Flat Head Helmets

It’s been an agonising decision but we’ve just ordered RB a helmet to reshape his wonky head. The advice is to wear it 23 hours a day, probably for 6 months. If you’re being generous, you could say it looks like a skater helmet. If you’re not, you could say it looks a bit special.

RB has had a wonky head since he was a few weeks old. It’s known as flat head, which can be plagiocephaly – flat on one side – and can be brachiocephaly – flat at the back causing the head to be wider than a ‘normal’ head. Normally, it’s caused by sleeping on one side on a hard mattress. Everyone says it’s much more common since the SIDS campaign said babies should sleep on their backs without pillows or soft mattresses. It seems to be more common in peaceful babies (who sleep well), bigger babies (big heads are heavy), and boys (I assume because boys are generally bigger).

As parents, we’ve been chilled. Our GP told us nature would do its job and his head would round as he started sitting up more and lying down less. We read early on that helmets are controversial and forgot about them.

Recently though, family began to be concerned that at 7 months old RB’s head wasn’t rounding. Once the head fuses (between 1 and 2 years old) the shape is mostly dictated for life. There’s only one window to reshape our little flattie, and that’s now. We started to explore helmets, knowing they’re controversial. And POW. So started our headaches.

Because helmets are controversial – it does seem to be pretty extreme to make a growing baby wear a helmet for 23 hours a day to remould his head – it feels as though sides are clearly drawn. As you’d expect, the helmet seller (they’re not available on the NHS and are pricey) said nothing would change, RB’s wonky head would stay wonky and only get bigger. Only a helmet can solve our problems. Funny that.

We quickly learned that generally, the NHS is anti-helmets (generally the NHS is anti cosmetic interventions, and that’s what changing a baby’s head shape is). However, I learned the hard way that the NHS has biases and withholds facts to further its stance (ahem, bias against c-sections vs withheld realities of vaginal labour, I’m looking at you). So we knew we couldn’t just accept the word of the NHS. Besides, cosmetic issues can become psychological in time.

It made it difficult for us. The research is limited, with few control trials. Given babies wear helmets from around 4 months old, as they’re starting to sit up, when nature would be doing its job, it’s hard to know if it really was the helmet, or if it was nature doing its job with the helmet taking the credit. (Unless people have a control trial of an identical child they didn’t helmet, telling me it was definitely the helmet that rounded a head bounces off my ears. It doesn’t even go in to come out again.)

And then some research says that helmets are no more effective than nature (though there are potentially valid criticisms of the research). There’s research that says that nature is relatively effective at rounding children’s heads. The SleepCurve mattress (we’ve just bought one of those, too) has undertaken proper research showing that it is relatively effective at rounding wonky heads. There’s a lack of control research from the helmet companies, which I don’t understand. They have a database of controls from all the people who chose not to buy a helmet. When I asked they said those parents won’t come back for a follow up measurement. Sounds a shit answer to me but anyway…

And then, I was worried that:

  • RB’s happy peaceful temperament would be affected by the helmet
  • He would absorb and internalise people’s stares – people can be moronic at the best of times. I’ve grown up with people gawping at my height and I’m only 6’1″
  • Helmets cause other side effects to development that aren’t yet known
  • I’d feel conscious. I can’t lie. My vanity causes an issue here, too

We contacted NHS paediatrician’s who’d historically commented on helmets in broadsheets. We spoke to friends of friends whose babies had worn helmets, and crucially, we paid to see a private paediatric consultant.

Friends of friends were brilliantly reassuring that their baby’s temperaments weren’t affected, and their baby’s retained their lovely characters. They also said that yes people will stare, some hilariously so, but you can just take the opportunity to chat to people to explain what’s going on. They all said, in hindsight, it’s not a big deal and they’d do it again in a flash. That helped us a lot (though I think it would be rare for parents to honestly admit they’d made a bad choice and fucked their child’s development. Plus, everything seems less of a deal in hindsight. Still, they’re lovely people and their advice was reassuring).

