August 23, 2005

If Only Your Kid Was Cool Enough For One Of These Plagiocephaly Helmets

Sometimes parents go to extremes to conform to externally imposed societal norms, ordering elaborate and expensive medical procedures be carried out on their children, just because they think their heads have an abnormal shape or appearance that'll keep them from scoring babes later on in life. But enough about circumcision [ba-dum-bum], let's talk about positional plagiocephaly.

doc_band_southpark.jpg docband_ducati.jpg
You might recognize it best as the flat spot on the back of your kid's head that results from him sleeping on his back all the time. Or the flat spot on the side of his melon that can result from always leaning one way or the other in a car seat. There are also several more potentially serious medical conditions that can result in/be associated with plagiocephaly

For the plain old flathead thing, babies' malleable, quick-growing skulls mean these aberrations are often considered temporary; some doctors--and the AAP--recommend trying exercises, repositioning, and "tummy time" to fix the spot naturally. For cases where that doesn't work, or for anxious flathead-fearing parents who don't want to take any chances, there are $3,000 helmets called Dynamic Orthotic Cranioplasty Bands--basically, braces for the kid's head--to do the trick.

From the Plagiocephaly.org parents' resource site, it seems like 4-5 months is a decision point for DOC Bands. Before then, repositioning and other treatments still have plenty of time to work.

As one Houston parent put it in the article below, her desire to have a roundheaded son overcame her fear that "people might think he was retarded." [charming. when you see a kid in a DOC Band at the mall, relax and try not to stare. But when you see some dope throw around the word "retarded" like that, well, feel free.]

Frankly, the only way a kid could look goofy in one of these badass helmets is if his parents decorate it badly. As the sleek monochrome Ducati helmet above shows, less is usually more. I'd try either a Vader-esque high gloss black, or a T2-lookin' chrome [like on this calendar, minus the antennas, of course]. Barring that, an all-over scene from South Park--which is what the one above reminds me of--is the next best. Geek parents will make their kid look like a little Borg, for which she will seek her revenge later on in life, rest assured. Your kid's head's fate is in your hands.

Shaping a child's future
[Houston Chronicle, via DT reader John]
DOC Band is a trademark of Cranial Technologies, Inc.; See the monthly photo album or the calendar for decorating examples [cranialtech.com]
Also: plagiocephaly.org, and one mom's blog, My Banded Baby

[Meanwhile, in Japan, having a square melon is considered an honor.]

24 Comments

There are other reasons that kids have to wear the DOC band. It is unfair to say that it is primarily cosmetic. Craniosynostosis is the early fusing of the sutures of the skull. In our sons case, the Metopic suture fused a little early (trigoncephaly). Due to that, the head started widening, bracycephaly. This DOC band keeps the head from growing in the wrong directions, allowing the brain to push the skull out in just the right areas. Cranial Technologies have been so wonderful to us. It's a shame that so many articles are coming out these days slamming them. Most of the other children we have seen have needed these for medical reasons as well. I think this is once again a case of finding a few people who do this for primarily cosmetic reasons and then blowing it out of proportion, kind of like the trend for Europeans leaving their babies alone :-)

My son has been wearing one of these for about 4 weeks now. There has been marked improvement, and the Craniofacial Specialist (no relation to Cranial Tech) that we saw last week stated that due to this, he doesn't forsee a need for surgery.

BTW, we have taken skateboarding decals to decorate his band. He looks like a little skater punk...

