Marcia, a new grandma, is bewildered by her daughter’s (the new mother’s) fixation with the position of her new baby daughter’s head. The new baby, Megan had a routine birth and great discharge assessment upon leaving the hospital. When Marcia arrived from her home in Florida for an extended stay in New York to congratulate her daughter and son- in- law and meet the new baby she was in for several unexpected twists in current infant care. There were no red flags or indications by the doctor or the hospital staff to be concerned about, so why was Marcia’s daughter, Lynda apprehensive and constantly checking Megan’s head and head position?

When Marcia’s four children were born (Lynda was the youngest) she does not ever remember being concerned about the alignment of each of her babies’ heads. Sure, she was concerned that they had enough formula and if the diapers were wet enough. A trip to the doctor was a must at the appearance of some fever on the all but extinct yet most reliable glass mercury thermometer. But all this chatter about head shapes and positions was getting this new grandmother Marcia just plain nervous.

The first of the many new revelations was the “Back to Sleep” rule. Marcia’s children slept like angels on their stomachs. Yes, she checked each of them numerous times to see if they were breathing and that the head was to the side and not facing forward on the mattress, but this business of never putting the baby on her stomach to sleep was too much to comprehend.

The second surprise for Marcia was the constant repositioning of baby Megan in the crib. One morning she was at the front of the crib and the next morning at the back. Her daughter, Lynda explained to this fresh grandmother how important it is to give each cheek a chance to lay on. By changing the baby’s head position daily, the parents are assured that the baby will have a symmetrical face. There are situations where the baby’s face droops on one side of the mouth, or one side of the forehead is indented. These and other conditions come from too much pressure on one side. When the new grandmother was given the privilege of feeding her granddaughter for a few feedings she was instructed to alternate sides. In other words, if the baby was held on the grandmother’s right side for the 10AM feeding she should be held on the left side for the 1PM feeding and so forth. With breastfeeding babies this alternation occurs naturally but when babies are bottle fed this method protects each side of the baby’s face from encountering too much pressure.

Marcia thought about this method. It definitely made sense. Marcia has a younger sister whose mouth is a bit uneven. Perhaps she slept on one side of her face more than the other. In fact, Marcia recalled that her sister was a preemie and was in the hospital for a couple of months after birth.

Premature infants spend most of their days and nights in the hospital crib where they are safe and watched carefully. These babies often come home from the hospital with some type of unevenness either in their face or flatness (plagiocephaly) of the head. If these conditions are noticed earlier enough, optimally by three to four months, they can be corrected by physical therapy or cranial helmet therapy. Parents (and grandparents) should be opened to listening to these treatments and check their baby out at a reliable cranial therapy center when necessary.

The third revelation that Marcia the new grandmother observed was, tummy time. When Marcia’s children were babies, sleeping time was on the stomach and play time on the back. There were many different options in different price ranges for toys that hung across the crib for the baby to “speak” to and grab onto. Parents had a wide choice of mobiles that the baby could gaze at while being awake. These toys and mobiles delayed the mom’s jumping out of the bed in the morning. Although these are still popular the crib is not the mainstay for baby’s “playtime”.

At least ten minutes of the part of the day when the baby is alert is spent making sure that the baby is on its tummy and trying to raise its head. For infants under three months, it is a very frustrating time of the day. Lynda, the new mother, takes tummy time very seriously and the beneficial results can already be seen. No flat head for Megan! So far so good. The new grandmother is just wondering what will happen if Megan is able to turn over by herself. She may decide that she prefers staying on her back. By the time a baby is able to lift its head and roll over the threat of plagiocephaly is much less and almost non-existent as the baby begins crawling.

Meanwhile Lynda is paying close attention to the latest recommendations of doctors and therapists who are attuned to the issues of plagiocephaly. At each routine visit to the pediatrician Megan the head shape is checked and sometimes measured. There is a general numbers guide for when the pediatrician Megan will deem it necessary for the parents to take the baby to a cranial therapy center to check on the status of their baby’s head. Lynda mentioned this possibility to her mother and when Marcia had a private quiet moment, she researched this new information on her phone.

It was all beginning to make lots of sense. We all need repositioning. Whether it is changing postures while sleeping or exercising during the day. Our rigid muscles need to be flexed to stay active and in shape.

An infant’s skull and bones are soft and pliable. This is both an advantage and disadvantage simultaneously. If a baby is born with a misshapen head, then it can be fixed in a timely fashion when caught early either with a baby helmet specifically created for him or her, or physical therapy and positioning. At the same time, the fact that the bones are soft means that parents must be careful to switch the babies’ positions whether sleeping or awake. If the side of the head becomes uneven with the other side a special helmet can be crafted to solve this issue.

After staying at her daughter’s home for a few weeks and watching her new granddaughter Megan grow and develop it was time for Marcia, the grandmother to return home to Florida. Marcia had a wonderful feeling knowing that her daughter Lynda had her head on straight and was taking care of Megan’s head as well. Yes, a grandmother can always learn new things. In fact, Lynda recalls seeing a neighbor’s child in a helmet and feeling so sorry for her. Lynda was afraid that the child had something seriously wrong with her head and needed the helmet as protection from anyone touching or pressing it. Now she understood that it was only a temporary inconvenience.

Even grandmothers can and should be open to new and innovative developments in infant and baby care. There are safe pacifiers and bottles that reduce gas and upset for a baby. Cribs are safer than years ago when the slats were too wide apart and terrible tragedies occurred when a baby’s head got stuck. Separate crib bumpers are not used anymore unless they are attached to the crib itself. This has reduced the number of crib deaths from suffocation when a baby pulled the bumper on to its head and could not breath. Lighter blankets and special weight buntings are the norm, preventing asphyxiation. Even the snowsuit is becoming obsolete with the advent of special winter liners for the car seat and stroller.

Most importantly the incidence of crib deaths has gone down directly correlating to the “back to sleep” campaign which began in the 90’s. Yes, it’s true that flat heads have become more prevalent since this campaign began, but helmet and physical therapy for plagiocephaly are small and temporary costs to pay for the saving of the life of a precious and innocent infant.

Final Words

Ignorance is not bliss when it comes to new grandmothers obtaining the most up to date knowledge in baby care. Those grandparents who are fortunate to live near their grandchildren have the opportunity to baby sit and be alone with them to enjoy their company away from their parents. It’s imperative that grandparents understand and learn the ins and outs of today’s correct and safe baby care. As in our story above, the grandmother did her own research and compared what her daughter explained to her to what she read about online. Only then was she ready to be open to this new era of baby care. If cranial helmet therapy is part of it, Marcia is all for it and hopefully her granddaughter will not need such therapy but if any of her future grandchildren do need it, it will not be a foreign idea but one that makes complete sense.