We could have prevented our plagiocephaly? How?

A few words, from our peditrician, could have helped us and many other families to avoid plagiocephaly.  One of the key words, that was left out of our early visits, is repositioning.

What is "repositioning"?

"Techniques to encourage your child to alter the resting position of his/her head."

Why is "repositioning" important?

"Careful attention to repositioning while your child is awake can prevent or reduce positional cranial deformities."

From the American Academy of Pediatrics:

"To prevent the [deformational plagiocephaly], parents should be counseled during the newborn period (by 2 to 4 weeks of age) when the skull is maximally deformable. Parents should be instructed to lay the infant down to sleep in the supine position, alternating positions (i.e., left and right occiputs). When awake and being observed, the infant should spend time in the prone position. The infant should spend minimal time in car seats (when not a passenger in a vehicle) or other seating that maintains supine positioning....

Once deformational plagiocephaly is diagnosed, parents should be made aware of the condition and the mechanical adjustments that can be instituted. In general, most infants improve if the appropriate measures are conducted for a 2- to 3-month period. These include positioning the infant so that the rounded side of the head is placed dependent against the mattress.

Additionally, the position of the crib in the room may be changed to require the child to look away from the flattened side to see the parents and others in his or her room..."

Source: Persing J, James H, Swanson J, Kattwinkel J. Prevention and management of positional skull deformities in infants. American Academy of Pediatrics Committee on Practice and Ambulatory Medicine, Section on Plastic Surgery and Section on Neurological Surgery. Pediatrics 2003 Jul;112(1 Pt 1):199-202.

Key points:

Infants should always be placed on their backs to sleep.

However to avoid positional plagiocephaly:

change the child's sleeping position by placing the child's head at opposite ends of the crib on alternate nights
turn the crib around every few days -- babies will turn their head away from the wall
change the position of toys (for mobiles) and other objects to encourage head movement.

Include supervised "tummy time" in your child's day. In addition to removing pressure on the back/side of the head, playing on his/her tummy is good for development.

Alternate the arm in which the infant is held for bottle and/or breast feeding.

During diaper changes, alternate the side from which you approach the infants. This will encourage the child to turn his/her head to look at the caregiver.

Gary Tate Jr.
President and Founder
Alexandra's P.H.A.T.E.
Pittsburgh, PA
412-860-4557
http://draft.blogger.com/gary@alexandrasphate.org

Yet Another Journey Begins. Meet Alexander!

Meet Alexander.  He is the newest little one to be added to our PHATEs blogs page.  You can follow his journey through helmet therapy HERE.

Alexander is our firstborn child. When Alex was born about 5 days before his due date, he had a slightly misshapen head. In the next few weeks, his head shape began to look more “normal” but there appeared to be a slightly flat spot on the right back side of his head. Early on, my husband and I always gave him plenty of tummy time. Yet during his 2 month check up, the pediatrician noted the flat spot and said it would be something to keep an eye on. We began to place a rolled up blanket behind Alexander when he napped during the day so he laid on his left side.  Read More.......

Gary Tate Jr.
President and Founder
Alexandra's P.H.A.T.E.
Pittsburgh, PA
412-860-4557
http://www.blogger.com/gary@alexandrasphate.org

Plagiocephaly? Whats That?

What is positional plagiocephaly?

Positional plagiocephaly (play-gee-oh-seff-a-lee) is the term used to describe a flattened or misshapen head that may result from crowding within the womb or from an infant being placed in the same position (such as on the back) for long periods of time.

Health care providers also use the term brachycephaly (bray-kee-seff-a-lee) to describe the flattening of the back of the skull. Positional plagiocephaly and brachycephaly often occur together.

The general term plagiocephaly refers to a head that is abnormally shaped from a variety of causes. Positional plagiocephaly is only one type of plagiocephaly. Other types can result from: skull sutures closing too soon (called craniosynostosis); twisted neck present at birth (called congenital muscular torticolis); and fluid around the brain (called hydrocephaly). Plagiocephaly can sometimes be severe and may require surgical treatments.

