Cranial Remolding Helmets: To Be or Not to Be?

It is common for parents to have many questions about cranial remolding helmets or orthotics.  Here is what you need to know about them:

What is the helmet and what does it do? There are several different types (helmets, headbands) that all have the same goal of remolding the shape of your baby's head.  The type used on your baby will be determined by the orthotist or cranial remolding center you go to for treatment.  The theory is that the brain grows in the path of least resistance.  The helmet or headband works by maintaining the high points or rounded areas of the skull allowing the flattened areas to round out as the brain continues to grow.  Optimally, the helmet is fit by nine months old and is worn anywhere from two to nine months depending on the severity of the head deformity.  The baby wears the helmet 23 hours a day and you must return to the orthotist or cranial remolding center for adjustments on a regular basis.  Insurance does not always cover this treatment with the average costs of head remolding orthotics ~$3000. 

Is there another option for treating a misshapen head? The short answer is yes!  Conservative measures are very successful when a positioning program is put in place right away.  This can mean from day one after birth to prevent head deformity in the first place or as soon as a flat spot is detected.  A positioning program is clinically proven to work and involves changing the position of your baby every time you put him or her down.  This means sometimes on the back, sometimes on the stomach, sometimes on the right side and sometimes on the left side.  The variety of positions ensures equal forces on the head to allow a rounded head appearance as well as developing equal muscle strength on all sides.  Head movement also develops the balance system itself.  Another must is limiting the time your baby spends in carseats, swings and bouncers as all of these items contribute to flattening of the skull.  These apparatuses are ok for brief periods to ensure not only a rounded head shape, but also developmental milestone acquisition. 

Who should get a cranial remolding orthotic? In my experience, there are two groups who could benefit from a helmet for the treatment of a misshapen head (plagiocephaly).  The first group are infants with a diagnosis of hydrocephalus or similar internal disease process that effects the shape of the head.  With hydrocephalus, once the spinal fluid is properly regulated and shunted off the brain, the head may have an abnormal appearance.  Where conservative methods could also work depending on severity, a helmet or headband would assist in the process of reshaping. 

The second group is if the parents/caregivers do not have ample time to institute a positioning program.  There is no judgement passed here, it is reality as we know it today in our busy world with both parents working, single parenthood, etc.  And the daycare is not always willing, able or allowed to assist in the positioning program.  A baby who spends the majority of his or her time confined in a carseat, bouncer or swing or flat on his or her back for whatever reason with little opportunity for floor/play time could benefit from a helmet or headband to ensure optimal rounding of the head if flattening exists.  Be aware that people rarely go to an orthotist or a cranial remolding center to inquire about a hemlet without walking out of there with one--often regardless of how minimal or severe the case.  So be prepared and stand your ground if you have reservations. 

Look for upcoming posts on why treating a misshapen head is so vitally important to your child.  In the meantime, I am happy to answer any questions you may have.  Good luck out there!