Bob Meadows
July 04, 2005 12:00 PM

Every evening before putting her year-old son, Diego, to bed, Maria Herrera gives him a bath, slips on his flannel pajamas—and places a fiberglass helmet on his head. Why? Several months ago Maria and her husband, Ken, noticed the back and side of Diego’s head looked a bit flat. Their pediatrician told them it would grow rounder over time, but the Fontana, Calif., couple didn’t want to take chances. In April they had Diego fitted for a new medical device called an orthotic headpiece—a snug-fitting helmet intended to remold the head into a classically shaped dome. “We were thinking about his future,” says Maria, 42. “We didn’t want him teased.”

Neighbors stare, and’ friends have called them crazy, but the Herreras, like thousands of other parents around the country, are turning to helmets to deal with what they perceive as a problem. Flatheadedness—described by doctors as positional plagiocephaly—can be an unintended consequence of the hugely successful campaign by American pediatricians who urge parents to lay newborns on their backs to prevent sudden infant death syndrome. Since 1992, according to the American Academy of Pediatrics, such deaths have dropped by almost 50 percent.

But what’s good for safety isn’t always great for aesthetics. The soft bones of an infant’s skull can actually be reshaped by sleeping in the same position, forming a flat patch on the back. Dr. John Graham, director of the craniofacial clinic at Cedars-Sinai Medical Center in New York, estimates the incidence of flatheadedness has jumped fivefold in the past five years, to 1 in 60 births. And while doctors stress that the condition is harmless, it can result in “a cosmetic issue,” says Joseph Madsen, a pediatric neurosurgeon at Boston’s Children’s Hospital. “This is the head shape a person may have forever. It makes sense to have the option of having it treated.”

Though not cheap (most cost between $1,500 and $3,000), baby helmets are lightweight and generally effective before a child’s bones start to harden at age one. But should an infant be forced to wear a helmet—in some cases 23 hours a day—to ensure a perfect head? “He’ll be glad we did this for him,” says Kevin O’Keefe, 29, a Harvard grad student, whose helmet-wearing son, Dylan, 6 months, has a distinctly flat spot on the back of his head. O’Keefe’s Chinese-born wife, Xiaoxue Cao, 30, however, isn’t so sure. “There is a cultural difference,” she suggests. “My parents and I think the fact the baby’s head is flat is good.”

Helmets aren’t the only way to prevent flatness. Yale plastic surgeon John Persing recommends alternating left-or right-side orientation of the baby’s head during sleeping hours, and placing newborns on their tummies for supervised play during the day. Maria and Ken Herrera, the parents of baby Diego, tried all of that, plus laying bags of rice alongside the boy’s head while he slept to prevent him from favoring one head position over another.

Finally, when they noticed a new bulge on Diego’s head just after his half-year mark, the Herreras, both payroll administrators, took a U.C.L.A. doctor’s recommendation to buy a helmet. (Insurance covered most of the $2,400 cost.) “Kids shave their heads these days,” Maria says. “You never know; he might want to do that too.” Even so, Maria’s mother urged them to “leave Diego alone.” But the Herreras consider the results nothing short of perfect. According to Maria, Diego even likes to wear it. “He hates to part with his helmet,” she says. “He wants to put it back on.”

Bob Meadows. Sara Libby and Ron Arias in Los Angeles and Anne Driscoll in Boston

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