What causes positional plagiocephaly?

Positional plagiocephaly usually results from an infant being placed in the same position, such as on the back, for long periods of time.

Babies' skulls are soft and are made up of several skull plates. These movable plates have space between them, called sutures, that allow the head to be flexible so that the brain can grow. If the head is left in the same position for long periods of time, the plates move in a way that leaves a flat spot.

The most common causes of positional plagiocephaly include:

• Too little time spent upright—sometimes called "cuddle" time
• Too little "Tummy Time" when the baby is awake and supervised
• Too much time in car seats, carriers, and bouncy seats

Preterm babies are more likely to get flats spots on their heads because their heads are softer than those of full-term babies.

How can I help prevent positional plagiocephaly?

Most cases of positional plagiocephaly can be prevented (and sometimes corrected) by repositioning, which relieves pressure from the back of an infant’s head. Techniques for repositioning include:

• Providing "Tummy Time" when your baby is awake and someone is watching. Tummy Time not only helps prevent flat spots, but it also helps the baby's head, neck, and shoulder muscles get stronger as part of normal development. Parents and caregivers can try Tummy Time 2 or 3 times a day, for short periods of time, until the baby gets used to being on the tummy. Once the baby begins to enjoy the position, parents can try longer periods of time or increase frequency of Tummy Time. [link to http://www.nichd.nih.gov/health/topics/Tummy_Time.cfm]
• Changing the direction that your baby lies in the crib from one week to the next. For example, have the baby's feet point toward one end of the crib for a few days, and then change the position so his or her feet point toward the other end of the crib. This change will encourage the baby to turn his or her head in different directions to avoid resting in the same position all the time.
• Avoiding too much time in car seats, carriers, and bouncers while the infant is awake.
• Getting "cuddle time" with the baby by holding him or her upright over one shoulder often during the day.
• Changing the location of the baby's crib in the room so that he or she has to look in different directions to see the door or the window.

Healthy babies should be placed on their backs to sleep for naps and at night to reduce the risk of Sudden Infant Death Syndrome (SIDS). It is important to note that even though back sleeping may affect the risk of flat spots on the head, flat spots are much less serious than SIDS and can often be prevented and treated. Parents should not stop placing babies on their backs to sleep, but rather should be sure to offer Tummy Time while awake and use repositioning techniques.

What are the treatments for positional plagiocephaly?

In most cases, flat spots on the head go away on their own once an infant starts sitting up and crawling. Repositioning (described above) can also successfully correct positional plagiocephaly.
If the problem is detected early, more severe positional plagiocephaly can usually be treated successfully under a health care provider's direction. Some options for this treatment include:

• A custom helmet that prevents the baby's head from always falling to one side when lying down. Most importantly, it allows the baby’s skull to expand into a more rounded shape as the brain and skull grow.
• Custom bands can also be used to help reshape a baby's head. Bands place a small amount of pressure on the baby's skull in the areas that need reshaping. A health care provider adjusts the band regularly as the baby’s head grows.

Using these treatments, the flat spots typically go away in about 2 months to 4 months.
If the abnormal shape is the result of some other disorder, and is not related to position, a health care provider may also recommend helmets and bands. Or, if the head is severely misshapen or the result of craniosynostosis, surgery may be required to correct the problem.

Talk to your health care provider about your baby’s head shape at each well-baby checkup.

Source: Eunice Kennedy Shriver | Nat'l Institute of Child Health and Human Development

If you would like more information on Plagiocephaly, Torticollis or Cranial Remolding Helmets, please feel free to conact us here.

Gary Tate Jr.
President and Founder
Alexandra's P.H.A.T.E.
Pittsburgh, PA
412-860-4557
http://draft.blogger.com/gary@alexandrasphate.org

Stretches for Torticollis

Torticollis (wry neck) is a symptom that causes a child's chin to be rotated to one side and his head to the other side. Disorders that can cause torticollis include congenital muscular torticollis, acquired torticollis, atlanto-axial rotary subluxation, and spasmus nutans (head tilt, nystagmus and head nodding).

