Cranial remolding helmets, are they a fit for your family?
By Kelly Roth as seen in Mom to Mom
Studies have found that roughly three-percent of newborn babies are born with severe plagiocephaly. By ages seven to 12 weeks, 46-percent of babies will have some form of mild plagiocephaly. With the implementation of the back to sleep program in 1992 and several other factors, head deformities have significantly increased over the last 30 years. Fortunately, there are non-invasive, pain free ways to treat head shape deformities.
How do flat spots develop?
A lot of times, plagiocephaly (flatness on one side of the head) will start because of in utero positioning or if a baby has developed torticollis. Torticollis is a tightening of the neck muscles that make it difficult for a baby to turn their head to both sides equally. When a baby is not able to turn their head to both sides equally, they end up spending more time turned to one side and plagiocephaly develops.
Brachycephaly (flatness across the back of the head) has been more common since the introduction of the back to sleep program. While the back to sleep program has significantly reduced the incidences of Sudden Infant Death Syndrome, there has been an increase in brachycephaly cases, as infants are spending more time laying on their backs.
What is a cranial remolding helmet?
A cranial remolding orthosis or helmet is a custom orthotic device that helps guide head growth to a specific direction, to help reshape a baby’s head. Cranial remolding helmets work through directed growth, there are void spaces inside the helmet where we want the head to grow and fill into and there is light contact on areas we do not want to be growing as quickly. The head grows towards the path of least resistance, the helmet does not push on the head to reshape it.
When would a cranial helmet be needed?
Babies that have flat spots across the back of their head or on one side of their head may benefit from a helmet. Babies’ heads are growing and changing most rapidly between the ages of four to six months old and that is the optimal time to be fit with a helmet. Helmets can still be successful when they are fit on older babies, but they might be in the helmet for a longer time as their head growth has started to slow down.
Will my baby be uncomfortable in the helmet?
No. The helmet quickly becomes a part of their everyday routine, and it is worn for 23 hours a day. Everything is new and changing in a baby’s world and they are very adaptable. Babies start to recognize the helmet as theirs and will often reach for it when it is not on. The biggest reason some babies are fussy in a helmet is if they get too hot. The helmet does trap some heat that is normally released through the head, but by dressing your baby in less layers, turning a fan on in their room, and making sure they are staying cool, most babies tolerate the helmet very well.
Is a helmet the only option?
No, repositioning techniques can be very successful correcting head shapes if the head shape deformity is caught early and is not severe. If you notice a flat spot on one side of your baby’s head, try and have them spend more time lying and looking to the opposite side. Have toys for them to look at and play with on the opposite side of the flat spot. If you are giving them a bottle, hold them so they turn their head in the opposite direction of the flat spot to take the bottle. If you notice your baby has a difficult time turning their head the opposite direction of their flat spot, they may have torticollis and physical therapy could help improve their neck range of motion.
If your baby has a flat spot more across the back of their head (brachycephaly), increased tummy time and spending as little time as possible laying on the back of their head during waking hours can help to correct the head shape without a helmet.
What if I choose not to correct my baby’s head shape?
There are consequences for not correcting a flat spot. When a baby has a flat spot on one side of the back of their head, it pushes everything forward on that side of the head. The ear, forehead, eye socket, as well as the jaw will all shift forward. This may cause depth perception and jaw tracking issues later in life. There are functional consequences as well, if a baby needs glasses later in life, they may have a difficult time fitting them due to asymmetrical eyes and ears. The baby might also have a hard time fitting into standard hat sizes or helmets if they are going to play a sport later in life.
When should my baby be evaluated?
It is a good idea to schedule a cranial evaluation with an orthotist as soon as you start to notice a flat spot developing. At Crown Cranial & Orthotics, initial evaluations are free and do not require a referral from a doctor. At an initial evaluation, the orthotist can take measurements and pictures of your baby’s head to see if the head shape can be corrected with repositioning or if a cranial remolding helmet might be needed. They can also help to educate about different repositioning techniques and will have baseline measurements to monitor if repositioning is working.