Cranial orthotic helmets, often called baby helmets, are specialized devices designed to address head shape irregularities in infants. They work by gently guiding the growth of a baby’s skull to help achieve a more symmetrical and rounded head shape during a period of rapid infant development.
Understanding Head Shape Deformities
Babies can develop common head shape deformities, primarily positional plagiocephaly and brachycephaly, due to external pressures on their soft skulls. Positional plagiocephaly manifests as a flattening on one side of the back of the head, causing an asymmetrical appearance. Brachycephaly involves a flattening across the entire back of the head, which can lead to a wider head shape. These conditions are typically cosmetic and do not affect brain growth or development.
These deformities often arise because a baby spends prolonged periods in one position, such as sleeping on their back, which is recommended to reduce the risk of Sudden Infant Death Syndrome (SIDS). Other contributing factors include pressure in the womb before birth or torticollis, a condition causing neck muscle tightness that limits head movement. Premature birth can also increase susceptibility because their skull bones are softer and they may have limited ability to change head position.
How Cranial Helmets Reshape the Skull
Cranial helmets operate on the principle of guided growth, leveraging the natural and rapid expansion of a baby’s brain. A custom-fitted helmet applies gentle, consistent pressure to the prominent areas of the skull, restricting growth in those specific regions. Concurrently, the helmet provides open space where the skull is flattened, allowing these areas to grow and round out. This process does not involve forcing or squishing the skull. The helmet guides the skull’s development as the infant’s brain continues its rapid growth, particularly within the first year of life.
Evidence of Helmet Therapy Effectiveness
Studies have explored the effectiveness of baby helmets. For moderate to severe cases of positional plagiocephaly and brachycephaly, helmet therapy can be an appropriate intervention. When treatment is initiated at an optimal age, typically between 4 and 6 months, success rates are often higher. Consistent wear of the helmet, generally around 23 hours a day, is also a significant factor in achieving desired outcomes.
While some research suggests that helmet therapy may not offer significant advantages over the natural course of improvement for mild cases, other findings support its use. Mild head shape irregularities can often improve with repositioning techniques and increased tummy time alone.
The Helmet Treatment Journey
The process for a baby prescribed a cranial helmet typically begins with a thorough assessment and diagnosis by a medical professional. This often includes precise measurements of the baby’s head, sometimes using 3D scanning technology, to accurately map the head shape and identify areas requiring correction. A custom-fitted helmet is then fabricated to match the infant’s unique head contours.
Once fitted, the baby generally wears the helmet for approximately 23 hours per day, removing it only for bathing and cleaning. The duration of treatment can range from three to six months, varying based on the condition’s severity and the baby’s age at the start of therapy. Regular follow-up appointments, often every two weeks, are scheduled to monitor progress, make necessary adjustments, and ensure proper fit as the baby grows.
Managing Helmet Therapy and Other Approaches
Wearing a cranial helmet involves practical considerations for parents to ensure comfort and effectiveness. Regular skin checks are necessary to prevent irritation, and the helmet requires daily cleaning to maintain hygiene. Babies may sweat during initial weeks of wear, but this often reduces as they adjust. While social interactions can sometimes present challenges, most babies adapt quickly to wearing the helmet.
Beyond helmet therapy, several non-helmet approaches are useful for managing head shape, particularly for milder cases or as initial interventions. Repositioning therapy involves consistently changing a baby’s head position during sleep and awake times to relieve pressure on flattened areas. Increasing supervised tummy time helps strengthen neck muscles and reduces pressure on the back of the head. Physical therapy can also be beneficial for conditions like torticollis, which may contribute to head shape deformities.