Flat head Syndrome

I have been working for a few families recently where I have noticed the baby’s head is slightly asymmetrical. In some cases, this is a tiny and natural deviation, but in at least one case, the baby’s head is dramatically flattened, his face bulges on one side and is quite noticeably uneven. It is a subject his mother and I have discussed endlessly.  It turns out that flat head syndrome is considered a cosmetic disorder because it does not restrict brain growth or cause brain damage but nonetheless it can be quite disturbing.  I know the mother in question will do everything she can to try to correct it in her son.

It seems that health visitors will carefully inform new mothers about the ‘Back to Sleep’ campaign but rarely mention the possible side effect, flat head syndrome.  Insisting that a baby is always put to bed on its back has been very successful in reducing cot deaths, but flattened head has become an unexpected consequence now that babies are spending much of their early lives on their backs on hard flat surfaces, such as cots, car seats, carry cots and baby bouncers. The latest research was based on American infants and found that up to 48 per cent of babies under the age of one developed the deformity.  Shocking!  Positional plagiocephaly or brachycephaly (flat head syndrome), results in the back or side of the head appearing flattened. The most critical time to be aware of this is during the baby’s first three months when a baby’s skull is at its softest and malleable and a flat spot can quickly develop. It is generally believed that this is purely an aesthetic issue; it does not affect brain development or function and should have no lasting medical effects.  But as a mother, is that OK?  Your baby is fine, just funny looking… Maybe he will grow hair over that flat bit – or he could wear a lot of hats… wouldn’t you rather he had a regular shaped head?  Is this another way for us mothers to feel guilty over yet another thing we have control over?

So what can you do? The 'Back To Sleep' campaign, which rightly promotes laying babies on their backs to sleep, has dramatically reduced cot deaths and should always be followed. However, even before you notice (due to sleep deprivation, hormones or just because you are overwhelmed at being a new mother) your baby’s head may be slightly flat already.  So try to ensure that bed and car seat time are balanced by giving your baby lots of tummy time when awake; being carried in a wilkinet or other sling relieves any pressure on a wonky skull. In fact any method to try to encourage your baby to put less pressure on the flattest part of his head would be worth trying once there is a flat part of the head – or better get in there before it even becomes a noticeable issue– perhaps a rolled up towel under the side of the mattress to encourage him to sleep partially on his side which you can alternate.

Babies' skulls are made of several bones that aren't rigidly joined and are initially soft enough to be molded. As they get older, these bones stick together and become more rigid.  There is a window, then, when a skull can become deformed and also a window where this can be corrected.  Another thing to consider is that breast fed babies feed equally on either side, but a bottle fed baby may only ever be fed on one side – so try to alternate to avoid any uneven recurrent pressure.

Helmets, which aim to correct flat head syndrome, are available, but whether they are beneficial is controversial.  They are also shockingly expensive.  You may wish to consider a pillow designed to release pressure from the baby’s skull.  These are Swedish in design and cost about £13 and are specially designed to avoid this issue by supporting the babies head and shoulders without allowing pressure points to occur.  One of my mothers got a pillow for her son and swears he sleeps much better now and even seems more comfortable – in addition his head seems to be becoming more symmetrical again. She said to me: "I just wish we had been told about this right from day one. If we had, we wouldn't be trying to correct it now."  I have made a point since then of telling my clients about this possibility as early as I can.

Posted on Wednesday, February 24, 2010 at 05:27PM by Registered CommenterLucy Symons | CommentsPost a Comment | References8 References

Who’s the dummy?

So… you’ve got your new baby home and you think you are doing pretty well.  Hormonally you are a bit all over the place and you could do with some more sleep – but isn’t he gorgeous!? And aren’t you clever!?

A few weeks in to motherhood, you may be becoming an old hand at reading your baby: understanding when he is hungry and when he needs changing, but there are times when he just cries… 

It is inevitable that at this juncture you will at least consider attempting to introduce a dummy.  Most babies will take one – but every now and again I come across one who won’t.  So, do you persevere?  Or give up?  I have tried both and can honestly say every baby is different (there’s a news flash!).  Some babies find their thumbs or fingers and that will pacify them, some will have a muslin or a special blanket that does the trick and some will take the dummy after some cajoling. And all these things are just fine… until… until… until…

I had a client whose daughter was very attached to her muslin, which she sucked.  The little girl was starting to get a rash on her face where the moist muzzy rubbed and her mother thought perhaps now was the time to try to get rid of it.

