AIBU to get a helmet fitted for my six month old

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My beautiful baby boy has positional plagiocephaly. He is six months old. He is just coming to the end of the "perfect" age to get a helmet fitted. His flat spot has been assessed and it is Severe 1. So bad but not horrific.

Treatment is for six months roughly and he will need to wear a helmet for 22/23 hours a day for that period of time. It is a lot of work and a lot of money (£2.5k) but I have the finances to do this for him and the time to dedicate to it. He only has until he is 16 months to have it treated. It will not go away on it's own it will just be less noticeable with his hair and as his head gets bigger. His face shouldn't get any more deformed. It is marginally deformed now but without looking for it you probably wouldn't notice it.

As the back to sleep campaign is only from the 1990s it is hard to find adults with positional plagiocephaly but research seems to suggest whilst there is no brain growth issues there could be developmental issues. This concerns me as I worry he is a late developer anyway. I also worry about the mental aspect of looking different. I was bullied in school, I wouldn't say I am attractive and I would hate my little boy to be on the receiving end of this. Children and adults can be very cruel. Whilst I will get looks and questions about his helmet for six months I would hope my family will understand and most of my friends most likely will. Also during a pandemic who is he likely to see anyway there are no groups etc to go to so no one (strangers I mean) to question me.

So AIBU to get one? Would you/have you done the same. Or have you left it and regret it. To me the money and the timeframe is nothing to a lifetime of people being arseholes towards him.

I would not hesitate. Go for it OP. Friends had one for their child who now has no problems. The NHS wouldn’t help, they had to go private.

PS not the point of the thread at all but I find this “ the helmet was decorated with dad's favorite American football team“ really distasteful!

Sorry posted too soon. Or at least it looks to me as if the flat bit is not there any more. My ds does have developmental delays. I think it was the developmental delays that caused his flat head.

You have to do what you think is best for your dc. It must be horrible for you having to worry about it.

I would go for it.

Friends of mine had a baby with this quite severely. They didn't do the helmet and now that he is 3, desperately wish they had.

I agree that it's a funding issue with the NHS. Much more common in the US where you have to pay for everything anyway.

@Bellesavage you don't know much about osteopaths do you?

OP if you're worried about your baby at least get advice from an osteopath, if it doesn't help no harm done.
Osteopaths are highly trained professionals who specialise in the skeletal and muscular structure of the body.

I am from an Indian background where babies are often kept on their backs - all my family and friends do it. Have only ever seen one child with positional plagiocephaly and had developmental delays (couldn’t even turn over by 7-8 months) - so the link a previous poster mentioned might be why the NHS has advised you against it. The helmet is a huge undertaking and can often cause other delays too.

My DS had a helmet, it was money well spent. His head was very flat at the back. The GP said he’d grow out if it when crawling but he didn’t. I found somewhere privately and he got it fitted 2 weeks later. He wore it all the time apart from in the bath. We cut his hair short so it was less sweaty in the summer. There were regular appointments where they reshaped the helmet as he grew. He didn’t seem at all bothered by it it was more looks from other people who seemed to be the ones bothered! He’s now 14 his head is head looks fine. Best wishes.

A cranial osteopath fixed my children's.

@Coffeecak3 a cranial osteopath is completely different to an actual osteopath. Of course some cranial osteopaths may also practice normal ostepathy but as cranial ostepathy is an entirely different beast, and one that provides little evidence of its efficacy. Cranial osteopathy is not something I'd want to trust with this issue.

my daughter had plagiocephaly caused by torticollis, we saw a cranial osteopath and did the physio several times a day and it was corrected, you could try that for a couple of months before the helmet.

Yes I wouldy ds had one and has a perfect shape head now at 13.. To the poster who asked can he roll, it It makes no difference, the damage is done.. Its more important to correct in boys as will be more noticeable when he older with short háir

My eldest son slept on his back and got a very flat head and wonky ears 😫

I bought him a pillow specially designed to help and it fixed it very quickly.

My son also had positional plagiocephaly, we tried everything, but it did not improve, so decided to pay for a helmet. Best thing we ever did. His head went from severely flattened on one side to normal in about 5 months. The helmet was absolutely no bother to him, and looked kind of cute in fact :) He had a protruding forehead and facial asymmetry, both of which have been corrected in that short space of time. If you can afford it, go for it, I'd say!

If it were me, I would get a second opinion from a private pediatrician and if they advice to get a helmet fitted ,I definitely would. I don't know much about the subject so will have to get a private pediatricians opinion and I will not rely solely on NHS and health visitors. NHS is all about cost. I would want to know if there is likely to be any side effects from wearing the helmet, and if the helmet is likely to do more damage than good. This is because I don't really know much about the subject matter and I would want to make sure the helmet will not cause other issues. As long as wearing a helmet is not likely to cause any other (more serious) problems then I would definitely do it.i wouldn't worry about people staring etc. Good luck.

If you can afford it no issue, I'd ask the question -will it do any harm?
If the answer is no -do it. The NHS does not have the resources to fund everything. So I'd do it in a heartbeat.

