Originally created 05/10/04

Reshaping the future



SAVANNAH, Ga. - Miki and Dave Allgire noticed the curious looks given to their daughter Samantha after she was born.

But lately their baby's misshapen head is less likely to draw stares.

"There are people who meet her who don't know right away," Mr. Allgire said.

The Allgires credit a custom-made, 6-ounce, pink helmet Sam has worn day and night for about a month as a low-risk alternative to surgery.

The custom-fitted plastic helmet with an open top and foam lining was developed by a team of engineers and doctors to apply gentle pressure to Sam's head.

The goal is to correct the deformity caused by a hole Sam had in her head in utero.

This disorder, called an encephalocele, was caused by a defect in the fusion of the cranial bone and required surgery immediately after birth. It left Sam with a pointy head.

Sam's helmet is called a Dynamic Orthotic Cranioplasty, or DOC Band, made by Arizona-based Cranial Technologies Inc. and approved by the U.S. Food and Drug Administration.

The process of making Sam's helmet began in the company's Atlanta clinic near Northside Hospital.

A cast of her head was made and sent to Tempe, Ariz., where technicians carefully mold the band.

Helmets are increasingly being used to reshape babies' heads, some for serious health problems like Sam's, but others for skull deformities that can be prevented.

Deformities such as positional plagiocephaly, or flat head, have increased sixfold since the "Back to Sleep" campaign began, WebMD reported in 2000.

This occurs when babies sleep exclusively on their backs and have consistent pressure on their soft, forming skulls. As a result, they develop flat spots on their heads.

A national American Academy of Pediatrics campaign that began in 1992 urged parents to have their infants sleep on their backs to decrease the risk of sudden infant death syndrome, or SIDS.

The campaign has cut the SIDS rate by more than 40 percent. But that obvious benefit has a side effect: a marked increase in cases of positional plagiocephaly. About 90 percent to 95 percent of the helmets made by Cranial Technologies are to correct positional molding of the head.

Although that disorder is usually resolved by time and Mother Nature, in some severe cases doctors prescribe helmets.

The deformity can be prevented by having babies spend supervised time on their tummies so they exert more muscle action.

Experts recommend placing them on their stomachs when they are awake and supervised or putting children to sleep on their backs in varying places in the room, so their attention will be drawn in different directions, and limiting time in car seats and other infant carriers.

Head deformities in babies also are on the rise because of premature births, restricted in-utero space in multiple births and an increase in children born to mothers in their 30s and 40s who have to fight against their tight uterus.

Children with plagiocephaly usually wear them about 23 hours a day for an average of 4 months.

Tim Littlefield, a biomedical engineer and vice president of Cranial Technologies, said many skull deformities treated with helmets can be prevented.

"We overuse car seats and swings and bouncy seats," Mr. Littlefield said.

"Parents are so afraid of SIDS they leave them in the seats 24 hours a day. If we can get the word out about the importance of supervised tummy time, we all win, because we don't need to be treating as many of the deformities as we do."

What is an infant helmet?

Samantha's helmet is called a Dynamic Orthotic Cranioplasty, or DOC Band.

The lightweight plastic bands, made by Arizona-based Cranial Technologies Inc., apply gentle pressure to the heads of infants.

Mild pressures are applied to capture the growth of an infant's head, limiting growth in the prominent areas and encouraging it in the flat regions. Adjustments are made to the band weekly or biweekly. Length of treatment depends on the age of the infant and the severity of the condition.

Each helmet costs $3,000.

Most helmets are used to correct a skull deformity called positional plagiocephaly, also called flat head, which happens when babies spend too much time on their backs.

Samantha fund

Donations can be made to the Samantha Allgire fund, P.O. Box 61629 Savannah, GA 31420