Our brand new little tike has been having problems that would have eventually resulted in this as well. Our son was born with a mild case of congenital muscular torticollis, which as our pediatrician explained to me can be caused by either one side of the neck muscles being shorter than the other resulting in the baby only turning his head one way all of the time and not having full range of motion, or some other injury that happened to the neck muscles during birth that caused scar tissue to form in said muscles and again not allowing full range of motion to one side. more than just a preference for resting their head on a particular side, this results in flat spots as well but is more difficult to correct than just flopping them over when they're sleeping. pediatricians often send the babies, starting preferably as early as 6 weeks old, to physical therapy for weeks or to a chiropractor for stretching exercises and realignment, as well as having the parents practice with the baby at home to create activities that will strengthen and use the atrophied muscles. in the worst cases, the scar tissue has to be surgically removed, which my cousin's infant actually had to undergo a few months ago. she narrowly avoided the helmet, actually, more because she couldn't afford it and would rather just wait out the period of her kid looking like blockhead from gumby. he's 9 months old now and seems to be progressing fine albeit slowly without it.
as far as our son, our pediatrician didn't even notice/diagnose the torticollis until he was 2 months old, and still tried to deny it after i threatened to seek a specialist myself. we brought him for an ultrasound last week that showed he did in fact have a mild case, but at this point with our working diligently at home since birth (without any help from our ped, thanks a lot lady) to encourage him to turn the other way as well as lots of tummy time, he's getting loads better. but honestly, whether you're concerned about him having a flat head or having to wear a helmet, when faced with the possibilities, i'd certainly opt for neither if given a choice.

Our kid followed the torticollis-plagio trajectory in late 2002 (pediatrician prescribed physical therapy + helmet). When anyone asked about the helmet we just claimed our daughter was a snowboarder, which confused people because we live in Michigan. But never pass up a chance to mis-educate, that's our motto.

Dude, I'm in love. I just found your blog today, and have been busy kicking myself in the ass for not finding it sooner. I'm an aspiring wit myself, but I suck. I'm always complaining about crappy baby products, and found your site in a search on bottle proppers. Now I'm in love with you, dammit. Give a girl a break! My four children (the round-headed little bastards) need their mommy to not be reading your blog all day, you know.

Seriously, thank you for speaking about these things, such as "melon helmets," it needs to be said and it needs to be said just like you said it. Egads, that was an awkward sentence. Hence the reason I am an "aspiring" writer and not an actual writer.

I've been kicked off no less than three "mommy groups" online (thanks Delphi Mommies! ~Smooch~) for talking about positional plagiocephaly. Which is a completely different fish from torticollis, which is most parent's main defense for the sappily-decorated melon helmets. What most mommies don't know is that our family pediatrician is also my best friend, so I get the direct scoop on how many cases of actual torticollis she sees per year versus how many cases of positional plagiocephaly she treats (this is non-HIPPA-violating gossip BTW). She hands out to every parent a sheet on how to prevent positional plagiocephaly at the 1-month well-baby checkup. By the 6-month checkup, quite a few of the babies she sees have slighly mis-shapen heads, and when she mentions it, the parents suddenly request either a helmet, surgery, or both. When she asks them if they tried positioning the baby differently, they usually say "Oh yes, we've tried everything, she just keeps rolling back into the same place, that's how I find him/her in the morning."

Our doctor is an advocate of co-sleeping and baby-wearing, so she explains to these parents that positional plagiocephaly is 1) caused by not monitoring the baby's position and correcting it often enough, and 2) not a problem unless the baby's sight, hearing, ability to eat, or posture is affected. Most parents opt for the melon-helmet, even though their baby has NOT been diagnosed with torticollis. Can you say "Munchausen's by proxy?" I thought you could.

In one mommy group alone, there were six babies with torticollis out of 31 babies - I call that an epidemic! The actual rate would be about one in 120, so I am just guessing here, that most mommies with melon-helmet-babies are dealing with positional plagiocephaly but calling it torticollis.


When I suggest that a mother pick up her child more often, have their baby sleep in bed with them or at least in the same room so they can watch their sleeping habits and move their bodies accordingly, or - gasp! - WEAR her baby, to prevent odd head shapes from Day One, the proverbial crap hits the wind-making device. How DARE anyone even hint that someone should carry their baby around with them more when their skull is still in an extremely malleable state!

You can't tell a mother that a helmet is a bad thing. Because she decorated it all pretty, see? She put her baby in the car, they went to the store, she searched for pretty stickers and decoupage glue, she purchased it, and she drove back home. (Never mind that her child might have laid on the flat spot in the carseat because she didn't check - oops, I digress.) That amount of effort is nothing for a mother to go through, because decorating her baby's helmet is SO important. They both have suffered so much, they are both so brave, so courageous to go through the hell they are going through. How dare you poke fun at them, you naughty Daddy!

