While the babies were in the NICU, both Physical and Occupational Therapists worked with them on feeding and positioning. Repositioning is critical for premature babies because they have soft heads and spend a lot of time in bed sleeping. At one point during our NICU stay, both Sydney and Mason began developing flattened heads. With repositioning, they both improved.
Once the babies were home, they all began receiving Occupational Therapy through Early Childhood Intervention to help address developmental delays from prematurity. While they have all responded well to therapy, Mason’s head continued to be a concern. Soon after coming home, we noticed he favored his right side often turning only that way and sometimes dropping his chin towards the right. He struggled to control his head and tummy time was a feat for him. Early on, our Occupational Therapist, Laurie, taught us a stretching regimen and showed us how to reposition him and encourage him to look left (e.g. putting favorite toys on that side, moving his mobile). Mason showed drastic improvements after only one therapy session. Turning left wasn’t as difficult as it once was, but he continued to favor his right side. Laurie ramped up Mason’s stretches and we saw some gains for him.
Back in November Mason could only hold his head up in short spurts during supported tummy time. he is on the far left with his head dropped.
To our surprise, Mason’s tight neck muscles did not hamper his motor skill development. He compensated and remains the only baby who skillfully rolls over both ways, changes direction, and scoots a bit. Additionally, he uses both hands together relatively well and explores his environment with gusto. On the downside, since he does all of these things we cannot reposition him anymore and we still observe facial asymmetry. Laurie urged us to have Mason evaluated for Plagioephaly, which means oblique shaped head. While it does not impact cognitive development, Laurie explained that some research suggests that asymmetry can result in poor gait and balance due to uneven ears and eyes. If left untreated, Plagiocephaly can cause problems with glasses sitting correctly and sports helmets fitting as well. I was also really concerned because social psychology research indicates that people prefer to look at symmetrical faces and consider them most attractive. It breaks my heart to think that Mason could later be viewed as less attractive if his parents didn’t want to explore treatment options. He’s much to handsome for that!
With time and therapy, Mason has no trouble holding his head up.
Of course when I asked our pediatrician about it at our six month check up he scoffed at the idea touting that no one has a symmetrical head. I’m sure he’s right, no one is perfectly symmetrical. However, Mason’s asymmetry is noticeable and there could be repercussions in the future. Despite Dr. Knapp’s lack of concern regarding Mason’s head shape, we chose to take him to Cranial Technologies for an evaluation, which was free.
We were glad we went with our intuition and opted for the evaluation because Mason was indeed diagnosed with Plagiocephaly. They pointed out that the back of his head looks great (thanks to therapy), but the side is uneven pushing his right cheek, ear, and eye slightly forward. Honestly, many people probably don’t notice, but his asymmetry was considered “severe” considering measurements from one side of his head to the other. Since he falls within the severe range, treatment is covered by insurance. which is a huge blessing because it costs $3800. Of course insurance required a pediatrician’s prescription, but Dr. Knapp agreed once he saw the evaluation results. (Whew!) We are also grateful that only one of the four babies requires treatment. Babies who are premature, multiples, sleep on their backs, and in the NICU are at the greatest risk for developing Plagiocephaly and that describes all four of them.
This week digital images were taken of his head to create a custom fitted DOC Band. When the initial images were taken for evaluation, Mason giggled the entire time and tracked the light they showed him. Two weeks later it was a different story. Mason grinned and flashed his huge dimples until I handed him off to a stranger. He wailed and blubbered the entire time even though I was three feet away talking to him. I think he met the “stranger danger” milestone.
Starting next week, Mason will wear his DOC Band 23 hours every day. We will take him back to Cranial Technologies for and adjustment every other week for the next two to three months. I know I will loathe not being able to kiss his sweet head all day long, but in the scheme of it I know it won’t be that long. I’m also glad we are doing this now while he is too small to remember and doesn’t have the dexterity to unfasten the straps on his band. It might even be handy as he becomes mobile bumps into furniture.
These bands are a bit clinical and frumpy looking so George is planning to paint it to look like camouflage. If Mason’s wearing this accessory all the time, it might as well be cute as he is. I’m affectionately referring to Mason as my “Plagiosaurus”.
From the back, Mason’s head looks similar to his siblings. He once had an off center bald spot from favoring one side. As he progressed with therapy the bald spot shifted to the center, but is gone since he tummy sleeps.
Mason is a man on the move so capturing a bird’s-eye view of his head was tricky. From this picture you can see where his right cheek and ear are further forward.
This is a bird’s-eye view of Sydney’s head. Of course she stayed still for the picture so it’s a better angle, but you can notice she is more symmetrical.
It is subtle, but if you look carefully, Mason’s right cheek appears fuller than the left.
If you’d like to learn more about Plagiocephaly or Cranial Technologies please visit: http://www.cranialtech.com/
We are fortunate that Cranial Technologies has a satellite office within thirty minutes from our home as we learned that many patients travel from out of state for treatment!
Hugs!
Amber
Four to Adore 