Omar Khalid
You may have seen babies wearing plastic helmets, also known as cranial orthotics, and wondered why they need to wear them. The helmets are used to treat unusual head shapes in babies, a condition known as plagiocephaly or flat head syndrome. This can be caused by babies spending a lot of time lying on their backs, which is the recommended sleeping position to reduce the risk of sudden infant death syndrome (SIDS). The helmets are designed to gently reshape the skull as the baby grows, and they are generally worn for around 23 hours a day, with breaks for bathing and cleaning.
| Characteristics | Values |
|---|---|
| Name of the helmet | Cranial orthotic |
| Other names | Helmet therapy, cranial orthosis, cranial bands |
| Purpose | To correct an abnormal skull shape |
| Skull shape condition | Positional plagiocephaly, flat head syndrome, craniosynostosis |
| Cause of skull shape condition | Sleeping on the back, multiple births, spending a lot of time in the neonatal intensive care unit, congenital health issues, genetic condition |
| Age to begin helmet therapy | Between 5 and 6 months |
| Duration of helmet therapy | About three months |
| Helmet composition | Hard exterior shell, foam interior |
| How does it work | Places gentle, consistent pressure on the protruding side of the head while allowing the flat spot to expand |
| How long to wear it | 23 hours a day |
| When to remove it | One hour for bathing and cleaning |
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What You'll Learn
- Helmet therapy is a treatment for unusual head shapes in babies
- Skull deformities can be caused by torticollis, a congenital issue that affects neck muscles
- Premature babies are more likely to have softer skull bones and spend time on respirators, contributing to skull deformities
- Positional plagiocephaly or flat head syndrome is more common due to recommendations for babies to sleep on their backs to reduce SIDS risk
- Craniosynostosis is a condition where cranial bones fuse too early, requiring helmet therapy or surgery
Helmet therapy is a treatment for unusual head shapes in babies
The human skull is made up of several malleable plates with soft spots (called fontanels) and ridges (called sutures) where the cranial bones have not yet fused together. This soft skull allows the baby to pass through the birth canal and creates space for rapid brain growth during the first years of life. Over time, the bones in the skull fuse together. As a result of their softer skulls, babies can develop irregularly shaped heads. In some cases, they might need a helmet to correct the shape of their heads and avoid future health issues.
Helmet therapy, also known as cranial orthosis, is a treatment method that helps to reshape a baby's head. The helmets are made from a hard exterior shell and a foam interior that places gentle, consistent pressure on the protruding side of the head while allowing the flat spot to expand. They are designed specifically to reshape the skull, not to protect the head from injury. Babies usually need to wear the helmet for 23 hours a day, removing it for just one hour for bathing or getting dressed. The average duration of helmet therapy is about three months, but this can vary depending on the severity of the case and how often the baby wears the helmet each day.
The best age to begin helmet therapy is between 5 and 6 months. By the time a baby is 1 year old, helmet therapy treatment is generally considered ineffective because the growth of the skull, including the fusion of sutures, is much further along. The helmet therapy should finish before the skull bones begin to fuse together. Helmet therapy is usually recommended for older babies who haven't responded to other treatments, such as physical therapy or frequently changing the baby's position.
One of the main reasons skull deformities are increasing is because of the success of the American Academy of Pediatrics' "Back to Sleep" campaign, which recommends that parents put babies to sleep on their backs to reduce the risk of sudden infant death syndrome (SIDS). This advice has lowered the number of SIDS cases but has also caused more babies to develop flat spots on their heads when they're a few months old because they spend more time lying on their backs. Other causes of skull deformities include muscular torticollis, a congenital health issue that causes one or more of the neck muscles to become very tight, forcing the affected baby's head to stay in the same position, and prematurity, as premature babies have softer skull bones and often spend a lot of time in the neonatal intensive care unit, typically on respirators, with their heads in the same position.
