Plagiocephaly

Tonight at Penelope's 2 month vaccination appointment, the public health nurse determined that her head was a bit flat on the back right side.  She pointed it out to Greg + I, and Greg was able to see it but I still can't see anything wrong.  The condition is commonly referred to as Plagiocephaly which became much more frequent when SIDS doctors insisted on keeping babies on their back until they were able to move themselves.  Because of the requirement to sleep on their back, it is recommended that babies have tummy time in order for the flattening to not occur. It can also occur during the birthing process or because of Torticollis which is the stiffening of the muscles in the neck.  

The nurse gave us a bunch of information on this and things that we can try at home to help Penelope regain the roundness of her head back.  The Alberta Children's Hospital offers a Infant Repositioning Class which is a hands on teaching of positioning strategies to aid in the correction of a flat area on the head.  The class includes practice of tummy time and side lying play and will also screen for neck muscle problems (torticollis) and for the severity of the flattening.  The repositioning therapy works best for babies under the age of 6 months because you can still control how they sleep.  It gets a lot harder once they start to roll and move on their own.

If the instructors believe that it is a muscle problem then Penelope will attend the Calgary Youth Physiotherapy Clinic to help her get rid of the stiffening that is causing her to lay on one side of her head.  Since getting home from the vaccination appointment, Penelope has been sitting up with Greg and regardless of which way she faces, she still looks to the right.  Every once in a while she will look to the other direction but it is not as frequent.  This leads me to believe that it is a muscle problem.  But I am not entirely sure.  Once the physio is complete, depending on Penelope's age and development we can try more repositioning therapy or we will be referred to a cranial specialist where Penelope will be fitted for a helmet.

If the repositioning class determines that it is not a muscle problem but that it is too severe for repositioning to fix it alone or is not working by the time Penelope is 4 - 6 months old, then we will also  be sent to the cranial specialist at the ACH to be fitted for a helmet.  If she has to wear a helmet, they typically have to wear the helmet for 23 hours a day for x amount of months.  

Obviously I will learn much more after I attend the class and speak to Dr. Bernhardt (our family doctor) regarding this.  We have a 3 month check up booked already but may need to make a visit earlier to discuss the plagiocephaly.

So in the meantime while we wait for classes + doctor's appointments, we will be watching Penelope while she is sleeping, while we are holding and/or carrying her, while she is in her car seat, swing, or bouncy chair, while she is playing and on her change table.  If she is on her flat side, we have to reposition her head to the other side. 

While she is sleeping we need to change the location of toys, mobiles and her bassinet/crib so that Penelope turns to the other side of her crib.

We will be increasing the amount of tummy time that Penelope currently gets.  She does get a great deal of tummy time much to her dismay.  She hates it unless she is lying on her tummy on top of you.  We just have to ensure that she is not lying on her right side.  It is a very important part of repositional therapy and it helps develop shoulder and arm muscles.

When we are carrying or holding her, we need to switch Penelope to our opposite arm while holding her and also when we are feeding her, we need to change to the other side.

 We also need to limit the amount of time that she spends in her car seat, swing and/or bouncy chair.  This won't be that difficult since she is rarely in these.

Hopefully these measures will help Penelope regain the shape of  her head and that we won't have to go to physio or the cranial specialist.!

Will let you know the progress of our journey and hopefully everything will work out for us!