Anyway. Methinks the Mommy Patrol has not found your blog yet, since you only have a few comments to your post. Fair warning, the Mommy Patrol that stalks my blog will likely find your melon-helmet entry since I am perma-linking you (love hath no bounds) from my blog. Call it "sharing the wealth." Have fun with the pack, bro.

[um, thanks, I guess. I can see how you might have no fun at torticollis parties. Meanwhile, I suggest you steer clear of the Salon.com crowd. -ed.]

The only explanation I can possibly come up with for parents' oddly decorating their kid's plagio-helmet is this:

When I was in the 7th grade, I snapped my cocyx as a result of a nasty fall off of a horse. My pediatrician prescribed that I had to sit on one of those blow-up hemerrhoid donut pillows for 4 weeks to let it heal.

My mom, out of the kindness of her heart as well as to alleviate my embarrassment and the possibility of my being SERIOUSLY made fun of by my 7th grade peers, in order to protect my delicate self-confidence in the only way she could, made me a toiletseat-shaped pillow with a gorgeous, plush slipcover to sit on during my classes.

Although it was pretty much impossible to avoid the stares and some jeering while sitting on a toiletseat-shaped hemerrhoid pillow in the 7th grade, the awesome slipcover was enough of a decoy/ruse to confuse the worst of the kids for a few seconds, long enough for me to make a quick escape if it looked like the jeering was going to get to be too much. Those few seconds of confusion was my mom's gift to me in a really embarrassing time in pre-adolescent life.

I think with these helmets, the parents are decorating them because they love their kids and they don't want their kids to be embarrassed or sad about the whole ordeal. I mean, yeah, they're so little they won't know the difference or anything, but if it makes the parents feel better about what's going on and allows them to feel that they're doing all they can for their kids, which is important, then go ahead and slap some stickers on that sucker. It's just showing their love and support for their kids.

[the CT site says it's to make it look less "medical," but it clearly sounds like an anxiety outlet for some people, which is fine, unless they have really bad taste on top of it... -ed.]

my infant son just had cranial surgery and has to wear a helmet and i wanted to educate myself

To Greg and Jabbermommy,

So, I'm just curious here. Judging by your comments in this, erm, "article," you would also not hesitate to make fun of wheelchair users who aren't either paralyzed or missing both legs. And you would also probably have choice comments for vets who decorate their wheelchairs with stickers and other war mementos. And how about all those lazy old folks who decorate their scooters and golf carts and walkers with all kinds of colored tape, stickers, paint, tennis balls, and whatnot.. I'm sure they don't really need all that stuff. They should just suck it up and walk already, right? I suppose they're worthy of a bit of your supposed wit.

I'm just glad these helmets exist so that my 4 month old son won't have to go through life with a funky shaped head, misaligned jaw (resulting in TMJ), and eye misalignment and the corresponding visual problems that I've had my entire life. When I was born, the only option my parents had was surgery, and no way were they going to cut on their kids head, so I got stuck with what I was born with. My boy is getting casted next week and banded the week after that and it's money my husband and I are gladly spending on our child. Oh sure, we could spend another 4 months taking turns checking on our kid who spends his nights and days sleeping on his tummy, breaking our backs wearing him in a Snuggli or baby sling whenever he's awake, and doing all the other crap recommended by the variety of pediatrician's we've consulted since the day he was born with that crazily mishapen head. Hell, we don't even own a swing or bouncer since we were warned it would make his head worse, and that stupid infant carrier stays permanently in the car.

