1.) What is Deformational Plagiocephaly?
Deformational plagiocephaly is a condition in which a baby suffers from having a head shape that is uneven or irregular in shape. This typically will be displayed with a flat spot on the infants head.
2.) What is Craniosynostosis?
The condition known as Craniosynostosis can cause plagiocephaly. This is caused by the premature fusion of the child's skull at its sutures. This would cause an irregular shaped head through growth in one direction and growth located at the suture closures. Nonsynostotic plagiocephaly actually does not necessarily require that a child have surgery and it can be treated with the use of a cranial molding helmet.
When a child has what is refereed to as "mild positional plagiocephaly", the condition may actually correct itself within the first six weeks of the child's life. If not, then treatment may be required when its irregularity is diagnosed.
3.) Who Suffers From Positional Plagiocephally?
In the past, positional plagiocephaly would occur in one out of every 300 babies. This would include synostotic and non-synostotic cases. (Note to reader: "synostotic" refers to the fusion of normally separate skeletal bones). However, more recent data suggests that the number has raised up to 40% in health infants! - This rise in incidence or diagnosis of non-synostotic plagiocephaly has been linked to two basic reasons:
A. ) There has been a rise in multiple births
B.) The "Back to Sleep" campaign. This was headed by the American Academy of Pediatrics in 1994. This campaign suggested for infants to be sleeping on their backs to decrease the onset of SIDS (Sudden Infant Death Syndrome). As you can guess, when the child sleeps on its back more, what can happen to the back of the child's head? - A flat spot can develop.
4.) What Can Cause Non-synostotic Positional Plagiocephaly?
It is possible that this type of plagiocephaly is caused prior to birth. This happens due to pressure that is located within the mother's uterus. Typically, this is caused by one of the following conditions stated below:
• The infant dropped down early, into the mother's pelvis prior to the deliver process.
• Bicornase uterus
• The infant was born breech
• Multiple births such as twins, for example
• The baby's size is unusually large
• The mother has a decreased volume of amniotic fluid or she (the mother) has a small pelvis
After birth, plagiocephally can be due to the infants frequent lying posture. This means that the baby is in the same position, such as in their crib or car seat.
5.) What Are The Current Treatments Available to Help Treat a Flat Spot on The Head?
The main treatment for positional plagiocephaly is a cranial remolding orthosis. Many people refer to them as "baby helmets" or "infant helmets". A child can begin using one of these special helmets between the ages of four and eight months. - This orthosis (helmet) will gently reshape the skull as it continues to grow in the coming months.
6.) Will My Insurance Cover a Helmet (Cranial Orthosis or Headband)?
Insurance can cover these items, but each insurance provider has its own medical guidelines and coverage percentages. It is best to get in contact with the insurance company to determine the coverage of benefits for these special helmets. In this case, these helmets will be covered under DME (durable medical equipment) and orthotics and prosthetics (O&P). It is not unusual for the insurance company to request a letter of medical necessity for these remodling helmets. This will basically tell the insurance company why it is medically necessary for your child to obtain this kind of orthosis.
If untreated, your child may have to deal with more than just a flat spot on their head. They may also suffer from vision and hearing problems and temporomandibular joint disorder (TMJ), etc. It is important for you to be in contact with your local, licensed orthotist to provide you with all the necessary information regarding these helmets prior to making a decision. Moreover, many health insurance companies will have published detailed criteria for DME (durable medical equipment) on their websites.
7.) Are All Cranial Orthoses (Remolding Helmets) And Bands Created The Same Way?
The general concepts behind the product are similar, although its our opinion that it is important to get complete coverage of the baby's cranium to achieve the best outcome. Typically we are concerned about the upper cranial vault. Bands typically only address this aspect of the infants head. However, your baby has sutures that are located over and around their ears. Sutures are also located at the top of the baby's head as well. Since the helmets functions by allowing growth at a flat spot and inhibiting growth in the direction of any bulge, a band would not be optimal coverage for the area around and above the ears. This could allow for a deformation to persist if left uncontrolled. It is our opinion that a complete helmet of the child's unique shaped head will help to insure against this rare side effect.
8.) How Quickly Will My Child Receive Their Helmet After Casting?
Every O & P company is different in how they approach cranial molding helmets. Ideally, your baby will be using their new helmet with one week of the casting date to assure the proper fit and function of the cranial orthosis. However, insurance approval is typically needed before a licensed orthotist can provide this special helmet to your child. Ideally, the insurance approval process will be complete prior to the casting visit and this will expedite the time it will take for your child to receive their helmet. If you are going to get one of these for your child, phone ahead to your local, licensed orthotist and talk with their company about coverage benefits. You will probably need your health insurance readily available when you call.
9.) What Kind of Special Training do Certified Orthotists Possess? What is it That Makes Them The Best Candidate For Taking Care of Your Child?
A certified orthotist has proven themselves in the field of orthotics. They have passed exams of the highest standard in the orthotics community and need continuing education to keep their credentials in the field of orthotics. Although some individuals might like to call them a helmet, the device your child will receive is technically considered to be an orthosis.
Licensed orthotists are allied health professionals. They are also specifically trained and educated to provide or manage the provision of custom or prefabricated orthoses. This strong background in patient care, using proven biomechanical principles and materials, gives these specialists the skills to manage infants with positional plagiocephaly. Orthotists have also been fitting and providing braces (orthoses) including cranial helmets for over a century in the United States.
Note: This is health information. Not medical advice or to be used as a diagnosing tool for your child. It is best to work with your local licensed orthotist and physician to get the best treatment possible.
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