Rhombus (or, why is my baby's head flat?)

"Your head looks like a rhombus, son," my husband semi-joked as he picked up our 4 month old son. From the top down, LJ's head definitely was flat on one side. His head really did resemble a rhombus, because it pointed forward in the front, too, making it look like his sloping forehead was showcasing one large eye, one little eye.

"Quasimodo," I laughed, but I was unable to mask the worry. I imagined my son in the bell tower, tortured by loneliness, his head keeping him from having a normal, full life. Hidden away because of his deformity.

"The doctor said it would round out," my husband continued. "It hasn't. We should ask again at his four month appointment."

We did. LJ was diagnosed with plagiocephaly. I had no idea what that was, but it sounded really scary. What would happen? Would we have to have his head operated on? How did he get it? Was it serious?

My son was 5 weeks early into this world. My preeclampsia meant that he had to come out quick! With that early arrival comes a skull that is softer and not as fully formed as a full term baby. Combine that with the "back to sleep" campaign that's all the rage and you'll likely see a flat head on your baby.

I don't mean to sound like I'm against "back to sleep." It has reduced the number of babies dying from SIDS each year. That's a really good thing. However, nobody told me when I was in the hospital about the possibility of flat head because my baby was a preemie.

In fact, since the "back to sleep" campaign, the number of babies with plagiocephaly (flat head) has increased from .3% to 10%. That's a huge jump. Right now, 1 in every 10 babies is diagnosed with plagiocephaly.

How is it prevented? Well, it's not that easily prevented, especially if you have a preemie, because babies need a lot of sleep to grow, they are going to spend quite a lot of time on their backs. There are some things you can do to help lessen the chances for your baby's head to get flat.

1. Rotate sleep positions. Put his head down facing right one evening, the next evening, put him facing left.

2. Switch nursing/bottle feeding sides. This is tough to do. I never quite got the hang of it, because he never felt good on my right arm. If you can do it, though, switch him from each side so he gets used to turning his head both ways.

3. Tummy time, and lots of it! My doctor said 15 minutes a day of tummy time. I honestly don't think that's really enough. With my first baby, the 15 minutes a day definitely wasn't. With the second baby, when he wasn't on his tummy on the floor, I had him lie on my chest.

4. Limit activities in swings, bouncer seats, and car seats. Oh, this one was hard. It was overwhelming to have a newborn, especially because I wanted to do many things like laundry, cooking, cleaning, and baby was ALWAYS in the way. A swing or bouncer was a convenient way to amuse him while I did what I needed to do. With the second child, however, I let my husband and brother-in-law help me do stuff around the house while I spent time with the baby. If you can do that great. If not... see number 5...

5. Babywear. You can do this many ways! I had an Ergo with the first baby and a cheap, stretchy Infantino with the second baby. First baby never got used to babywearing because I didn't do it that often. Second baby is much happier riding in the Ergo because I did it a lot when he was tiny.

So what happens if you fail to do the above, or you do and your baby's head is STILL flat?

It wasn't so simple. We took him to a neurologist at Connecticut Children's Medical Center, and she flatly (har har) told us that his head wasn't bad enough for surgery, and it was cosmetic. "Reposition," she said, "And it'll go back to normal."

It sounds easy to do, but at 5 months, most babies are rolling all over the place. At least TJ is. LJ, however, was a preemie and not quite adjusted, so he wasn't rolling yet. It worked for a month. We rolled up a receiving blanket and placed it behind the flat part of his head, pushing his head onto the pointy end. We did this for all naps. We didn't do it at night because we were still worried about SIDS. He spent lots of time on his tummy. But at 7 months, he started crawling and repositioning wasn't doing anything anymore.

I went to see the pediatrician, and she said that studies had shown that not addressing plagiocephaly can cause later health issues, believe it or not. LJ's frequent ear infections could have been from the fact that the internal tubes could not drain properly like in normal babies. He could, later in life, have issues with his teeth due to his jaw being slightly out of alignment. She said this made it medically necessary for him to get a helmet, which meant it would be covered under insurance, especially since repositioning had failed.

We went to Cranial Technologies in Madison, CT. They were excellent. This really interesting machine measured LJ's head and they were able to make a helmet for him from the resulting 3D images.

We were very concerned about his ability to adjust with the helmet. Cranial Tech told us we shouldn't be worried, the babies really get used to it very quickly. They were right. LJ adjusted to his helmet within a couple of weeks. He wore it from about 8 1/2 months until he was a year old, and barely noticed it.

Each night, we cleaned it with alcohol wipes and left it off for an hour. And each week, we went back to Cranial Tech and they adjusted the helmet so it would continue to reshape his head.

In the end, it did a lot of good. His head was almost completely round. I didn't have to worry about him being teased for his deformity! And believe it or not, he only got one more ear infection after he had the helmet off (prior to that, he had ear infections at least every 6 weeks).

Questions about my experience? Feel free to post below.