What should she do? 

First consider the timing.  Is your child just starting school or have you just had a new baby or moved?  Any disruption is not a great time to try to instil new behaviour.  Give at least three weeks before suggesting a change to habits.

Try to limit the times of the day or places where the habit is acceptable.  (This is where a thumb or finger sucker comes unstuck – you can’t confiscate the offending digit nor can you try to limit time alone with it…  try bribery in these cases if you can’t appeal to your child’s natural honesty and sense of fair play!)  Perhaps in the car, in the house and in bed is OK.

Once you have limited the habit significantly for a week or two, constantly praise the child in terms of how grown up he is (and do it in front of teachers and other significant adults “Oh Mrs Barley!  You will never guess how good Josh has been!  He hasn’t sucked his thumb outside of our house for a whole week!”) and then renegotiate the terms, limiting it further – only in bed, only in the car, etc.

If necessary, determine an event that you can connect the surrender of the object (if there is an object - thumb suckers beware!) and negotiate.  Perhaps Father Christmas will only exchange a stocking full of presents for all the dummies?  Maybe it is the Easter bunny who has a yen for muslins?  This can be a huge event:  collecting up the items and placing them all in a box in readiness for the overnight exchange (unless daddy likes dressing up as the Easter bunny…), writing a note and then lots and lots of praise/phone calls to granny etc. once the goal is reached.  You could even plan a trip to the dummy tree in Frederiksburg Gardens where the Danish have institutionalised the surrender of dummies.

I promise you that all children will at some stage or another be able to manage this.  I do have a friend whose daughter had a blanket.  It was a special blanket and she had never seen the reason to wean her daughter totally off it.  It stayed in her bed and her daughter only needed it at night.  Her (teenage) daughter was going to Glastonbury one year and siddled up to her mother and asked her advice about blanky coming with her…  My friend was possibly a little readier for a warning discussion about drugs and alcohol and boys… but between them they came up with a plan.  My friend duly sewed a small piece of blankey into her daughter’s sleeping bag in a secret corner…  greater love hath no mother.

Posted on Thursday, January 7, 2010 at 05:55PM by Registered CommenterLucy Symons | CommentsPost a Comment | References3 References

The Mummy Bank

I’ve been working for a lovely family recently who have just introduced their new son to their 3 year old daughter.  She has reacted as you would expect, mostly positive with the occasional outburst; hugging, kissing and every now and again squeezing just a little too tight to see how mummy and daddy react.

My lovely client was desperate the other evening and phoned me, I could hear her daughter screaming blue murder in the background.  It transpired that ultimatums had been issued and as a consequence someone was now shut in her bedroom for refusing to take a bath and was waiting until daddy got home.

My

 “What do I do?” asked my client near to tears herself.  We went through all the events that had lead up to the stand off and my client said “But I spent an HOUR today playing with playdough with her…”

 and I thought to myself, we really do, most of us, have a mental tally that we add checks and minuses to.  In her head, my client imagined that her 3 year old would behave herself in exchange for time spent with mummy earlier that day.  My client had invested a whole hour (a tedious hour, perhaps, or a frustrating hour when she knew she had a pile of other things to do) playing with her daughter, focussed entirely on her and this is how she is repaid!  The bank of mummy is suddenly found to be overdrawn when mummy believed it was bulging with credit!

I talked through the entire situation with my client and immediately gave her encouragement to give her daughter an option to get herself out of her pickle.  “Put the baby somewhere safe and leave him until this is sorted out.  It doesn’t matter if he howls, you know he is clean and dry and fed and safe.  Go and knock on your daughter’s door and very quietly say that you would like to give her a hug because she is sad and that you will wait outside until she is ready to speak to you.”  I then suggested that she explain to her daughter that daddy would be home soon and he would be very sad if the bath hadn’t happened yet.  Would she like to run the bath, or would she like Mummy to run a quick bath now? 

