As I’m sure pretty much any parent will tell you (especially first timers), we always think our babies are perfect. It’s so hard to spot small abnormalities in their appearance or behavior, because it’s all so new and incredible to behold. Well, in this case Amy and I felt we needed to give other parents a look at how that cognitive hole can end up coming back and causing issues later.

First off, Taylor is completely fine (and that is not me being in denial). He’s progressing against his developmental milestones very nicely and is a wonderful, happy little guy. I wanted to point that out up front so nobody gets freaked out.

At around his four month checkup, our doctor noticed that Taylor’s head was slightly deformed, in that he had a flat spot on his left rear side and his right rear side had become pronounced. He also noticed that his face had developed some slight asymmetric characteristics, in that his left eye was slightly larger than the right. He immediately recommended that we get X-Rays of Taylor’s head to rule out a serious condition known as craniosynotosis, where the gaps in a baby’s skull close prematurely. He was fairly certain this was not the case, but wanted to rule it our for sure.

Thankfully, the X-Rays proved our doctor’s position correct; Taylor’s skull was fine. This meant that Taylor was diagnosed with a condition known as positional plagiocephaly. Basically, it is a deformity of the skull caused by a baby’s tendency to remain in a particular position, thus putting pressure on a certain part of the skull more than others. Because an infant’s skull is soft and malleable for many months after birth, this pressure causes the skull to be rounded in an unusual way.

We had previously noticed that T tended to sleep with his head turned sharply to his left, with his chin titled upward. But we didn’t make anything of it; it was just one more lovable quirk about our little guy. It turns out that this was due to a second condition called torticollis, which is a stiffening of the muscle and tendon tissue connecting the neck to the shoulder, causing T’s head to be pulled off center. Most likely he was either born with this or it was exacerbated by his vacuum delivery; regardless the doctor explained it as being somewhat like a semi-permanent charlie horse. This caused his tendency to remain in one position, which in turn caused the deformity of his skull.

So fast forward five months later. Taylor has been being seen by a physical therapist once per week and has made tremendous progress. He can now turn his head both ways with ease and is displaying neck strength pretty much on par with where he should be (just look at the most recent pictures on this site). We’ve also been strict about changing the position he sleeps in, from both sides to his back, and even sometimes his belly (mostly at his own choice). But despite all this, his skull has not completely returned to a normal shape. Even though I would bet that most people looking at him would never notice, his left-rear side is still somewhat flattened, with an equally subtle pronouncing of his right side.

So because of this, his PT has recommended we pursue the fitting of a cranial orthotic, or basically a fancy molded helmet that will gently help realign his skull in place. Treatment will last between 3-6 months, with T wearing the helmet for up to 23 hours per day. Insurance some times does not cover this treatment, which would mean we would have the awful choice of either putting a significant dent in our emergency fund (the helmet costs about $3,000) or possibly leaving our little guy with a problem that, while it may turn out to be nothing more than cosmetic, could cause issues down the road. Needless to say if that decision comes to us, we’re choosing for Taylor’s best interest.

So why, you ask, am I writing about this? Because I hope that our experience will help other new parents to remember that while your little one may always seem perfect in your eyes, it’s also important to keep an objective (as possible) eye on their behavior and appearance. It turns out that since the advent of the “Back To Sleep” campaign, which without a doubt has had tremendous positive impact on the rate of SIDS, this condition has increased significantly. If we had noticed Taylor’s knack for sleeping and holding himself in one way earlier, the condition could well have been prevented or at least resolved without the need for expensive medical gadgets.

And by the way, helmet or no helmet, we still think our little guy is pretty damn special.

Some good resources on positional plagiocephaly:

http://www.cappskids.org/

http://kidshealth.org/parent/general/sleep/positional_plagiocephaly.html

http://www.nichd.nih.gov/health/topics/positional_plagiocephaly.cfm