Tag Archives: Safe Sleep surface

Essential Info about your Baby’s Head Shape (Pedcast)

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Transcript: Essential Info about your Baby’s Head Shape (Pedcast)

-Welcome to another edition of DocSmo.com, your reliable source of information for parents about a wide range of pediatric parenting and health topics ranging from the bassinet to the boardroom.

-Thank you for joining me today.

– I am your host and the founder of DocSmo.com…Dr Paul Smolen, a board certified pediatrician with 30 years of private practice under my belt.

-These “pedcasts” are intended to bring parents useful practical information about important pediatric topics.  A supplement to your child’s regular office  visits with their health-care provider.

-This is the kind of discussion your pediatrician would like to have with you if they had unlimited time during your child’s health supervision visits.

-I want to stress that by making this podcast, I am not intending to give specific medical advice for your child, rather general information on the topic of the day which today is “What parents need to know about head shape in babies.”

 

-Parents often worry about their baby’s head shape…especially in the first year of life.

-First, we have all the consequence of the birth process… and what a process it is.

-Babies usually come head first into the birth canal, first hitting the hard bones of Mom’s pelvis, then squeezing through Mom’s cervix and vagina.

-Bruising and molding of the skull bones are almost inevitable as a consequence of these processes.

-Many parents are startled and frightened by the molding and bruising their infant is born with but rarely are these a serious concern.

-With the rapid brain and skull growth that occur in the first few months of life, the distorted shape of a newborn’s skull rapidly disappears…unless they spend so much time on their backs in monotonous positions that flattening starts to occur in the back of their little heads.

 

– The medical term for this one sided flattening is plagiocephaly and pediatricians definitely started seeing more of this deformity after the back to sleep campaign started in the US…that’s the recommendation to always have babies sleep on their backs on a safe surface whenever they are unattended.

-Not only can plagiocephaly be a cosmetic problem, but some feel that with enough asymmetry of the skull can come along vision problems since, with enough forward shift one side of the face,  one eye may be in a different plane than the other.  A similar process is thought to possibly cause jaw problems since the mandible may not fit properly on the skull if the upper face is not symmetric.

 

-Everyone agrees that flattening of one side of the skull is something that we want to avoid.

-It can persist into adult life if it is severe.

-Here is what you can do to avoid problems with your baby’s head

         -Start doing tummy time, as soon as your little bundle of joy comes home from the hospital.

         -Try and turn your infant’s head to alternating sides when you lay them down for sleep as soon as you get home from the hospital.

         -Try to get Tummy time, supervised of course, for 30-60 minutes a day on a firm, safe sleep surface…for more on that, I remind you to check out my pod cast on “Safe sleep”

         -If your child always wants to lay on the same side of their head, they probably are doing so because of a cramped womb position.  Have your pediatrician check their neck for tightening or stiffness.  Should this be present, have them show you some exercises to help alleviate this tightening or have them send you to a physical therapist for this purpose.

 

-Here are some things you should not do in an attempt to help your infant’s head shape are:

         – Let your infant sit in a car seat or any seat for that matter  for long periods of time in the same position.

         -You should not buy devices to hold your baby in a certain position to lower pressure on his or her head.  These devices are well intentioned and may work, but their safety is always a concern.  Experts recommend that they not be used.

         -When using tummy time, never leave your child unattended even for a second.

 

-It has been my experience that the flattening can be avoided if parents are proactive with Tummy time and be careful not to miss neck stiffness.

-Should the flattening occur despite your efforts, referral to an specialist in head orthotics should be made by 6 months of age.  They will help you decide if your infant needs a skull-molding helmet to reshape their head.

-These helmets are expensive and don’t always work especially if not put on by 6 months so remember the DocSmo pearl…. Prevention trumps treatment almost every time.

 

 

– I hope the new parents in my audience today found this pedcast useful.

– The head shaping helmets I referenced in the pedcast cost between $1500-$4000 in my community and are not always covered by insurance so by listening to DocSmo today, potentially I may have saved your family a significant chunk of change… all in a days work.

-If you found this and other pedcasts useful, go ahead and take the plunge.  Subscribe on itunes, like DocSmo on face book or follow us on twitter.