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Skull deformities can be caused by torticollis, a congenital issue that affects neck muscles
Skull deformities in infants can be caused by torticollis, a congenital issue that affects neck muscles. Torticollis, also known as wryneck, occurs when the neck muscles cause an infant's head to twist, tilt, or rotate to one side. It is characterized by stiff and swollen neck muscles and can result in spasms, causing pain and difficulty straightening the neck. The condition can be congenital or acquired. Congenital torticollis is typically caused by the shortening of one of the baby's sternocleidomastoid muscles (SCMs), which connect the back of the skull to the breastbone and collarbone. This shortening can be attributed to various factors, such as the baby's position in the womb, abnormal development of the SCM, or Klippel-Feil syndrome, a rare birth defect affecting the vertebrae in the neck.
Acquired torticollis, on the other hand, can develop later in infancy or childhood and may be caused by swelling in the throat, lack of "tummy time," or a preferred head position. In some rare cases, it may be due to a tumour in the back of the head or spine. While torticollis itself is not a disease, it can lead to skull deformities if left untreated. The tendency to turn the head to one side caused by torticollis can result in positional plagiocephaly or flat head syndrome, a type of skull deformity. This occurs as the baby's skull is made up of soft plates that gradually harden, and a consistent head position can impact the shape of the skull as it develops.
To correct skull deformities caused by torticollis or other conditions, helmet therapy or cranial orthosis is often prescribed. These helmets are custom-made by certified orthotists and are typically worn for 23 hours a day, including during sleep. The helmets work by gently shaping the baby's skull as it grows, forcing flat spots to round out. The ideal age to begin helmet therapy is between 5 and 6 months, as it allows for effective skull shaping before the fusion of sutures, which typically occurs by the age of 1. While helmet therapy is a common solution, physical therapy may also be prescribed to address the underlying torticollis and improve neck muscle flexibility.
It is important to note that not all babies with flat spots require helmet therapy. Mild cases of skull deformities often improve with repositioning and as the baby grows. Parents concerned about their baby's head shape or development should consult a pediatrician or specialist to determine the best course of action. Early intervention is crucial for effective treatment, and the success of helmet therapy depends on early diagnosis and the severity of the condition.
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Premature babies are more likely to have softer skull bones and spend time on respirators, contributing to skull deformities
A baby's skull is made up of soft plates that gradually harden and grow together, allowing for rapid brain growth. However, this softness also means that a baby's skull can be susceptible to deformities, especially if they consistently lie in the same position. This is a common issue for premature babies, who often have softer skull bones and spend extended periods on respirators, remaining in the same head position.
Premature babies, in particular, are at a higher risk of skull deformities due to a combination of factors. Firstly, they tend to have softer skull bones compared to full-term infants. This natural softness makes their skulls more malleable and prone to shape changes, especially when external pressure is consistently applied. Secondly, premature babies often require specialised medical care and may spend a significant amount of time in the neonatal intensive care unit (NICU). During this time, they are typically placed on respirators to support their breathing, which can result in their heads remaining in the same position for extended periods.
The consistent pressure of a baby's head against a surface, such as a mattress or respirator, can cause a flattening of the skull, known as positional plagiocephaly or flat head syndrome. This condition is quite common, with estimates suggesting that up to 50% of 6-month-olds may have plagiocephaly to some degree. It is important to note that plagiocephaly does not typically cause long-term issues with neurological development, and in many cases, it can resolve without intervention.
However, for cases where the condition persists or is more severe, helmet therapy, also known as cranial orthosis, may be recommended. This therapy involves the use of a custom-made helmet that applies gentle, consistent pressure to the protruding side of the head, allowing the flattened area to expand and the skull to gradually regain a more rounded shape. The helmets are designed to be comfortable and are typically worn 23 hours a day, only being removed for bathing and cleaning.
The effectiveness of helmet therapy is highest when started between 5 and 6 months of age, and it is generally considered ineffective after 11 to 12 months. This timing is crucial because, by the time a baby is a year old, their skull bones have progressed further along the path of fusion, making it more challenging to correct the shape. Therefore, early intervention is essential for optimal results.
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Positional plagiocephaly or flat head syndrome is more common due to recommendations for babies to sleep on their backs to reduce SIDS risk
The American Academy of Pediatrics (AAP) launched the "Back to Sleep" campaign in 1992, recommending that parents put babies to sleep on their backs to reduce the risk of sudden infant death syndrome (SIDS). This advice has been successful in lowering the number of SIDS cases. However, it has also led to an increase in positional plagiocephaly or flat head syndrome cases. This condition is caused by babies spending many hours lying on their backs or sides, which can cause flat spots to develop on their heads.
