten lots and lots of good advice.

DS was born with moderate to severe plagio and severe tort caused by his position in utero. We knew something was wrong from birth but our ped at the time was one of the less receptive ones and just kept telling us most babies exhibit a side preference and he'd grow out of it. We did all of the suggested things like turning him so he'd be "forced" to turn to his non-preferred side to see anything interesting. We still ended up in a helmet (from Cranial Tech, which PP gave a link for) for 7 months (from 7 mo to 14 mo) and with months of PT. We had a really good outcome but felt like we were the ones who had to push and advocate for it.

Another tiny addition about the "turn to look at something interesting" -- PP mentioned a crib mirror, which we found helped as well. Also, I had always shied away from noisy, light-up, plastic toys but PT encouraged me to pick up a couple of "noise toys" that we would get out only for exercise time. It was amazing how interesting these things were to a baby who hadn't seen them before. Sometimes he would be willing to turn his head to look at those things when nothing else would work.

GL!