The next day, I heard how it had all worked out, that by the time my client had put the baby down, her daughter had appeared on the landing, still sniffing and squirting tears, but no longer hysterical.  Together they negotiated the bath and when daddy came home, the daughter told him that she had made mummy very sad.  Apologies and hugs abounded.

We also discussed this idea of “paying” in credits in the hopes that we can withdraw them later.  We decided that it was much better to do things with the children because we enjoyed doing them and not with any expectations or anticipated payback attached to them.  A lesson worth learning, but perhaps difficult six weeks post-natal without a friendly neighbourhood doula who has the ease of distance.

 

 

Posted on Saturday, December 12, 2009 at 01:35PM by Registered CommenterLucy Symons | CommentsPost a Comment | References3 References

Doula of the Year... 

It transpires that Pregnancy and Birth Magazine has been sponsoring a “DOULA OF THE YEAR AWARD” and received around 100 letters from Mums nominating both birth and postnatal doulas.  After a lot of reading, discussing, reflecting and debating, they have made a shortlist, from which they will select three finalists. 

The winning Mum will win a holiday for 2 adults & up to 2 children in Malta. 

 and it turns out that I was on the short list...

I asked my clients who was responsible for this and received the following copy of her entry in to the competition and thought you might want to see what she said about her experience of having a birth doula:

"I would like to nominate the duo Lucy Symons who was by my side in Labour and her partner Maggie Vaughn who have changed my perception of pain and the World. These two wonderful ladies made the birth of our son extra special, less daunting and magical. I had originally wanted a Doula because I find visiting hospitals tricky because I had a spinal injury (fractured my neck in childhood) This has caused me great anxiety and triggered memories ..... so we met Lucy and Maggie and they were the perfect fit. 

Pre-Labour

Our Doulas supported both my partner and me through pregnancy and gave us top tips to remain calm, settle baby in my womb & for sciatic nerve pains towards the end of pregnancy. They reassured me at every stage and actually enabled me to enjoy pregnancy. My mum did not enjoy pregnancy yet our Doula's enabled me to not follow in these footsteps but to be positive, have baths, bond with baby via massage and relaxation. (this worked like a DREAM

I even had a car crash at 5 months in pregnancy - Oooops! Both Lucy and Maggie were there for us and again I focussed on being positive and praying how lucky we are to have such a resilient baby. Maggie visited promptly after this. 

Our 'Charlie's Angels' (Doulas) visited us on numerous occasions, providing books, DVDs and helped with ideas for the Birth Plan. They enabled me to be mentally prepared and were honest too and enabled me to manage pregnancy and the stress / pressures of work. (combining the two) 

Our Charlie's Angels were in contact with my boyfriend and supported him through the pregnancy too. 

Lucy and Maggie talked me through the stages of labour which initially shocked me. However, when I attended my ante-natal classes I was psychologically more prepared. 

Maggie and Lucy suggested ways to help us get baby in the correct position using gym ball, swimming etc. I felt I was being pro-active and in control of the pregnancy and doing my 100% best I could - thanks to our Charlie's Angels.

Labour 

My Contractions began.......Lucy protected me by not telling me that the maternity ward at our hospital may have to close as they were so busy & understaffed.  She did not tell me that if we turned up we would have to go home or to an alternative hospital. Had I known this information I would have gone into distress mode and started to hyperventilate. 

Our Charlie's Angel created distractions throughout labour, even washed my hair and consoled me.  She kept the family calm and requested they sleep, she timed my contractions for me and noted them. 

Lucy continuously rang the hospital back to try to get a room for me - thank the lord for our angel because we did eventually get a room and knew this on the car journey there (what a gem).

She helped me manage pain until I was 7cm dilated in my own home using water, massage and tens machine. UNBELIEVABLE - I could not have done this without Lucy. 

She supported my decisions 100% especially when I asked for an epidural.

When my baby was born I was in shock.  Lucy was able to cuddle him whilst I gained some awareness through all the medication/drugs

Post Natal 

I had no memory triggers from my childhood trauma when I got to the labour ward and even enjoyed my stay at the hospital. (thanks to our Doulas) 

We received an entertaining letter for our son outlining all the various conversations and stages of labour.