Positional plagiocephaly or flat head syndrome is a condition where a baby's skull develops a flat spot or uneven appearance due to the soft and malleable nature of their skull bones. In the first year of life, a baby's brain grows rapidly, and their skull is made up of soft plates with spaces between them to accommodate this growth. However, if a baby sleeps in the same position for extended periods, these soft plates can develop flat spots or become misshapen. While this condition is not dangerous to the baby's brain, it can lead to concerns about their head shape.
To correct positional plagiocephaly, parents may seek helmet therapy or cranial orthosis. Helmets are custom-made to fit the baby's head and are worn for 23 hours a day, only being removed for bathing and cleaning. The helmets apply gentle pressure to the protruding side of the head, allowing the flat spot to expand and the skull to reshape as the baby grows. Helmet therapy is most effective when started between 5 and 6 months of age, as the baby's skull is still malleable, and treatment generally lasts for about three months.
In addition to helmet therapy, other treatments for positional plagiocephaly include physical therapy and frequently changing the baby's position. If plagiocephaly is caused by craniosynostosis, a condition where the cranial bones fuse together too soon, surgery may be required in addition to helmet therapy. It is important to note that mild cases of positional plagiocephaly often resolve on their own as the baby grows, and not all babies with flat spots require helmet therapy.
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Craniosynostosis is a condition where cranial bones fuse too early, requiring helmet therapy or surgery
A baby's skull is made up of soft plates that gradually harden and grow together, allowing for rapid brain growth during the first years of life. This softness of the skull also means that babies can develop irregularly shaped heads, a condition known as positional plagiocephaly or flat head syndrome. This condition is not dangerous to the baby's brain and often resolves on its own. However, in some cases, it may require helmet therapy or cranial orthosis, which involves the use of a special helmet to correct the shape of the skull gently.
Craniosynostosis is another condition that can affect a baby's skull development. It occurs when one or more of the sutures or fibrous tissues that hold the skull plates together close too soon. This early fusion can restrict brain growth and cause an unusual skull shape. Craniosynostosis almost always requires surgical treatment, followed by helmet therapy, to further correct the head shape. The helmet is custom-made by a certified orthotist to fit the baby's head and is typically worn for 23 hours a day, seven days a week.
The goal of helmet therapy is to gently reshape the baby's skull as they grow. The helmets are designed with a hard exterior shell and a soft foam interior that applies gentle, consistent pressure to the protruding side of the head while allowing the flat spot to expand. The average duration of helmet therapy is about three months, but this can vary depending on the age of the baby, the severity of the condition, and how often the helmet is worn.
It is important to note that helmet therapy for craniosynostosis is most effective when started early, preferably between 5 and 6 months of age. As the baby's skull bones begin to fuse together after the first year of life, initiating helmet therapy after 11 to 12 months is generally considered ineffective. Therefore, early diagnosis and treatment are crucial for the success of helmet therapy in correcting skull shape abnormalities associated with craniosynostosis.
In summary, craniosynostosis is a condition where cranial bones fuse too early, requiring surgery and/or helmet therapy to correct the shape of the skull and ensure proper brain growth. Helmet therapy involves the use of a custom-made helmet that gently reshapes the skull as the baby grows. Early intervention and consistent use of the helmet are key to the success of this treatment.
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Frequently asked questions
Babies may need to wear plastic helmets to correct an abnormal skull shape. This is known as helmet therapy or cranial orthosis. The helmets are designed to reshape the skull, not to protect the head from injury.
Babies' skulls are made up of soft plates with spaces between them. This allows their head to pass through the birth canal and their brain to grow rapidly in the first couple of years. However, if a baby sleeps in the same position for too long, the soft plates may develop a flat spot or uneven appearance. This common condition is called plagiocephaly, or flat head syndrome, and it is not dangerous to the baby's brain.
The helmets are made from a hard exterior shell and a foam interior. They place gentle, consistent pressure on the protruding side of the head while allowing the flat spot to expand. Babies usually need to wear the helmet for 23 hours a day, removing it for just one hour for bathing and cleaning.