Congenital muscular torticollis occurs when the sternocleidomastoid muscle on one side of your infant's neck becomes tighter than the other, pulling the head and neck to that side. This can occur when scar tissue forms in this muscle so that it can't grow properly. Congenital torticollis is sometimes the consequence of injury to the muscle during delivery, although it is also thought that it may occur prior to delivery and be a contributing cause to a difficult birth and not its consequence. It can also be caused by congenital abnormalities of the cervical spine, so sometimes xrays are required in evaluating newborns with torticollis.

If the right sternocleiomastoid muscle is affected, the infant will hold his head with his chin rotated to the left and his head rotated to the right. In addition to the head posture, you may be able to feel a lump in the affected muscle, which is usually most noticable between 2 and 8 weeks of age. Unlike acquired toticollis, congenital muscular torticollis is usually painless.

Congenital muscular torticollis usually improves with range of motion and stretching exercises and massage, but it can lead to positional plagiocephaly and facial asymmetry if your child's head lies in the same position all of the time. If it isn't quickly improving, then your child may need to be evaluated by a physical therapist. In cases that aren't improving by 12-18 months, a surgical release/lengthening of the sternoidcleidomastoid muscle may be required.

Here are some stretching exercises recommended to help with Torticollis. These exercises are provided by KeepKidsHealthy.com:

• Instructions for Stretching and Positioning Left Sternomastoid Torticollis: stretching, side bending, rotation, positioning, carrying and other suggestions to treat your child with congenital torticollis.
• Instructions for Stretching and Positioning Right Sternomastoid Torticollis: stretching, side bending, rotation, positioning, carrying and other suggestions to treat your child with congenital torticollis.

If you have any questions or need more information regarding torticollis, please fill out the "contact me" form below or call 412-860-4557.

Gary Tate Jr.
President and Founder
Alexandra's P.H.A.T.E.
Pittsburgh, PA
412-860-4557
gary@alexandrasphate.org

What does torticollis look like??

Isn't This picture adorable? We thought so too. However, it was trying to tell us something, but we couldn't see the forest through the trees. What Does Torticollis Look Like? Hmm, the first question people usually ask is, What is torticollis? Most new parents are completely unaware of what to look for when they bring their newborn home from the hospital. If during your pregnancy, you had low amniotic fluid, or your baby was breech there is a higher possibility of torticollis. In our case, low amniotic fluid caused our baby's head to be held in the same position because of lack of room to move.

This lack of movement, caused the sternocleidomastoid muscle to be tight on her left side(Torticollis or Wry Neck). We have created a video to show parents the signs of Torticollis in infants. Initially, most won't see any issue with the photos, but it is plain as day. If you know what Torticollis looks like. Had we been able to view this early on in Alexandra's life, we would have know right away, what Tortcollis looks like. You can link directly to the video by clicking here.

Gary Tate Jr.
President and Founder
Alexandra's P.H.A.T.E.
Pittsburgh, PA
412-860-4557

mailto:412-860-4557Gary@alexandrasphate.org

Meet Cazzy!

Meet Cazzy.  He received his helmet in January of 2012.  His journey has just begun, but he still has a big, big smile on that cute little face.  Best of Luck Cazzy!  See our other STARband kids by visiting our website at www.alexandrasphate.org/

Gary Tate Jr.
President and Founder
Alexandra's P.H.A.T.E.
Pittsburgh, PA
412-860-4557
http://www.blogger.com/gary@alexandrasphate.org

Welcome Emily to our STARband blog family!

Please check out our newest blogging family.  Emily has just started her STARband journey and has invited us along for the ride.  You can follow her journey here.


You can also visit her blog by visiting http://myhelmetbabysquared.wordpress.com/

Gary Tate Jr.
President and Founder
Alexandra's P.H.A.T.E.

Pittsburgh, PA
412-860-4557
http://www.blogger.com/gary@alexandrasphate.org