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Reshaping Your Baby's Head 

Staff Writer

It is not unusual for an infant to have an abnormal head shape at birth or the weeks immediately following. However, if there is still some kind of abnormality after six weeks of age, the infant may require further medical treatment. Unusual flattening of the head often with a prominent or flattened forehead is known as positional plagiocephaly. There are a variety of different head shapes that are associated with plagiocephaly, including those that have flattening on one side of the back of the head with an asymmetric forehead. Brachycephalic (due to Brachycephaly) head shapes are flat across the entire back of the head with a very prominent forehead, and scaphocephalic head shapes are long and narrow. There are several treatment options available for positional plagiocephaly, including repositioning techniques to move the infant off the flattened area of the head, physical therapy to stretch tight and/or weak neck muscles, and cranial remolding orthoses. If repositioning and therapy don't seem to help, a physician may refer the infant for orthotic treatment. A cranial orthosis is designed to help redirect cranial growth toward greater symmetry. Many orthotic facilities use the STARbandTM cranial orthosis on patients. The first step in cranial molding orthotic treatment begins with an orthotist evaluating the patient to make sure he/she is a candidate for the orthosis. The orthotist will work closely with the patient's physician and therapist to make sure the appropriate treatment is given. If the patient is a good candidate, the orthotist will then make an exact duplicate of the infant's head from a plaster impression. The casting process involves the orthotist laying a series of plaster splints over the infant's head to capture the exact cranial shape, which normally takes 15-20 minutes. After approximately two weeks, the infant will return to the orthotist for the initial fitting. At this time any final adjustments to the orthosis will be made. After the infant is fit with the orthosis, he/she will return frequently for follow-up visits so the orthotist can determine what kind of progress is being made. The length of time for wearing the cranial orthosis varies for each patient, but generally speaking treatment usually lasts 4-6 months. A prescription is needed for an infant to obtain a cranial remolding orthosis. Also, documentation and a letter stating that the orthosis is medically necessary will help in getting it covered by insurance. If a patient's insurance doesn't cover it, orthotic facilities can work with the family to determine a payment plan.

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