The Bunch Triplets Story
What could possibly be cuter than a baby in a football helmet? How about three babies in football helmets? Meet the Bunch triplets—Colton, Ethan, and Hunter—who wore cranial remolding orthoses for 23 hours a day when they were infants in order to gradually reshape their heads. A cranial remolding orthosis puts slight pressure on a baby’s newly forming skull over the course of months. "When we were out in public, people certainly had a lot of funny reactions," says mom Ami Bunch of Tucson, Arizona, who explains that onlookers usually came in two sizes: those who thought the problem was gravely serious, like a congenital brain injury, and those who thought it was frivolous and merely cosmetic.
The babies had plagiocephaly, a term that describes an infant’s flattened or misshaped head. It can be corrected before the age of 18 months when a baby’s skull bones begin to fuse together. Some health insurance companies see it as merely a cosmetic problem, while others concur with many doctors who believe plagiocephaly and its associated conditions can cause babies to prefer turning their head to one side over time, and to under-use a hand and leg on one side of their body. Research is ongoing, but some early studies suggest a link with muscle imbalance and jaw alignment problems.
Ami and husband Brian first noticed a flat spot on the side of baby Colton’s head and a corresponding shift forward in his ear and eye socket. They pointed it out to their pediatrician, who also noticed that all three babies appeared to have the beginnings of torticollis, a twisting of the neck in which the head is tipped to one side. Colton’s torticollis was the most severe. Their limited movement likely exacerbated Plagiocephaly in all three babies during a stay at the neonatal intensive care unit after the triplets were born. (They were born seven weeks premature and had to be hooked up to tubes and sensors.) Plagiocephaly has been on the rise since 1992, when the American Academy of Pediatrics launched its "Back to Sleep" program. Putting infants to sleep on their backs has lowered the incidence of sudden infant death syndrome by 40 percent, but it has increased mild to severe plagiocephaly by 600 percent, according to the journal Pediatrics.
Plagiocephaly has also increased with the growth of multiple births in the United States, when crowding in the womb often deforms prenatal skulls—"denting them like a grapefruit at the bottom of the pile," as one clinician puts it.
The Bunch’s pediatrician referred them to a Hanger Clinic, where their orthotist used the Insignia™ Laser Scanning System to capture a digital image of the infants’ heads in three dimensions. But that is making it sound easy, says Ami; their clinician scanned three potentially cranky babies with one hand while expertly rattling a noisy tape measure with the other. "She was a maestro," says Ami, who posted images on her blog.
Insurance and Fitting
The scans showed that all three matched the "severe" category for plagiocephaly, and the Hanger Clinic location they had received their free evaluation from began the approval process for coverage with the Bunch’s insurance company.
A few weeks later, when the custom orthoses—called Hanger Cranial Bands—arrived, the babies cried briefly when they first tried them on.
Their Hanger Clinic orthotist customized each band further by trimming down each device around the ears and brow so that the babies would be comfortable.
"She went back to the lab while we were there and trimmed the babies’ cranial bands," Ami said. "She also put foam inside the bands in just the right spots, trying different thicknesses until she was satisfied with the fit."
To Ami and Brian’s surprise, the babies soon became so used to the new headgear that, even while sleeping, they hardly noticed them. The Cranial Bands stayed on almost around the clock for about five months, and the family returned to Hanger Clinic every three weeks for adjustments.
Each child’s treatment length varied as they grew at different rates. Colton wore the band three and a half months, Ethan wore his for five and a half months, and Hunter wore her cranial band for six months.
Then, final laser scans showed the bands had done their job, leaving the babies with nicely symmetrical, oval heads. The process was relatively painless for the triplets.
"We’ve educated dozens of people just from having the kids in public," says Ami. "With three all in a row, it’s a sight to behold."
"The triplets started to recognize Elizabeth (their Hanger Clinic orthotist) and got very comfortable coming to see her," Ami said. "My biggest worry was that I’d have screaming triplets in cranial bands. But the babies were completely unfazed. They slept in the cranial bands without any resistance or problems. And the folks at Hanger Clinic were wonderful to work with."
Today, the triplets show no signs that plagiocephaly was ever an issue in their lives. They are happy and healthy children, and the family is glad they sought treatment early. "The whole process was a lot more pleasant than I thought it would be," Ami concluded.