Aftercare

We received a meal & home made chocolate cake delivered to our home which was divine.  I received help with breastfeeding and general aftercare. Maggie advised me on what to eat and the natural approach to breastfeeding really worked better for us. 

Lucy explained all the details of labour afterwards. How the hospital was going to close and things she had protected me from hearing. My jaw was on the floor. I'm so glad she shielded me from this and for taking the time to explain what happened in labour in more detail. (Our baby had been in a tricky position, with both his hands on his head)

I could not have asked for more!!!!!!! Both Doulas who worked in partnership are already winners in my eyes and our family. They made labour a positive experience and they have a special place in our hearts."

What more could a doula ask for?  I Love my job.

 

Posted on Tuesday, September 15, 2009 at 04:42PM by Registered CommenterLucy Symons | CommentsPost a Comment | References5 References

The Magic of Oxytocin

I was at a birth recently where the baby was in a rotten position (it turned out he had both hands clasped under his chin, the little tinker) and so my lady couldn’t progress beyond the fabulous 7cm she had reached at home in the bath with my support. Inevitably syntometrin was required to help her along and so she had an epidural and the midwife started a drip.

What had been a perfectly natural, really lovely labour at home was suddenly transformed into a strange medical procedure in the hospital where we all waited for things to happen, feeling disconnected and slightly like observers rather than participants. My role as a doula was suddenly transformed into that of companion, her boyfriend was quietly sleeping in a corner and the midwife would come in, smile at us both and go straight to the monitor or the drip – no longer really paying attention to the person in labour.

Eventually my lovely lady managed to get to 10cm and started to push. She was instructed what to do because she had no natural urge to push. She did brilliantly and after a long hard second stage, her son was born. I remember quite clearly through a sleep deprived haze bursting into tears as he was born and her boyfriend doing the same as their son took his first breath. The midwife was efficiently kind and also obviously moved. But my lady lay on the bed watching us with what appeared to be detached confusion. My tears and those of her boyfriend seemed totally alien to her and even a little annoying. We passed her the baby but she didn’t seem to be terribly interested. She asked that I take him and so I took him for a little walk around the room as her boyfriend held her hand whilst she was being stitched. Finally, I brought him back to her side and she gestured for me to give him to her boyfriend. I left that birth wondering how she would manage.

A few days later I went to their home and met with them. We discussed the birth of their son at length and I was thrilled to see she had bonded brilliantly with her son as she breast fed him. I asked her about the moment he was born and she admitted (after a little nudging) that she had felt absolutely nothing, but was only aware of the brutality of the experience. My emotion and her boyfriend’s at the time was exactly the opposite of her feelings… she said she felt like she was observing everything and not experiencing it. I gently explained to her that oxytocin (the body’s natural expulsive hormone necessary for giving birth) is also known as the “love” hormone. She had received a synthetic form of that hormone in the drip which does everything that oxytocin does physiologically but none of the emotional things that you would expect. As a consequence, she was going through the motions of giving birth but had none of the natural endorphins nor did she experience the woosh of maternal love that she would have done had she been able to have a natural labour and birth. In breast feeding her son, she was producing the oxytocin that she had missed at birth and as such was rapidly falling in love with him.

Oxytocin plays such a vital part to bonding with your baby it is little wonder there has been a recent spate of men writing about how removed they felt from their children when they are first born. Several journalists have reported recently that they feel it is the unspoken taboo, fathers who don’t feel anything towards their newborn children. Of course (most) men learn how to love their children but sometimes it takes a little time. They don’t have that natural leg up that we women do. And nor do some women who have surgical or chemical births. It is something to consider if you feel that your birth experience was less magical than you were expecting. It is very helpful to know that with the absence of oxytocin, you can experience a more disconnected birth than if you have a totally natural experience. Don’t beat yourself up about it, but be aware that it is perfectly normal for it to take a few days of breast feeding for you to feel that deep connection with your baby, and for your partner to grow into loving his child.

 

Posted on Wednesday, July 15, 2009 at 03:37PM by Registered CommenterLucy Symons | CommentsPost a Comment | References1 Reference
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