1. Images, data and video from Cranial Technologies, http://www.cranialtech.com/my-babys-head-shape/what-is-plagiocephaly/
2. Beyond Cosmetic Concerns: Functional Deficits Associated with Deformational Plagiocephaly, Phil Stevens, MEd, CPO, FAAOP http://www.oandp.com/articles/2012-04_02.asp

World Breastfeeding Week

World Breastfeeding Week has just ended, launching Breastfeeding Awareness month. For many, this is a time of celebration, camaraderie, or just extra activities. But for many women, this week serves as a reminder of a failure, a source of guilt, or even a type of judgement. These are the women I would like to address today. You have many different stories. All of you, for one reason or another, fed/feed your babies formula. You may have tried to breastfeed, but encountered innumerable problems. Maybe you had to return to work. Maybe you got sick. Maybe you sought help but were turned away or couldn't find it. For one reason or another, you were not able to nurse your child. I have heard from many moms in these situations that they feel disparaged, guilty, or left out of all of the events of this month. Many have felt that they are being criticized or put down for choosing (for whatever reason) not to feed their child breastmilk.

For you, I'm sharing my story. One I seldom share in it's entirety, because I worry I will scare mothers away. For you I'm sharing why we have a month dedicated to education and awareness of the facts of breastfeeding. Because I've been in the position of the moms who have been in pain, and awake at night; who have had infections and blockages, supply problems and babies who have lost weight. While we fought and were able to continue, many women aren't.

When I gave birth to my son in 2012, he had a 'lazy' latch. He just didn't want to open his mouth, and would fall asleep quickly. However, he desired to suck constantly. So, we gave him a pacifier hoping he could sleep without waking every time he fell off the nipple. When my milk came in about 36 hours after his birth, he ate even more greedily than he did the first day. By the end of the second day, I was sore, and my nipples were red. They tested his suction, and he was fine. By the next night I had cracks and was bleeding enough for my skin to stick to my bra. I had also shot up 5 cup sizes. I was given nipple shields for nursing, and a separate one to keep the fabric of my bra off of my nipples, as well as to help them 'pop' out more, as they were semi flat. Milk would drip out of the non-used nipple and collect in these shields while I nursed my son. The night nurse came in the fourth night, and told me I had given my tiny son nipple confusion, and that's why he couldn't latch correctly. She then told me I should 'just pump', and feed him that way. When I refused, she became indignant, and stressed her experience and 'facts'. I called her back four hours later and handed her a small plastic cup full of milk. She applauded me for expressing some. Her shock was very satisfying when I corrected her that this was just drippings, more than 4 oz, from two feeds. A lactation consultant came in the next morning, diagnosed me with oversupply, and warned strongly me NOT to pump so as not to cause exacerbate the problem. I was finally sent home with papers explaining the condition (I had a C-section, and the benefit of a longer hospital stay).

My pain continued at home. It didn't seem possible for my cup size to get bigger, but they did. I stretched out a 3X nursing sleep bra until it more resembled a string/triangle bikini or a tent. My husband could no longer appreciate the boost, instead he was horrified at the expansion. The nursing nipple shields would pop off mid-feed, and get stuck to his nose (I tossed them quickly). I could get no answers on how to manage this condition from my paperwork, the lactation department, or my OB. I began developing friction blisters on the side from my sons desperation to latch on my rapidly increasing, granite-feeling breasts. I discovered block feeding*, and cabbage compresses**, along with some other things from cousin. These saved us for a while, but it never became 'easy'. It took two months just to regulate my supply down to no more pain. I was able to finally take a deep breath.

It was short lived. When he was about five months, the blockages began. At first it was one here, and then another there, easily remedied by nursing or expressing as much as possible. They soon increased. No longer just one, but both breasts would have 3-5 blocks apiece at all times, complete with nipple blisters that would prevent the milk from draining. No amount of nursing would suffice. I started cycling fevers, which would break when I finally ripped the blisters open and allowed them to drain. My OB sent me to my primary stating I wasn't under their 'jurisdiction' any longer. My primary never had a patient who exclusively breastfed. She didn't know what to do. They gave me an antibiotic, which did nothing. I asked that they check, again, for a lip or tongue tie. "Nothing's there," they said. I started taking supplements, and block and dangle feeding to get relief. I received a breakthrough, and the blocks decreased, but I still continued to have 1-2 continuously for the next six months. Amazingly, my son did not get his front teeth until 14 months. When his teeth popped in, we saw something amazing! His frenulum, which had been deemed 'normal' by all professionals, stretched down his upper gums, through his tiny teeth buds, and onto the roof of his mouth. Too late to get it fixed, it was deemed the reason behind so many problems.

I am stubborn, and quite a geek. I love research, and hate to be told what to do. So many people not told me to quit, so of course I couldn't. Even so, I came very close. I had given myself two days to see the pain stop, and it was in the final 24 hours when things suddenly improved. But I had to search, and search, and search some more to find answers and solutions. Other friends? Not nearly so lucky. They experienced massive infections, pain, abscesses, and more. They quit, and I can't blame them, and have even envied them. I have permanent scars across my breasts, which closer resemble a force-flex trash bag than they do mammary glands. I'm still nursing my son at almost three years, and having a very hard time weaning. Part of it is from an almost defiant sense of success. We made it.