-Currently, all of my content is available for free at my website, www.DocSmo.com.

-And don’t forget to check out my Smo Notes posted at my website where you can find reliable reference material with a simple click of the mouse.

-As always, this is your host, Dr Paul Smolen, broadcasting from studio 1E, that’s the first child’s bedroom on the east side of the house, protecting you from the dread of having a child with a misshapen head.

 

Until next time.

Smo Notes:

Clinical Report: Prevention and Management of Positional Skull Deformities in infants, Pediatrics Volume 128, Number 6, December 2011

 

*By listening to this pedcast, you are agreeing to Doc Smo’s terms and conditions.

 

All Rights Reserved.

Lunchroom Lowdown- Safe Sleep Guidelines for Infants 2011 (Article)

 

I convened a “lunchroom lowdown” the other day on the topic of new AAP Safe Sleep Guidelines, and my partners eagerly offered their opinions and impressions when it comes to safe sleep for infants. My partners–Drs. Plonk, Riley, Downing, and Moorman–are outstanding doctors, and I can’t thank them enough for sharing their expertise with me.  Let me try to summarize our conversation about “Safe Sleep for Infants.”

 

A lot of the discussion revolved around the practicality of running a household with three or four children following the new recommendations.  I think all the doctors felt that the guidelines are good goals but are not always practical.  Dr. Riley doubts that parents can always be present when their infant is asleep.  Also, can the surface they sleep on always be on a “sleep safe surface” as outlined in the guidelines?  Probably not. Dr. Plonk wonders what happens when an infant falls asleep in a swing or car seat: should they always be awakened and moved to a safe place?  Again, unlikely.  Dr. Downing thinks that it is very unlikely that after a child feeds in their parents’ bed that the child will always be put back onto a safe surface by an exhausted, half-asleep mother.  Since only one person is supposed to be in the bed with the infant, does that mean Dad gets exiled with every feeding?  Dr. Downing doesn’t think that will happen, and neither do I.

 

Drs. Plonk and Riley felt that not only are some of the guidelines impractical, but some are ambiguous.  The “no monitor recommendation” seems to imply not to use audio or video monitors; why?  If not, do parents need to watch their children sleep 24/7 in person? What about that “no over-bundling recommendation” (not to use more than one layer more than would make an adult comfortable)?  How many layers are in a swaddle?  Is swaddling with a large blanket now forbidden?

 

 

 

Dr. Downing felt that the new guidelines are excellent recommendations, but wondered if they will change very many parents’ behavior.  We all know how difficult it is to change someone’s behavior.  There was uniform agreement that despite the new guidelines’ impracticality and potential ambiguity, overall the AAP’s new guidelines for safe sleep are a big step forward for children.

 

As we were discussing this topic, the thought crossed my mind that hospitals should be the number one place where these guidelines are followed, but that is often not the case.  Hospitals should be setting the best example for parents and physicians.  If anyone should know what actually happens in a hospital, it is the group at the Lunchroom Lowdown; combined, we have over 100 years worth of hospital nursery experience.   We know what goes on in hospital nurseries.  Many of the guidelines are not being followed on a routine basis to this day.  For instance, twins are often put in one bassinet together (“Babies should sleep on a safe surface by themselves”).  Babies are routinely swaddled with multiple wraps (“No more than one layer above others in the room”) and placed on their sides (“Back only”).  Additionally, the bassinets have solid sides which could get up against a baby’s nose and cause obstruction (“No surfaces near a baby’s face that can cause suffocation”).  It is not unusual for lovies to be placed in the crib from the day a child is born (“No toys”).  What about those cute little hats that almost every newborn wears: could it get down over a child’s face? You bet. Finally, the move toward infant bonding, skin to skin, and rooming-in encourages very exhausted moms and dads to hold their newborns when everyone may be very sleepy (“No sleeping on unsafe surfaces”).  Hospitals, let’s get with the program!

 

The death of a otherwise healthy infant is a terrible thing, and the new guidelines are a big step toward making such an event a thing of the past.  When you really dig down into the recommendations, you begin to see how difficult they are to follow at all times.  Let’s hope that both parents and hospitals can do a better job in the future of providing the safest sleep possible for our newest citizens we call our children!