Imperfections

Our babies have flat heads.

At our two-month appointment in January, I asked about it and was told not to worry (we saw a nurse practitioner for that one, not our regular doctor). At the four-month, I asked again, because they were still flat. Our pediatrician said it would probably be fine, but she said we could have the craniofacial specialists check it out.

I was simultaneously scared to have it confirmed and not have it looked at. But I did the grownup thing and made an appointment. (It’s a huge university/hospital complex at the top of a big hill in northwestern Portland. Huge buildings and structures everywhere you look–honestly I felt like I was in the Jetsons or something!)

Anyway, the woman we saw there was wonderful–very warm, loved the babies, and was very open with us. It was clear that she had no agenda, wasn’t going to automatically make us do helmets, but was very objective. She measured their heads, and sure enough they were flat. Emmett’s worse than Malcolm’s, by a lot. We’d already been able to see that, but the numbers were stark. There’s a certain measurement difference cutoff that would make a baby eligible for a helmet; Malcolm’s was below, and Emmett’s was above. But both have acquired positional plagiocephaly (the medical term for flat head).

She gave us exercises and stretches to do with both of the babies, to work on their torticollis, which would also help them move their heads and necks better. She wanted us to have the babies do fifteen minutes of tummy time every few hours, which was WAY MORE than what we’d been doing, and quite frankly, way more than the babies wanted to do. We were to come in again two months later to check the progress.

We did fairly well with the tummy time, and the babies got a lot better about tolerating it. We would give them toys and squishy books, or lay them on our laps facing out/down, and they would be okay. The stretches really helped their neck tightness ease and loosen. We also had them do a lot of supported sitting–in the Bumbo, activity seat, jumperoo, exersaucer. Lots of playtime not laying on their backs.

By the follow up appointment, Malcolm’s head had gotten noticeably less flat, and his measurement difference dropped in half. Emmett’s had also gotten less flat, but his hadn’t improved as much, and he was still over the ‘cutoff.’ Too flat.

Time for a helmet.

The specialist was again very honest and caring. She told us that after a year or two, heads/skulls aren’t really that malleable anymore, so if you wait, a helmet either takes longer to round out the head, or won’t work at all.

Three weeks ago we had our first appointment at the orthotist so his head could get scanned for his custom helmet. Doesn’t he look like an adorable little Ewok?

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Last week we went back to get the custom-fitted helmet.

The night before, I took a special photo of his cute, happy little self.

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At the office, still happily unaware.

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The doctor had to adjust the helmet openings to fit his head. It’s made of molded foam and has a rounded back to guide his head growth over time.

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Here he is back at home, getting used to wearing the helmet for an hour. This first week is a schedule of increased time wearing it so he can get used to it. Starting at the end of this week, he’ll wear it 23 hours a day. He’ll have it for 3 to 6 months, depending on his growth.

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It’s been a few days now, so he’s worn it for hours at a time, including for naps. He seems to be doing just fine with it. When we go to put it on him, he moves his head around to look at it, and then I swear, he recognizes it and lowers his head so we can put it on. When we take it off, his head is sweaty and his considerable hair is plastered to his forehead. But that’s just how it goes, so we’ll be washing his hair and cleaning the helmet every day during the one-hour break.

Okay, so those are all the facts about Emmett’s helmet.

Now for my feelings.

I’ll sum up: as the orthotist put the helmet on him that first time, tears welled up and rolled down.

When the craniofacialist confirmed the flatness for both and that Emmett would probably need a helmet, I felt my heart sink. Sadness. Guilt.

My poor little babies. Their heads were perfectly fine when they were born. But since they slept in the Rock N Plays pretty much all day and night for the first however many weeks and months, and they both leaned their heads to the right, they got flat spots on that side. I could have held them more. Or forced them to sleep in the co-sleeper (they didn’t sleep as well in there and also spit up more). I could have carried or wore them more. (With naps, feedings, and pumpings, and two babies…I don’t know how.)

The specialist told us that twins are extra susceptible to flat heads, especially Twin A’s (the twin closer to the ‘exit’, if you will). Emmett was our Twin A and his head was wedged in my pelvis for the last three months in utero (Malcolm was breech; neither of them ever flipped), so I guess it’s logical that his little skull already had some extra pressure on it.

So in theory, it happens to a lot of babies and it’s not my fault. But I still feel like it’s my fault, like I let him down, like I didn’t do my job. I dreaded the fact that something was Officially Wrong with one of my babies. We have been so incredibly lucky that our babies have been so healthy thus far. I know that many twins have a lot of medical issues right away, and that sadly many babies come down with flu, RSV, whooping cough, and all kinds of other scary things. We’ve avoided all that so far. I also know that flat heads and helmets aren’t really a health problem, and that he’s still a healthy baby, and I should shut the fuck up with my whining.

But oh, my sweet little baby. We already get looks and comments all the time because they’re twins–and now there’s another reason people might gawk and say dumb shit. He won’t know any better, but I will. I know that we’ll be glad to be helping his head round out, and it’s only temporary, and he won’t remember, but I feel bad that we’re making him look ‘different.’

I’m getting used to it, sort of. I’m happy that Emmett doesn’t care and is his usual self. I still think he’s really cute. It’s harder to kiss his adorable little face with the helmet in the way. And I still have a little sinking, sad feeling when I see it. My poor baby.

Nobody’s perfect, and everyone has a ‘thing’ or issue. But I didn’t think I’d have to accept imperfections for my small babies quite yet. I know that over time there will be plenty more and it won’t be a big deal. Maybe this first hurdle is the biggest.

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Update: He outgrew the helmet three months later! Read the post here with more details about the experience with the helmet.

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