Specialized helmets, known as cranial remolding helmets, gently guide the growth of a baby’s head. They address conditions where the skull has developed a flattened or asymmetrical appearance, aiming to achieve a more typical head shape as the baby grows.
Understanding Head Shape Conditions
A baby’s soft, pliable skull bones are susceptible to changes in shape from external pressure. Two common conditions that can result in a flattened head are positional plagiocephaly and brachycephaly.
Positional plagiocephaly involves a flattening on one side of the back of the head, making it appear asymmetrical. The ear on the flattened side might seem shifted forward, and facial features like the forehead or cheek may appear uneven. This condition is common, affecting about half of all infants.
Brachycephaly presents as a flattening across the entire back of the head, leading to a head that is wider than it is long. When viewed from the side, the head might appear taller at the back. Both conditions often arise from infants spending extended periods lying in the same position. While primarily cosmetic, they can be associated with underlying factors like torticollis, a tightening of neck muscles that limits a baby’s ability to turn their head. It is important to distinguish these positional deformities from craniosynostosis, a rarer condition where skull bones fuse prematurely and typically requires surgical intervention rather than helmet therapy.
How Corrective Helmets Function
Cranial remolding helmets gently redirect the natural growth of a baby’s skull. These custom-fitted devices consist of a hard outer shell with a foam lining. The helmet provides snug contact over prominent areas while leaving open spaces for flattened regions to grow into. This mechanism encourages growth in the flattened areas and restricts further expansion in the rounded parts of the skull.
The process begins with a precise measurement of the baby’s head, often using 3D scanning, to create a customized helmet. As the baby’s brain and skull grow rapidly in infancy, the helmet continuously guides this growth toward a more symmetrical shape. Regular adjustments are made by specialists to ensure the helmet fits correctly and promotes the desired head shape. The helmet itself does not apply painful pressure, but rather provides a mold for the head to grow into.
When Helmets are Recommended
Helmet therapy is typically considered after conservative measures, such as repositioning techniques, have been attempted without sufficient improvement, or when the head shape deformity is moderate to severe. The optimal age range for beginning helmet treatment is generally between 4 and 12 months, with 4 to 6 months often cited as ideal. During this time, a baby’s skull and brain are undergoing significant growth, making the skull pliable and responsive to molding. Starting therapy earlier within this window can lead to a shorter treatment duration and potentially better outcomes.
A pediatrician or specialist will diagnose the condition, often through a visual examination and by taking measurements of the head’s asymmetry. If a helmet is recommended, babies typically wear it for approximately 23 hours a day, removing it only for bathing and cleaning. The duration of helmet wear varies depending on the baby’s age and the severity of the condition, but it commonly ranges from three to five months. Treatment is generally less effective after 12 to 18 months of age because the skull bones begin to fuse and harden.
Strategies for Preventing Head Flattening
Parents can implement several strategies to help prevent or alleviate mild head flattening. One important practice is “tummy time,” which involves placing the baby on their stomach for supervised periods while awake. Tummy time removes pressure from the back of the head and strengthens neck and upper body muscles, assisting in developing the ability to move the head freely. It is important to ensure babies always sleep on their backs to reduce the risk of sudden infant death syndrome (SIDS).
When a baby is sleeping on their back, parents can vary the head position by gently turning the baby’s head to alternate sides during sleep. Changing the baby’s orientation in the crib, such as placing their head at the top one night and the bottom the next, can encourage them to look in different directions, redistributing pressure. Limiting the time infants spend in devices like car seats, swings, and bouncy seats outside of travel is also beneficial, as these can restrict head movement and contribute to flattening. Holding the baby often and varying feeding positions also helps minimize prolonged pressure on one area of the head.