So Cadence wore the Pavlik harness (hip brace) for six weeks full time, and then six weeks at night- for a total of three months in the brace. Three months that seemed like forever, but in the grand scheme of things were not that long and gave cadence the support she needed to have full hip healing.
During that time, she was not able to move around or roll from side to side, and placement was very limited (either she was being held or she was lying down). She developed a little bit of a flat spot on one side of the back of her head, and the pediatrician noticed it at her four month appointment. Since she had been out of the brace for a month, I was able to tell a difference in the significance of the flatness. We decided to watch it over the next two months to see if over time it would diminish.
The shaping became more rounded out over the two months because she was able to start sitting in the bumbo and can spend more time on her tummy, but there is still an asymmetrical shape to the back of her head. So I went ahead and called the pediatrician for a referral to an orthotist to be fit for a cranial band (cranial helmet).
I'm sure you have seen babies out in public with these helmets on. It is not a big deal. There is nothing neurologically wrong with cadence. She will not wear the helmet for a long time, it is not for "padding" of her skull. It will simply round out the back of her skull.
So I figure a lot of people have questions. Let me explain what the orthotist (a guy who makes braces and splints) found.
He did a scan* of cadences head and found mild plagiocephaly and severe unilateral (one sided) brachycephaly. Anatomical landmarks: Looking down on the crown of her head, her right ear is more forward than the left. Looking at the back of her head, her head appears to have a slight curve to the left. Her left forehead is ever so slightly more pronounced than her right.
***(It was a digital scan. The old school way of making braces involved a plaster cast, mold, and set cast and lots of adjustments afterwards. It is now computerized and fabricated with more accuracy than the plaster molds)
He measured her head circumference and compared it to her birth and 4 month measures and set a plot to estimate her head growth amounts for the next six months. In order to round out and be symmetrical, she needs 6mm of growth. In line with her charts, he estimates this to take 2-3 months.
So here are some questions I anticipate people having:
1. How long does she have to wear the helmet? For 2-3 months, or until results are seen and measurable.
2. Does she wear it all day every day? Initially she will have to build up to a full days wear. But yes, she will wear it for 23 hours a day (like she did the hip brace).
3. Why now? We could wait a few more months to see if it rounds out on its own, but the longer we wait, the more difficult the process becomes. As she ages, her skull is becoming closer to fusing (closing of the soft spot at the top and becoming less pliable/moldable). As this is the case, the duration of the wear could have been extended. I don't feel like it will round out on it's own and I don't really want to risk the chance
4. Why is the head shape so important? Well there are little things - like her future image of herself if her head is misshapen. Pigtails wouldn't be even, things may be uncomfortable. For the larger things: sports and bicycle helmets may not fit correctly. Glasses may not sit right on her head. She could be at risk for TMJ or other jaw related problems.
5. How much does it cost? I have friends who have shared their stories of helmets and cranial bands with me, and there are a lot of variations here. We have BCBS insurance, and they are covering 80% of the band cost. Other insurance providers do not cover the band and it can cost upwards of $3000.
6. What is the difference in a cranial band and a helmet? There are a variety of cranial band fabricators. The orthotist that we saw uses "kinder-bands", which look like helmets with a cut out on the top. He explained that certain low profile bands (like the doc-band) uses pressure against the babys skull. These low profile bands are a four to five step process, so the family would have to pay $3000 for each band made. That adds up to a very expensive process, very very quickly. The helmet is total contact, which does not "push" the skull, but rather facilitates growth in certain areas. So her head is growing right now, so the helmet will help her skull grow in the areas that it needs to in order to round out. She will only need one helmet.
So we were scanned on April 10th, and we will be fit in person for it on April 19th. She will be evaluated in the office every 2-3 weeks to check growth and fit.
I'm going to post pictures from my phone (it's so much easier than adding them to the computer etc). So they may not be in any particular order, but you will be able to see how she was scanned and what her head shape looks like now.
We did everything we could to try and prevent any issues, but life happens and we are going to do everything we can to take care of our sweet baby girl! :)
Otherwise, last week was pretty busy. We have 2 teeth coming in, and she said "da-da". :)
Sweet pea is growing like a weed!!!!
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