As if moms didn’t already have enough to worry about! No one talks about plagiocephaly or torticollis, how are you supposed to know about it or be on the lookout as your newborn comes into this world?

What is plagiocephaly? Deformational, or positional plagiocephaly is when a baby develops a flat spot on one side of the head or the whole back of the head. (Source: Johns Hopkins Medicine)

What is the cause? It happens when a baby sleeps in the same position most of the time or because of problems with the neck muscles (Torticollis – see previous Wish4Bliss post on Torticollis) that result in a head-turning preference. (Source: Johns Hopkins Medicine)

After going through this experience with my son, my best advice is: if you notice something (especially early on) keep questioning it and be your biggest advocate. In our situation, we asked two doctors multiple times. It wasn’t until I pushed for pediatric physiotherapy where I finally got more answers.

*I am not a medical professional, this is feedback from my experience with my son who had plagiocephaly (confirmed at 4 months), now 13 months old.*

1. Sleeping: If your newborn seems to always sleep to one side of the head, make some positional changes as soon as possible. Switch the way you put them to sleep in the bassinet or crib. Change which side (wall) you put their head towards (always placing to sleep on their back).

2. Diaper changes: Switch up the diaper changing position. Changing more on the opposite side of where they naturally seem to turn or lay their head. This takes practice on your part. It is challenging at first to do it the opposite way.

3. Feeding: For breastfeeding, feed from both breasts. If your baby is having difficulty latching on one breast consistently, this could be a potential sign they have torticollis. Recommendation to see your medical professional. If you are bottle feeding, have you and any family members/friends work together to feed your baby from both sides, taking turns feeding from oppositive arms each feed (and yes it also takes some practice 😊).

4. Don’t wait: If the above is not making improvements in their ability to turn their head or filling out a flat spot with natural growth, they may have Torticollis (see previous post). If so, I would recommend you explore pediatric physiotherapy (as early as possible) to support with stretches and strengthening exercises early on. This can resolve the tightness sooner and may reduce the chance of plagiocephaly developing altogether.

5. Flat spot: If you notice a flat spot on the back or side of their head, speak to your doctor. From my experience and research, most physicians will encourage you to wait until at least 6 months to see if the flat spot self-corrects with the above simple repositioning methods (#’s 1-3). Please NOTE #6.

6. 4 Month Milestone: If your baby is coming close to the 4-month mark with a flat spot (plagiocephaly), I would highly recommend to meet with a pediatric physiotherapist AND go see a registered, qualified orthotist about a corrective helmet. Although many doctors encourage you to wait until 6 months, many orthotists recommend capitalizing on the 4-6 month growth spurts to reduce your baby’s time in the helmet. Many physiotherapists and orthotists believe that self-correcting opportunities at the 4-month mark without a helmet is limited (depending on the level of severity of plagiocephaly, in our case it was moderate/severe).

7. Proper compliance: should you choose to proceed with a corrective helmet, you will only have strong results with proper wearing compliance. Yes, it’s hard to get used to your little bundle having to wear a helmet for 23 hours of the day but you can do so. Remind yourself that you chose to go through the process to make the improvement; by wearing it correctly you’re doing the best for your baby and will have wonderful results.

8. Find new joy: for me, one of my largest deterrents was around not being able to kiss my little one’s head for months. Yes, it was hard the first few days but then I found new ways to show my love – kissing his ears and little chubby cheeks.

9. Ask LOTS of questions: don’t be afraid to ask…our orthotist was amazing. She was responsive by email and has been doing this for a long time. She has seen it all, any potential, rash, mark or concern we had – she had a quick answer. Make sure you choose a vendor where an actual orthotist is both making the helmet (for 3-D printed), fitting and regularly sizing / checking progress. You want someone who is extremely knowledgeable is this area.

10. Cleaning tips: For us, we found a few specific options really helped manage the hygiene and smell (yes unfortunately smell, they are human and sweat in their little helmet for 23 hours a day). Of course, regular daily cleaning at least once a day is required. This for us involved a good scrub with rubbing alcohol followed by a swipe of tea tree oil on the inside of the helmet followed by a wipe down with water. Air dry or use your hair dryer (only on the cold setting) if you need to expediate the drying time. Make sure the helmet is fully dry before putting back on their head to prevent a rash. Using (a very small amount of) conditioner on our baby’s hair at bath time also seemed to help manage the smell better. For days when the helmet seemed extra sweaty or smelly, I would wipe it down in the morning as well. A baby wipe was also a good a quick option whenever needed, on-the-go. For us Vaseline (prevention) and Polysporin (treatment) really helped with prevention and treatment of any light rashes.

11. Dress light: If you proceed with the helmet, do listen to the recommendation provided to dress them lighter than usual. We did this process for 4 months from November to February and even in those winter months we dressed him significantly lighter. It makes a huge difference in how much they sweat!

12. Don’t be embarrassed (well try not to)! I was concerned with how people would look at my family. Did it look like I was a bad mom? I had built so many thoughts and questions up from other people – ‘why does the baby have to wear a helmet?’ ‘What happened to your baby?’ ‘What is that for?’ In the 4 months my son wore it, I forced myself to go out with him. I didn’t want the helmet to stop us from spending precious time together and exploring new things. I had (or felt like I had) a few odd looks; but the majority of time I received many kind, warm smiles and comments. Only once did I have someone ask me what it was for but the person was genuine and didn’t know. I took the time to honestly answer. Once I got over my own ego and fears, this didn’t phase me.

The 4 months for us flew by and it was over before I knew it. I am very happy that we decided to move forward with the helmet and at the 4-month mark (earlier than the doctor recommended). This allowed us to capitalize on those critical growth spurts and therefore the helmet was able to reshape my sons head faster!

Oh, and finally there is no pain for your little one. I was concerned about this too but honestly once it was on, he didn’t even notice or seem to care – phew! This is also a benefits of putting the helmet on earlier, once they are older they have more of a personality and have done longer without anything on their head. I could see it being a bit more of a challenge if you were to start the helmet later as they might now try to fight putting it on or try pulling it off.

My son is now 13 months and has a lovely round shaped head. He is a happy, healthy, squishy little baby. Being through it, it can be a stressful situation but I know it’s possible to successfully move through it. I hope some of the above tips can help calm other families going through this situation.

Stay patient, calm and kind (for your family and little ones 😊).