A cranial helmet, also known as a cranial remolding orthosis, is a custom-fitted medical device designed to gently reshape an infant’s skull. It applies consistent, light pressure to guide head growth into a more symmetrical and rounded form. This non-invasive therapy addresses head shape irregularities that can develop during infancy.
Conditions Treated by Cranial Helmets
Cranial helmets are primarily used to address deformational plagiocephaly, brachycephaly, and scaphocephaly, often called “flat head syndrome.” These conditions are non-synostotic, meaning the skull’s sutures have not prematurely fused. This distinction is important because premature fusion (craniosynostosis) requires surgical intervention, not helmet therapy.
Positional plagiocephaly involves one-sided flattening on the back of the baby’s head, leading to an asymmetrical appearance with potential ear misalignment. This condition frequently arises from a baby consistently resting their head in the same position, such as while sleeping on their back. Brachycephaly presents as flattening across the entire back of the head, causing the head to appear wider and shorter. Like plagiocephaly, it is often linked to prolonged supine (on-back) sleeping positions.
Scaphocephaly, the least common, results in a long, narrow head shape due to flattening on the sides. It is often observed in premature infants who spend extended periods lying on their sides. The incidence of plagiocephaly and brachycephaly has notably increased since the “Back to Sleep” campaign, which recommends supine sleeping to reduce the risk of Sudden Infant Death Syndrome (SIDS).
How Cranial Helmets Work
Cranial helmets operate on the principle of guided growth, taking advantage of the rapid brain and skull development that occurs during infancy. A custom-made helmet applies gentle, consistent pressure to prominent or bulging areas of the infant’s skull. Simultaneously, it leaves space in flattened areas, allowing the skull to expand into these open regions as the baby’s brain grows.
This process is passive and corrective, meaning the helmet redirects natural growth rather than actively forcing a new shape. For instance, in cases of plagiocephaly, the helmet provides room for growth on the flattened side while subtly restricting growth in more rounded areas. For brachycephaly, it encourages expansion at the back of the head while gently containing lateral growth. This consistent redirection of growth helps to gradually mold the skull into a more symmetrical shape over time.
The Cranial Helmet Treatment Process
Cranial helmet therapy begins with an initial assessment, often following a pediatrician’s referral. A specialist evaluates the baby’s head shape, sometimes using 3D imaging to capture precise skull measurements. This assessment helps determine the deformity’s severity and whether helmet therapy is recommended.
If pursued, a custom helmet is fabricated based on these precise measurements. The helmet features a hard outer shell and foam lining for a comfortable fit and necessary corrective pressures. Parents receive instructions for the wear schedule, typically 23 hours per day, removed only for bathing or brief periods.
Regular follow-up appointments, often every one to two weeks, monitor head growth and allow for helmet adjustments. These adjustments accommodate ongoing growth and ensure the helmet continues to guide the skull effectively. Parents also receive guidance on helmet hygiene and infant skin care to prevent irritation. Treatment duration varies, often ranging from several weeks to a few months, with an average of about three months, depending on the baby’s age and condition severity.
Effectiveness and Safety of Cranial Helmets
Cranial helmet therapy effectively corrects deformational head shape abnormalities. Treatment success is influenced by the infant’s age when therapy begins and consistent adherence to the wearing schedule. Earlier intervention, ideally between 4 and 6 months of age, yields more favorable and quicker results because the skull is highly malleable and growing rapidly.
Administered under professional guidance, cranial helmet therapy is safe. Common minor issues include temporary skin irritation or rashes, which can often be managed with proper hygiene and helmet adjustments. Some infants may experience increased sweating or mild discomfort initially, but most adapt to wearing the helmet within 24 hours. Serious complications are rare, and studies indicate helmet therapy does not hinder brain development.