I sincerely hope that as a Dad or Mom, nothing will ever go wrong with your child. It's terrible knowing that you would just make fun of your kid and not deem them worth your time or money to fix. Good luck to you in life.

actually there are medical reasons why kids wear these: ocular, hearing, neurological etc.
obviously you're far from being a medical professional.
and if people want their kids to be happy and un-teased, who cares if they are "conforming with social norms"

[who's the "you" you're talking about? The doctors in the article who said parents sometimes get helmets when they really don't need them? The crazy Jabbermom commenter who sees attachment parenting as a cure-all? Or the guy--me--who wrote the post and mentioned "conforming with social norms" in relation *to circumcision*, not plagio helmets? The whole point of writing the post this way (i.e., irreverent, sap-free, dad-targetting) was to float the idea that parents' attitudes and perceptions matter. If parents consider their kid a freak with a medical device that needs concealing, other people--and the kid himself--will pick up on that. OTOH, if the parent treats his kid as normal, treats his plagio helmet as badass, and puts some fresh thought into what to do with it, maybe it'll make the challenges of raising an atypical kid or dealing with a medical condition somewhat easier to manage. Some day, I hope my roundheaded kid would come home from the park and beg me to get a cool helmet like that kid has who she played with. Or that she'd want her own wheelchair, too, like her friend's. That's the point, and it seems to be lost on at least half the people who come across this post and discussion late in the game. -ed.]

Munchausen's by proxy is the same as getting a helmet for your baby? Good lord, can someone please get this person a medical dictionary!

Munchausen's is injuring your child to get attention for yourself. It is a farflung notion to correlate parents being concerned about brachycephaly, plagycephaly, macrocephaly, or early suture closure and it's impact on their child's medical and emotional state to parents who injure or kill their children to get attention put on their twisted selves.

Responsible parenting is doing what is best for your child even if it means putting up with attitudes from ignorant, uninformed people like yourself.

Cervical torticollis can cause genuine medical problems. Early suture closure is a surgical issue that MUST be addressed.

Helmets are the conservative approach to fix a problem that could have ended on the operating room table with a child's skull split open and cut.

Get a grip on reality. You're ridiculous to make a statement like that. These parents are not getting botox or breast enhancements for their kids. They're trying to fix a medical problem.

By the way, head symmetry and suture closure issues are NOT all a result of putting a baby in a carseat. Some are a result of the birth process. Others are genuine medical conditions such as hydrocephalus and early suture closure.

Maybe one of these critical people should put themselves in the shoes of a parent who's child is about to undergo brain surgery to break apart the bones in their head in order to allow their brain to grow normally so that they live to see the age of 5 or 6. Post-surgical, these children literally have stitches across their entire head. They look like they've had a lobotomy. And yes, they need to wear a helmet until their skulls heal.

Walk a FOOT in one of these parents' shoes then maybe you'll understand why a parent will want to do small things like decorate a freakin' helmet to give their child a little bit of happiness in the midst of a painful, horrible, hideous medical condition.

Compassion is something you are taught, and frankly I wonder what kind of parents YOU had.

[thanks for your comments, Christine. I agree, which is why this post exists in the first place. Please take care not to let one inaccurate and insensitive driveby commenter blind you to the fact that the site and most everyone else who's made comments here is sympathetic, empathetic, in the same boat, or otherwise supportive. The point about decorating freaking helmets in the first place was just a wish that people would decorate them cool, not tacky. In the context of the reason for getting a helmet in the first place, though, it's a pretty small/meaningless point to make, I am fully aware. -ed.]

Jabbermommies, et al -

We are a co-sleeping, babywearing family who waited for our baby's head to "round out" 18 months as recommended by our pediatrician and pediatric neurosurgeon. Well, her head improved, but it is still misshapen, causing her ears to be misaligned and one of her eyes to be larger than the other. We have opted to band our baby because after 24 months, we lose the opportunity to do so. Cosmetic? maybe. We're not willing to take the risk. TMJ and/or sight problems? probably. The same reason parents opt to put braces on their children's teeth or hang glasses on their face. Would you consider this Munchausen by proxy? Are you really such a holier than thou psychomommy?


So tell me, smug mom, arent you afraid that you will suffocate your baby during co-sleeping or wearing the little darling? I cant wait until your little darling reaches adolescence and wants braces for its crooked little teeth and you tell it, "No, we dont believe in doing anything for cosmetic purposes"....that is, unless you have a special set of rules your your childs problems while judging others for dealing with their own.

Happy smug childrearing!