My physicians, nurses, and even lactation departments failed me, and my friends. Breastmilk has been proven benefits over formula. Yet doctors, bosses, businesses, family members, etc inhibit, criticize, and discourage moms from being successful. There is no education on how to manage supply, heal mastitis, treat lip and/or tongue ties (especially minor ones), or even on appropriate medications to give the nursing mother (which, by the way, is most).  Unless it becomes common, then medical professionals will never be forced to learn proper interventions for supporting the breastfeeding mom. This is why World Breastfeeding Week exists. Not to condemn or judge mother's who have given up, or chosen to bottle feed. Not to put breastfeeding mothers on a pedestal. No. World Breastfeeding Week is to help prevent other mothers from going through what you went through. What I went through. It is to allow other women to become successful, and skip the difficulties or tragedies that you experienced. It is to spare another mother the pain and guilt that you went through.

Who wouldn't support that?





Notes:
*Block feeding is to nurse a baby one one side, say your right breast, until it is fully emptied instead of switching sides mid-feed. When I started block feeding, it took 18 hours of every 1 1/2 hour feeds to empty one side. This dropped to every other feed I could switch, but never more frequent than that until now.
**Cabbage compresses have been used for many years to help dry a mother's supply. Since it was so hard for me to find out how to actually use a cabbage compress, I will spell it out here. You take a full cabbage leaf, or two, and use it to line your bra. To diminish oversupply, three 20-minute sessions are recommended per day (I did one hour sessions). To dry up supply entirely (without medication), you keep them in until they become soggy/limp/wilted, and then put new ones in until your milk has stopped.

Heavy hide

My mother used to pray every night, "Jesus, please let me live long enough for my children to remember me." She told me this one evening a few weeks ago in a haze of good French burgundy, as we watched my children playing on the floor.

I thought for a long time about this afterwards. How will I remember her? How will my children remember me? How do I want them to remember me?

Thinking back on my childhood, if I had to describe my mother as wearing a particular armor type, I'd definitely say her armor was heavy hide. (Can you tell I once was a gamer?) Thick enough so that arrows couldn't easily penetrate it, but not so thick that a non-parried dagger couldn't stab through the side (I achieved this once; but that's another article for another time!). Unbendable, unbreakable, but not hard and reflective. That made it difficult for me to feel like I could confide in her. When I was younger, I resented that heavy hide.

Considering this now, I understand why she wore it. I think you have to have a heavy hide armor when raising children. You have to be resilient enough to not break at all of hateful words children can scream at their parents ("You're unfair!", "You're the worst mommy ever!", "I'm running away to Grandpa's house!","I HATE you!"). If you're wearing cloth armor, every barb that comes your way is going to destroy you.  It's harder and harder to get over those cruel words. Not that I have first-hand experience receiving that kind of feedback yet, but I certainly gave enough of it out as a child.

Heavy hide armor allows you to be nimble while wearing a nearly impenetrable shell; it's lightweight enough so that you can continue hunting, running, jumping, riding, etc in it. My mom used it for work. She was a teacher, always in control, never off duty, and that made it hard to have fun with her. She was always working; when she wasn't being a teacher, she was cooking and cleaning and shopping and shuffling us off to activities. She was hunting, running, jumping - in her own way. She wasn't relaxing. She wasn't having fun.

I think where my mom went wrong is rarely taking that armor off. I very infrequently saw her as vulnerable or human. My fondest memories of her were not how she cleaned the house, cooked for us, and played chauffeur. They were of the times she took off that armor and relaxed. When she allowed herself to have fun with her kids, instead of just protecting and providing for them.

My mom taught me to paint when I was 6. I'm sure my painting expertise started much earlier with watercolors, but it wasn't until I was in first grade that she actually took me to a ceramics class with her and I painted a Christmas ornament. She was patient. She showed me how to apply the paint, ready to be fired. And it was fun. I loved it when I saw her get out her paints, because I knew she'd scored a little knickknack for me to ruin.

And she read to us. And she played the piano for us. And she went bowling with us. And she played games with us.

I will remember the heavy hide, of course, but I'm sure it won't be the only thing I remember. I will remember how she endeavored to teach us things to help us to grow our creative minds. I will remember her learning to ski because we loved it, even though it landed her in the hospital. I will remember her playing songs from "The Sound of Music" and Christmas carols on the piano for us. I will definitely remember the ceramics.

As I get caught up in the day-to-day whirlwind of working, housework, cooking, and taxiing my children places, I try to think about my mom's prayer. I try to remove my armor every now and then, and sit down with my toddler and show him how to draw Elmo and Thomas the Tank Engine. I rough-house with him or play "tent" with a blanket. I try to push him on the swing, or swim with him in the pool, pretending to be a crocodile nibbling at his toes.

I want my boys to remember me as more than just their mother, insisting that they eat their dinner or not throw rocks at the cars. I want them to remember me as a person who loved them so much that I took off my heavy hide, stepped away from my work laptop and pretended to be a crocodile.