A cranial orthosis, often simply called a baby helmet, is a custom-molded medical device designed to gently reshape an infant’s skull. It is prescribed by a physician to correct certain head shape abnormalities caused by external pressure on the soft, rapidly growing skull bones. The overall purpose of the helmet is to guide the direction of skull growth into a more balanced and symmetrical form over time. These devices are medical treatments, not protective gear like bicycle helmets, and are used to address specific deformities that do not resolve with repositioning techniques alone.
Identifying the Specific Head Shape Abnormalities
The primary conditions addressed by cranial remolding helmets are deformational, meaning they are caused by external forces rather than an internal issue. The two most common types are positional plagiocephaly and positional brachycephaly, collectively referred to as “flat head syndrome.” Positional plagiocephaly is characterized by an asymmetrical flattening on one side of the back of the head. This flattening often results in the ear and forehead on the same side being displaced slightly forward.
Positional brachycephaly involves a symmetrical flattening across the entire back of the head. This results in a head shape that is shorter from front-to-back but wider from side-to-side. Both conditions became more prevalent following the “Back to Sleep” campaign, which successfully promoted placing infants on their backs to sleep to reduce the risk of Sudden Infant Death Syndrome (SIDS). When a baby consistently rests their head in the same spot, the constant pressure can lead to these deformational changes.
It is important to distinguish these positional deformities from craniosynostosis, which involves the premature fusion of one or more of the skull’s sutures, or fibrous joints. Craniosynostosis is an intrinsic condition that can restrict brain growth and typically requires surgical intervention. A medical evaluation is necessary to rule out craniosynostosis, as only deformational abnormalities are primarily treated with a remolding orthosis.
How Cranial Remolding Helmets Work
Cranial remolding helmets function by leveraging the rapid growth of an infant’s skull and brain during the first year of life. The orthosis is custom-fabricated based on a 3D scan of the baby’s head to ensure a precise fit. The design applies gentle, passive pressure to the areas of the skull that are bulging or prominent.
Simultaneously, the helmet leaves an open space over the flattened region of the skull. As the infant’s brain naturally grows, the skull expands into the path of least resistance, which is the empty space within the helmet. This redirection of growth encourages the skull to fill out the flat areas, gradually correcting the asymmetry or flatness.
The helmet acts as a constant mold, guiding the natural growth process. Since the largest increase in head size occurs during the early months of life, this period of rapid growth is utilized to achieve the most effective reshaping.
The Treatment Timeline and Monitoring Process
The effectiveness of cranial remolding therapy is dependent on starting treatment during the optimal age window, generally between four and six months. By this time, a positional deformity is less likely to correct on its own, and the skull is still growing quickly. Treatment can be successful for infants up to 18 months, though the process may take longer as head growth slows.
For successful correction, the orthosis must be worn for approximately 23 hours per day. This high degree of compliance is necessary to sustain the gentle pressure required to redirect the skull’s growth. The helmet is typically removed only for bathing and hygiene, and parents are guided through a short break-in schedule to allow the baby’s skin to acclimate.
The total duration of treatment varies based on the severity of the initial deformity and the baby’s age at the start of therapy, but it commonly lasts between three and six months. Regular appointments with an orthotist are necessary. The orthotist monitors progress using 3D scans and makes adjustments to accommodate the baby’s growth and maintain corrective pressure. When the desired correction is achieved, the orthotist determines that the treatment is complete, and the baby is gradually weaned from wearing the helmet.