Have you seen a paediatric physio to assess if he has any muscle shortening that is pulling his head one way ?

If any muscle tightness is not corrected the helmet will make his head heavier and potentially increase the pressure on the flattened areas. If his head is relatively big and heavy as many babies with plagio are, a helmet may limit his ability to hold his head up in tummy time and to roll.

It is not an easy decision to make as there is no clinical research that proves the use of a helmet improves head shape over time when compared to positioning advice, soft tissue stretching, normal growth and moving through the physical milestones

Has he had a skull xray to check if the skull sutures (spaces between the skull plates) are prematurely fused. If they have, the skull will not correct and that requires very different intervention (possibly surgery). If they haven't, the shape will continue to correct until the last suture fuses around the age of 3-4 years. This is essential really before considering a helmet and should form part of the assessment.

All the reasons above are why helmets are not officially recommended by the NHS, it is not purely on a cost basis. Although, if you do decide to go ahead, you should be supported in it, don't feel that you would need to "pick a side". A helmet would be in addition to standard advice, not instead of.

Good luck and I am sorry you are having to face this dilemma.

Thank you everyone being so supportive. Yes the damage is already done by 4 months it if hard to correct it with repositioning and tummy time. I think I will get a second opinion as that's what I would advise a friend tbf. I personally like the patterns you can get. I think either a white one with dinosaurs on or a galaxy pattern would be most suitable for a cute chubby boy not biased at all!!!

The evidence base for helmets is terrible. My son’s head was far more deformed than the severe 1 category - he’s now 4 and it looks totally fine. Not completely symmetrical but who is?! My youngest had slightly less deformity and had a normal head shape at 16 months.

£2.5k is cheap in Nhs terms - if there was a good evidence base for this then the NHS would recommend and pay for it.

The back of my dds head was SO flat It was practically a straight line, but it did grow out by itself. Shes 7 now you’d never know she had a flat head.

I did this, years ago, when there were no companies operating in the UK and I had to get a specialist from Germany to help. My dd's face was quite badly affected though, it wasn't a small patch at the back, her ear on one side was 1 inch in front of the ear on the other side, and her face looked like it had been smacked by a frying pan (i.e. parallel flatness).

I decided not to worry what others (including the HV thought) and go ahead, we did, she has a perfectly symmetrical head and is very lovely looking. I am not going to out myself, but saying 'the hair will cover it' is not always true- what if the child has short hair, or loses their hair?

She did also have torticollis though (which the helmet consultant demonstrated), so we did neck exercises for that.

The good thing to come out of all this was my second started to develop a bit of a flat patch, like probably 50% of babies, and so I immediately did lots of tummy time, carried her, repositioned her in the cot so she would look out both ways, and once she was sitting, it was gone by about 9 months. So in mild cases, and without any neck disorder, I think it's perfectly possible to reposition babies and this just disappears of its own accord.

I knew my older's wouldn't just disappear though, and I have no regrets any more than I regret her having block braces for 2 years!

It is cosmetic in the vast majority of cases though and I think there's little argument the NHS should be starting to pour money in, however this leaves the current state of affairs as very unfair to those who don't have the money, as treatment is expensive.

We only got laughed at once, by some teenagers. Most people smiled at my little girl in her pretty helmet (they weren't patterned then and I stuck butterflies all over it) and it was all done and dusted very quickly.

Also just wanted to say I'm feeling very emotional atm with lock down etc and your replies have meant a lot to me sorry to sound sappy but it is true.

You sound like a wonderful loving mother. When your son grows up, he will have wanted you to get the helmet and try to fix the problem. If you can afford it, do it.

www.bmj.com/content/348/bmj.g2741

Decent RCT here

I have read that RCT (which suggests no difference in results between the helmet therapy/non-intervention group). It seems a bit strange that there was such a poor outcome in the helmet therapy group- in other words not as many resolved as you would have expected.

I also wonder whether, having alerted the parents in the non-intervention group that there was indeed an issue, but then reassuring them that it would naturally grow out, if some of those parents didn't then go away and google about the condition and realise there are lots of non-helmet based things you can do- like make sure your child is off their back constantly! This is actually good news though and suggests that non-helmet based positioning might work (as much as doing nothing).

I found it worked for my child fantastically, BUT if I went ahead and then had a baby who hated the helmet or didn't like the side-effects (as they can be uncomfortable) I would just abandon it, and continue as AnyFucker said, to do all the additional things you should be doing anyway, particularly physiotherapy for the neck, lots of tummy and sitting up time and so forth.

The study does show though, that there are children with significant facial asymmetry as a result of this- it is not just a bit of a flat spot and people exaggerating!

Good luck with making your decision.

My DD had this very severe. So severe they sent her for x-rays to be absolutely certain that it wasn't a cranial deformity.

No helmets at the time but waste assured it would go back to normal. It was very hard to believe at the time.

She is now a young adult, studying for a Master's. A*AA at A levels. Her head is perfectly round. It was totally normal by the time she was 18 months, not noticeable any longer by 12 months.

It is very very common and indeed, how many adults we see with flat heads?