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Starband Orthoses for baby heads |
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Sometimes, either at birth or shortly after, a baby's head can be squashed sideways or front to back (plagiocephaly and brachiocephaly). The baby's head may look shaped like a parallelogram, with one ear further forward than the other. When combined with "cranial" osteopathic treatment, Ossur starband helmets can help.
At an initial consultation at Ossur for a Starband orthosis a full case history is taken from the parents with an emphasis upon the plagiocephaly or brachiocephaly that the child is experiencing. In particular they take note as to whether the deformity was present from birth, or whether it formed over the following few months.
Then the clinician takes a series of measurements regarding the diameter of the head from various angles to measure the assymetry of the head as well as an assessment of whether any torticollis is also present. If it is felt from these initial measurements that there is a significant plagio- or brachiocephaly then the child is scanned with a Starscanner, which is a non-contact laser data acquisition system that can give highly accurate information on the actual degree of assymetry and the measurements from this are used if the parents decide to go ahead with the Starband orthosis.
Ideally treatment will commence within a couple of days of this scan for complete accuracy of the scan else another will have to be done. A letter is normally sent following this appointment to the infant'GP/consultant to inform them of the scan results and clinical findings.
Once a scan is undertaken it usually takes a couple of weeks for the Starband to then be made, and it is fitted at the earliest opportunity. The idea of the orthosis is to provide a void for the flattened/restricted part of the cranium to grow in to. It puts no pressure upon other areas of the cranium but rather acts as a protective shell so that when the infant is placed upon their backs (as per the back to sleep campaign) or during waking times that no pressure is placed upon the flattened part of the cranium but rather taken up by the Starband orthosis. The benefit of this is that it gives an opportunity for a compromised cranium to expand to its potential rather than be futher compromised by perhaps habitual positions where by the flattened head shape becomes further accentuated by ease of lying (and thus placing more pressure in turn) upon that compromised part of the cranium.
Cranial Osteopathy can assist this process by releasing any compressions and strain patterns in the tissues that may be holding the various cranial bones and other tissues in this altered shape, hence helping the cranium to 'unfold' and grow into the void that the Starband provides.
Because of the shape of the deformity in plagiocephaly there is a natural tendency for the Starbands to try to turn to fit the current shape of the head and fill the void. This is an acknowledged problem and it is tackled as best as possible by putting a small soft pad on the inner surface of the starband at the 'apex' of the deformity (usually just anterior to the ear) to try to stop it from turning as much. There is frequent contact in the first few weeks of wearing the starband where a small portion of the orthosis can be shaved off as well to try to prevent the starband creating pressure sores upon areas of the head (usually just posterior to the ear on one side).
Of the children seen wearing the Starband so far, it seems that the first couple of weeks are spent with the child getting used to the feel of the Starband, along with various trips to have the Starband adjusted so that it is comfortable and not pressing upon any particular points of the cranium. Most children wearing it do not seem to be distressed by its presence, other than when it is taken on and off. In the first five days that the child is given the Starband to wear, its 'wear time' is slowly build up so as to gradually allow the child to grow accustomed to its use, and eventually they are encouraged to wear the Starband for 23 hours a day (barring when the child is ill and has a fever, when it is not to be worn at all).
On average the Starband treatment programme ranges from 3 to 6 months depending on the age of the infant, with older infants generally requiring longer treatments due to the slower cranial growth at their age relative to younger infants. Ideally children with a significant plagio- or brachiocephaly are encouraged to start treatment closer to 4 months of age for best results, with children over 14 months having far less satisfactory results, as cranial growth has significantly slowed by this stage so the cranium does not have much more growth to 'expand' into the void with. Treatment is concluded when the clinician determines that an acceptable degree of symmetry has been achieved and/or when the child has outgrown the Starband.
Those who might want further information can reference the following websites:
Technology in Motion: www.technologyinmotion.co.ukParents forum for Plagiocephaly: www.plagiocephaly.co.uk
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