[it's amazing to see how one crazy commenter's irrelevant, discredited rant over a year ago still manages to provoke such defensiveness. I really regret not shutting down the comments here a long time ago. -ed.]

I'm not going to freak out at that one crazy moms's long winded comment. Rather I'm just going to announce that I have decorated my daughters DOC band, and I have to say, I did a damn good job. I feel for the poor little babies whose mothers slap on a Mickey Mouse sticker and call it a day. But then, DOC band or not, babies of nerds are destined to be nerds anyway, right?

Perhaps Jabbermommy could ask her pediatrician friend to educate her about plagiocephaly caused by having multiples in the womb which is very resistant to repositioning. I also co-sleep and babywear (twins no less, so there, bite me JM) and my baby A is wearing a DOC band which I plan to decorate because it will be fun, not because of any deepset neurosis or fear of what ignorant people think.

Jabbermommy...Unless your doctor friend is a co-worker of my doc @ Harvard Medical School & Children's Hospital in Boston (ahem, one of the top two pediatric hospitals in the US for 16 years) you may want to open yourself up to the helmet idea.

My son (10 1/2 lbs at birth, diagnosed with torticollis and associated head flattening) was fitted for a helmet which he will receive in 2 weeks. It is the LAST thing I would ever invite upon him...to be stuck wearing this through the hottest part of the summer.

Your suggestion that anyone would do this for kicks is ridiculous.

[the extreme ridiculousness of Jabbermommy's comments were thoroughly established a looong time ago. -ed.]

Our son just started wearing the helmet 3 days ago and I also take issue with your comments. It's the last thing we wanted but his severe flat spot and completely misaligned ears required it. It was completely doctor recommended (by our pediatrician and a specialist) and confirmed by the orthotics dr. Really... you should research this a bit further before making broad assumptions.

[I think we can all agree that Jabberwocky's comment was insensitive and off-base. I would have deleted it a long time ago, but so many subsequent comments referred to it, it didn't make sense. -ed.]

My son has torticollis which is a real problem!!! Have you dealt with this decision in you life for your child? You should not judge people!! The last thing I wanted for my child was to have him where it!!! But his head is severly misshapen and we have exausted all the other possibilites!! Maybe you should become more educated before you make comments like this!! Not everyone does it to be vain!!!

I think it is safe to say that Jabbermommy has serious issues. She even called her 4 children ("Bastards") How sad, how pathetic. No wonder she was kicked out of other Mommy groups. No one wants someone like that to be around them or their children. Their lack of intelligence would be insulting to tolerate. My son was born with both Plasiocephaly and Torticollis. It had nothing to do with how he was sleeping. And, yes we tried it all to remedy at home. After 4 months of insisting we see a Plastic Surgeon we finally were prescribed the DOC band. (Which is not covered by our insurance. We payed $3,000. A small price to pay for the well-being and life of our child.) He is also in PT twice a week and we are seing improvement. We just got the band and assume it will be worn for about 4-5 months. I do believe I'll decorate it for the simple reason that its a great conversational piece. It will help alert those (who dare to ask) about Plag/Tort so that maybe if they have a child or know someone who is having the same cranial problems they can be seen. So many doctors are dismissing this wide spread problem. And, after about the 14th month it is hard to fix. The skull is already formed thus creating so many other problems in the future. As, for Jabbermommy, I hope she seeks to try and be open to others ideas even though they may differ from her own. Otherwise, she is doing her children a huge misfortune. As they will end up being made more fun of their lack of social skills as our will with Plag and Tort.

Actually, it's been said over and over. I think it's safe to ignore her insensitive, inflammatory comment, which would have been deleted long ago if so many people hadn't responded directly to it with their own personal experiences. Deleting it would have muddled the context for subsequent reactions. Still, in the nearly three years since this post went up, no one besides her has either commented or emailed similar sentiments. It's really alright to write her POV off.

Funny....I laughed the whole way through not only Greg's posting, but the jabbermommy's as well! It's so interesting to read other peoples' take on situations....from the outside looking in. My son is almost 5 months old and is getting banded on Monday. Now, he DOES have torticollis and his ear and eye are very mis-aligned. Don't think my husband and I didn't cry tears of sadness at making this decision....it wasn't as if we only sat around wondering how to decorate the thing!

