Avoiding NICU head aka Plagiocephaly

Image from Here with tons of info for the medical people.A more severe version go here and for the same thingsI'm saying but in doctor speak, go here.
You maybe asking yourself...  what is NICU head or Plagiocephaly?  It is where the skull gets misshapen due to being in the same position for extended periods of time. It is very common in preemies/long term NICU residents, but is becoming more common in termies as well.

I have been promising this post for awhile and have finally gotten to it!  YEAHHH  to having interwebs again!
Now I have to start off with some basic info....  I am NOT a medical professional, but I am the Mom of a NICU grad.  A long term NICU resident. We were in the NICU for 5.5 months (figured out the other day.. 170+ days).  In our NICU plagiocphaly was EXTREMELY common.  The fact that we managed to leave the NICU with a "normal" skull shape was amazing to many of the medical professionals there, and has inspired some changes in our NICU.

The first signs of NICU head. Lil'C was only a few days old.
So how did we avoid NICU head?  One way is that our nurses rocked and let us know about it.  Another is something I have said before... the greatest asset a NICU child can have is their parent(s)!
A parent gives a unique perspective on the medical interventions.  A parent will notice if their child's head has been in the same spot over 24hrs, which you should point out to your nurse(nicely!).
Even when we were barely allowed to touch him we could still make sure his head got turned side to side daily. We even got center when we started to notice him showing signs of NICU head, which is when we got really serious about finding out how to avoid it.
In the beginning there wasn't much we could do. But we did start letting the nurses know at each shift change about when the last time his head was turned. We made sure his head was turned every 12 hrs (each  shift change). They are supposed to do that anyway but nurses have so much to keep track of, and I would rather they focus on the other things.
The blanket roll method

The blanket roll method with an extra light sheld
One of the other parents told us about Early Intervention and we started asking the medical people about it, but it was early on and we were told that there wasn't anything EI could do for us that early.   We did have one awesome nurse who came up with the blanket roll method.
The blanket roll method requires many receiving blankets.  We used two as sheets to cover the mattress in the isolate. One rolled into a tube on either side another rolled at his feet.  Another blanket was laid over the top of all of these creating a little nest. A cloth diaper and/or scrap of faux fir was placed under his head as a pillow.
The idea was to basically swaddle him/mimic the confinement of the womb as much as we could since he missed those last 3 months in utero.  We baised this idea off of Dr.Sears  (oops... read both books at the same time)  Dr. Karp's "Forth trimester" theory, we figured if it had proven helpful for termies it should really help someone who had missed the whole third trimester.  He stayed a lot calmer after we did, plus it helped avoid NICU head. we still had to make sure his head was turned at least every shift change, but not being on a flat surface helped.
In the beginning we were barely be able to touch him, so the great thing about the blanket roll method is that the nurses were able to do it whenever they had to change his bed anyway.  That way he wasn't disturbed unnecessarily.

Christopher with his EI happies. Froggy pillow under his head and snugglie wrapped around him
Later on we were able to finally get Early Intervention to come in, unlike EI when you are at home they don't actually touch/play with the baby.  They bring HAPPY things!  Bendies, Frog pillows and snugglies.  They generally work the same as the blanket method but are easier to change/customize. 

Kangaroo care is the BEST! This was my favorite day, first day happy holding.
Once he finally got big enough to do kangaroo care, we started that.  Kangaroo care also helped us avoid NICU head by putting him in different positions and in different angles.  Later on when he was in a crib we also used a Boppy as a positioner.  He continued to use the boppy to sleep in at home, which you shouldn't do unless your LO is on O2 and a monitor, it's right on the bobby not to, it just isn't safe otherwise.
Once we finally got home kangroo care morphed into baby wearing, which I highly suggest for all parents whither you had NICU time or not.  Wearing him in a wrap and later a sling allowed him to be nearby, kept him calm and relaxing for me.  I only retired my sling about a month ago when it got uncomfortable with my pregnancy bump.  He was 19mo and 17lbs.  My sister comfortably wears her much heavier (aka healthy normal termie) 1 year old.
The Plagiocehaly is becoming common in termies is due to the "bucket baby" mentality.   A bucket baby is when parents keep their baby in containers such as the baby carrier/car seat, swings, bouncy seats, strollers and cribs. I firmly believe that car seats should stay in the car... my sister isn't as strict as I am about that.   She has no issues but my niece isn't a bucket baby, a true bucket baby is almost always in some bucket device. Babywearing is a great way to keep that from being an issue and is easier on mom and baby.
Now I'm not saying these devices are bad. Christopher loved his swing in the NICU and loved it some at home. The trick is to use these things sparingly.  Ok... getting off my soap box.

Soo how does his head look after 5.5 months in the NICU?    You would never know he spent months in a bed.
No NICU head. The ears are genetic.. both sides, he didn't have a chance. :P

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