head shape (plagiochephally) - updated after visit!

[Guest Mama]

We had a midwife assisted home birth. 3rd stage was precipitous and baby fell onto the covered carpeted floor (splash!) from my kneeling position. He is totally fine and a very sweet happy baby, now just over 6 months :-)

We noticed a few months ago that his forehead shape is not symmetric. Viewed from the top, one side is slightly more forward than the other side. I have been following this and it seems to be stable ... one side is just a little more forward. Baby is getting lots of "sitting up" time and since this is the front of the head, it is not sleep position related. The shape problem was caused by the drop during delivery or just a random head shape thing from how the bones seated together.

His doctor is not concerned about it, and suggested that our baby might not meet treatment guidelines for a head mold. DH is not concerned about it cosmetically. I worry lots about how the head shape will look when he grows up. We had the doctor order a head x-ray and refer us to the local university medical center to ask about treatment (a band/mold for the head.) It sounded like a great idea until I found out the specialist is a pediatric neurosurgeon. I am having difficulty taking my baby to a ped neuro even though surgery is not the proposed treatment. It just makes me so stressed out to take him to a dr that does very major invasive surgery.

Has anyone had a head xray for their baby? how did that go? Has anyone considered or done head mold/band for their baby? How was it? I have canceled the head xray for now and need to make a decision in the next few weeks.
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Update:
Thank you all for your concern and support! We went on to the doctors appointment. (100 degree weather that day!) The short answer is, everything is good. We are not going to do any treatment. The doctor feels that the head shape issue is positional - a tiny flat spot on the back of the head corresponds to the "bump out" or the front. The doctor expects it to go away, though he also said kids in school are not going to notice... kind of a mixed message. DS is now at an age where he is crawling, sitting, etc most of the time, so the positional issue is not going to get worse. There is no followup.

Now, a word of gratitude. We had our baby boy after 2 years of testing and infertility treatments. One doctor suggested IVF, we went to another doctor for IUI, and have our beautiful baby. It is hard to not be scared for every little possibility, when the baby took so long to create.
The pediatric waiting room was crowded. There was a kid with a broken arm, a 10-12 year old boy with toe walking, a boy in a wheelchair with ventilator, etc. And a dozen other parents with children with non-obvious issues. In the adult area, there was even a prisoner in chains, accompanied by 2 officers. I felt a little bad going to the doctor with my tiny concern, when there are so many children with serious, longterm medical issues they are facing. When I was a teenager, a friend in a wheelchair told me that able bodied people "take walking for granted." Something we need to be reminded of, sometimes.

[pigpokey]

I have very grave concerns about head CT scans and the developing brain. Is it a CT scan that was ordered? Read about radiation and IQ before consenting. It sounds like maybe a helmeting protocol would work cosmetically.

[Guest Mama]

a single head xray (to check if the seams are fused) not a ct. i don't think we can get the mold without the xray.

[sewingmommy]

My son had positional plagiocephaly...he was diagnosed at 9 months...our Physical therapist recommended the helmet and our pediatrician didn't want to give us the prescription for it ...The ped then referred us to a ped neur who I think he was hoping would discourage us from wanting the helmet ...the ped neuro just assured us that everything was okay and that if we really wanted it he would give the prescription for the helmet...we got the helmet and our son wore it for all of three months (some do have to wear it for longer ) and we were very happy for it ....the ped neuro really is not going to suggest surgery ....the one we went to actually was one of the first drs in our area to suggest the helmet .......if you want to talk more just pm me

[Letitia]

DD wore a helmet. She had positional plagiocephaly that was just so classic nobody seemed worried at all about it being something else so she really didn't have much in the way of evaluation. She wore the helmet about 5 months, part of that was at night only, and I think she looks normal now. She's 3-1/2.

While I was freaked out about her pretty weird-looking (to me) 4 month old head, I did a lot of research. If you go to the original research and publications on plagiocephaly, this seems to have been a problem that neurosurgeons had to deal with even though it shouldn't really be a neurosurgical issue. It's similar enough to craniosynostosis (head looks weird because it grows in abnormal patterns due to suture(s) fusing early) that kids would get referred to them. Craniosynostosis is very different, and usually is a surgical issue. So neurosurgeons have been seeing kids with this problem for years even if it's not really something that makes sense. The plagiocephaly outcomes information I could find was in the pediatric neurosurgery literature.

I share a PP's concerns about imaging. Your son's head sounds very different from my daughter's and I have no idea about the imaging, but perhaps the best person to discuss that with would be a pediatric neurosurgeon. I seem to remember reading that some kids (like my daughter) don't even need it.

[annettemarie]

Moving to Health and Healing. You could also cross post in Life with a Babe.

[Momo123]

My DS also had plagiocephaly (due to torticollis) and my pediatrician referred me to a pediatric neurosurgeon. I was also nervous about taking him to a neurosurgeon, but all he did was touch DS's head and look at him from several angles (no x-ray), and he wrote the prescription for a helmet. They do scans of the head (I think it's laser?) before they create the helmet so you can see exactly how their skull is shaped before you begin treatment.

[KimPM]

My DS also had some back of the head shape issues. He had a couple bumps on the back on each side of the crown. He also had a little plagio (and torticollis). I went to see the local platio specialist. He was more concerned about the bumps on the head than the mild plagio. I was concerned about having a CT scan, so much radiation...so he had one x-ray done instead. I just wanted to make sure there wasn't something in there that needed serious correction, not just cosmetic. There wasn't. And the torticollis resolved with a combo of CST and PT. The plagio also worked its way out by my careful positioning of him over many months. You'd never know he had it today.

PM me if you have any questions about the x-ray process, or anything else.

ETA: I believe the plagio specialist I saw is also a ped neurosurgeon. He seemed pretty conservative in not recommending anything too invasive unless necessary. He even suggested that we didn't need the helmet for plagio correction.

[Kalea's Mommy]

Positional plagio

Hi there. I have experience with positional plagio and Craniosynostosis. My son was born with an abnormal head shape. The bones in his skull fused too early causing his head to take on a long and narrow shape. He was refered to a craniofacial clinic at Seattle Childrens hospital and had a CT scan to further diagnose him. He did great and didn't even need sedation. He was seen by a neurosurgeon and a plastic surgeon. He had surgery to correct it at 9 months.
How is your little one now? Did they get helmet therapy?