As far as "social norms" go, there aren't any. I also have a 7 year old who has Poland's Syndrome. She is missing her pectoralis majoy/minor, her breast and has a small arm, small hand and barely functioning fingers....this only affects her right side, by the way, so the left is completely "normal". I would love to explain how hard her life has been, from the teasing to the questions to the constant feeling that she has to prove herself to everyone she meets that she's "normal". My husband and I have NEVER allowed her to use her situation as a crutch and we expect her to act, treat and "be" just like everyone else. We are doing the for our son because we DO see how people treat our daughter, and we would love to save him from the horror my daughter has, and always will, face. Hope that makes sense to everyone that seems to think this is a "social" thing.
PS My daughter just made the cheer competition team in our area.....she didn't have a choice, someone told her she couldn't do it, so she HAD to prove them wrong!!

Im actually utterly depressed because my son has to wear one of these starting next week. He was born at 30 weeks gestation with a twisted neck because he had a twin brother sitting on top of him. The doctors told us it would return again after early therapy, and it did - he neck muscle hadnt completely grown in and was making it difficult to keep his head placed in one direction for long.

He was so severe that he could barely do tummy time without screaming. Many months of PT helped him, and now he does a strange army sort of crawl on the floor (still does not use his left leg). He can lift his head on the bad side, but does not like to.

We tried everything...you can reposition until the cows come home, but there isnt much you can do.

To attempt to shame parents that have babies who end up needing this is cruel...our hearts are tormented enough that our child is going through this agony. I wouldnt do this, but the fact that he is starting to fall behind his twin brother developmentally by quite a bit has me turning to it - by order of my physician - to see if it will help.

Its so sad that people feel the need to be so hurtful and judgemental about other people's situations when they have no idea what that person is going through. They just assume they know the whole story. I get your blog, youre pointing out the ones that are merely vain...but then again, i wouldnt want a crooked head in grade school, would you? Youd be the target of all the kids's jokes. So there is that to contend with too...

thanks for sharing your experience, and my sympathies and best wishes. In the face of such somber experiences as yours and other folks who've commented over the four years since I first posted this, it seems a bit lame to point out that it was the original newspaper article which quoted critics of "vain" uses of plag. helmets.

Frankly, a parent's worry about the shape of his kid's head is just as valid and worthy of respect as a parent's worry about torticollis or other medical conditions. This is even more true now that we stare at our second kid's flat spot on the back of her head and wonder if it'll really mellow out in a couple of years like the pediatrician says, or if we should hustle her off to the helmet shop before it's too late.

Over the years, I've found that my original, slightly naive, intention for posting about plag. helmets has missed with people more often than it's connected. That objective was to try and change the perception of helmets from something shameful and traumatic to something cool, even awesome. An attitude shift like that would, I'd think, be an incredible boost to a kid's self image and disposition, and it'd help parents alleviate some stress as they navigate their kid's treatment. Getting stoked about customizing the helmet is just one small, probably insignificant reflection of this shift. And it probably just underscores my own superficiality and vanity that putting a helmet on the kid is less distressing than if I had to cover it with bunch of Dora the Explorer stickers.

How do you decorate the helmet ?Is there a place i can take it in to decorate it?

If it was purely just cosmetic for my daughter I would still do it but in her case she has severe torticollis and PT is no help so far. Her plag is 10 mm so we will see if it gets better. do you know what constitutes severe plag mm wise?

My son is six months old and just started wearing a DOC-band. He does have torticollis which contributed to his flat-spot, but the doctors seem to think that most of the shaping occurred while in the womb. Even without the tort, I would definitely have spent the money on the helmet. I'd much rather spend the money and spend 6-9 weeks getting him the best treatment I could, than have him be insecure as a teenager and not be able to shave his head when he wanted to, or lose his hair and be insecure about the flat spot. I love my son and want the best for him, it has nothing to do with my vanity.

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