If people gawp, I figured it would be the beginning of me teaching him to accept and embrace who he is – however he looks / sounds / feels – and not give a fuck about the opinions of strangers. This one is important to me. I wish I was less self conscious growing up and intend to help him learn my lessons faster than I did. I’ve learned there is a direct correlation between my own self-worth, self-acceptance, and happiness. Random people’s opinions don’t matter. Besides, recently I’ve learned that when people stare the best response is to make eye-contact and smile at them. If they still gawp hope is lost (for them). Normally, they smile back and it’s a nice little interaction, sometimes we start a conversation. That lights up my day.

There is another reason that teaching RB self-acceptance and confidence is important to me, too. Chances are RB will have ginger hair. It’s a sad reality that people with ginger hair get singled out. I need him to grow up knowing that objective facts about appearance are just that, objective facts. They don’t affect his worth. If people point at him and tell him he’s ginger, I need that not to bother him. I need him to be able to say, ‘Well observed. My hair is in fact ginger’ and move on, and not give a shit.

I thought about why I gave a shit about him wearing a helmet. I fought myself – I couldn’t let the opinions of strangers affect my judgement of what’s best for my child. I realised that when I see babies in these helmets, my brain tells me they’re poorly. I feel sad and awkward. No-one wants their (inevitably perfect) child to be or seem to be poorly. I’d just have to re-trick my brain to know nothing is wrong, except a wonky head that’s slowing getting less wonky. And still some parents have to look at their child and know they are poorly. Ours is truly a privileged and first-world concern.

I started to think about any damage that a helmet could do to RB’s developing brain and figured it couldn’t be any different to what his original mattress was doing to his brain – it’s deforming his head – and no-one told us the mattress was bad for his development. So I moved on from that worry.

We were amassing research and opinions, but because there seems to be little objectivity on this topic, we were stuck. Our GP suggested we speak to a paediatric consultant to help us calm our fizzing heads. Although our health insurance wouldn’t cover this, we paid to see a private consultant. That was the best £250 we could have spent. Firstly, the doc gave RB the most thorough MOT we could have asked for. Secondly, he was a genuinely reflective and helpful support. He talked us through research. He talked us through his decades of experience. He could talk without knowing he was representing the NHS or incurring a cost for them. He talked about the pros and cons of both sides. And that’s what we needed. An honest, informed reflection of all of our options.

He said, if he was us, he would leave it and not get a helmet.

What swung me the other way, and made me want to get a helmet, was a comment he made. He said, on the whole, nature rounds out babies heads. But it doesn’t round every baby’s head. It depends what kind of odds we’re happy to take. Helmets work, they don’t seem to cause side effects for development, the million dollar question is does RB need one?

I don’t like gambling and I don’t like risk. I had an elective c-section because I didn’t want the 15% risk (1 in 6) of a difficult labour followed by a panicked emergency c-section. How could I know I’d chosen a section to reduce my risk and control my labour as much as I could, without trying to get the best odds for him, too?

I’d also just had train-track braces fitted to straighten my wonky teeth. How could I sit there knowing I was doing something to correct a vanity issue in me, knowing some people would say, ‘You don’t want train tracks at your age’, without doing the same for him? I know the end result is why I’m enduring 18 months of braces.

I remembered the comment of a helmet mother I’d spoken to. She said, if her child’s head stayed wonky she’d regret knowing she could have done something to try to fix it but didn’t. Heads aren’t like teeth. The window to ‘normalise’ them is far, far shorter. Our time to try to help RB is now.

So we’re going with a helmet. We’ll see how it goes. He might hate it. It might make him too hot, cause pain or skin issues, as it sometimes can. And we’ll have to go back to the odds of nature, the SleepCurve mattress and the Lilla Kuddis pillow we bought for his car seat and pushchair. He might wear it for months and see little improvement. But we’ll know we tried. We’ll know that based on our circumstances, we made a decision that we thought would be best for him in the long run. I’m sure I’ll cry when he puts it on, despite everything I’ve said. Sometimes (maybe all times) despite knowing all the reasons in the world, emotion still wins out. I hope that in no time, we’ll forget it’s there, and we’ll just see our smiling little world rocker. Let’s see. I’ll try and keep you updated.

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