Skull Molding
With the Back to Sleep program initiated in 1994, we have seen a greater than 50% reduction is Sudden Infant Death Syndrome(SIDS). http://www.nichd.nih.gov/sids However, because we are laying our babies on their backs, there is also a higher incidence of occipital molding (flat spot on the head). We have set aside a specific clinic for Skull Molding, occurring in the morning on the first and third Wednesday of each month. Our Skull Molding clinic allows you to be seen by the neurosurgeon and the orthotist (person who makes the band, should a brace for the head be indicated), as well as discuss the band with families already undergoing treatment(should you so desire). We see more than 50 children monthly with skull molding and have more than 20 years experience in the treatment.
40% of patients will get better on their own(they are getting older, getting better head control, and not necessarily laying in the same position). Neck range of motion exercises can help (we should then hot link to the attachment). However, despite your best efforts, up to 60% of children will have some residual flatness. If the flatness is disfiguring, a band is often recommended. Bands and helmets are identical devices, the manufacturers started calling them bands a few years ago as better marketing. Each band is custom-molded (by the orthotist, a separate company) for the child. Because we are trying to take advantage of the natural head growth and the head is growing all the time, the more they wear the band, the better the outcome. The band is worn 23+ hours a day, for about 3 months. We serially review the progress and customize the plan for the child. Ideally, band treatment is started prior to 9 months of age (corrected) as, at 12 months of age, some physiologic changes are happening that make the band less effective(the velocity of head growth is slowing down so, if the head isn’t changing as much from day to day, we can’t change it as much either; and the sutures (the natural connections between the bony skull plates) are starting to close, meaning the skull is becoming more firm). Infants tend to tolerate the bands very well. The analogy used is, children tolerate what they become accustomed to (wearing the band is less irritating than wearing a diaper and yet they tolerate both well).
View Dr. Trumble's clinical presentation on Pediatric Skull Molding. (Viewer Discretion Advised: The presentation contain graphic medical imagery)
