Have you ever seen a baby wearing a funny-looking helmet and wondered what it was for? Or maybe you’ve noticed a substantial flat spot developing on the back of your own baby’s head and you’re worried about it. Plagiocephaly, also known as Flat-Head Syndrome, is a growing concern among many parents. And one of the most popular ways to treat it is with helmet therapy. Whether you’re faced with the diagnosis or want to know more about this syndrome, we’ve got the scoop below.
What is Plagiocephaly?
The primary type of plagiocephaly (which we will discuss here) is Positional Plagiocephaly. It occurs when excessive pressure on one area of a baby’s head causes a pronounced flat spot or misshaping of the skull. While most babies’ flat spots round out by the time they are sitting up and moving around more, for many it is so severe that other options must be considered to round out their head.
Positional Plagiocephaly is a condition characterized by the development of a flat spot or misshaping of a baby’s skull due to excessive pressure on one area. Although most babies’ flat spots naturally round out as they become more mobile, severe cases may require additional intervention. If you’re concerned about your baby’s head shape, consulting with a healthcare professional can provide guidance on the best course of action.
Potential Causes of Positional Plagiocephaly
The primary reasons a child may end up having Positional Plagiocephaly are the following:
- Too much time spent in one position:
Infants have extremely pliable skulls with plates that don’t fully fuse together until the toddler years. When an infant spends an extended amount of time on their back (which is common these days with the SIDS “back to sleep” campaign and all of those fancy infant car seats, swings, and bouncers), they can easily develop a flat spot on their head. - Pregnancy & delivery:
If a mother is carrying multiples, oftentimes the tight space can cause one or more of the babies to come out with a severely misshapen head. A traumatic birthing situation, like a breech birth, can also lead to excessive pressure on a baby’s skull and plagiocephaly. Preemies are also more likely to develop plagiocephaly because their skull bones are softer and they move around less than full-term newborns. - Infant Torticollis:
Torticollis (aka wryneck) occurs when tight muscles in a baby’s neck make them prefer to only turn their head one direction or their head seems like it is always slightly tilted one way. Since babies with torticollis sleep with their head turned the way they favor, they are more likely to develop plagiocephaly.
Prevention of Flat-Head Syndrome
Here are simple things to keep in mind during those first few months of your baby’s life that can drastically reduce their chances of developing plagiocephaly:
- Limit time in infant car seats, swings, and bouncers:
With all of the awesome, comfortable infant lounger options these days, it is so easy to put your baby down while you get stuff done around the house. And when they fall asleep in the car seat, why not leave them there? Well, too much time spent on their back during the early months is the leading cause of plagiocephaly. Instead, invest in a top-of-the-line baby carrier (like this one from ERGOBaby) and wear your baby during the day. - Lots of tummy time:
Tummy time is the ultimate way to strengthen a baby’s neck muscles and keep them off their back. Many infants aren’t huge fans of being on their stomachs, but if you keep incorporating it into their daily routine, they will get used to it. - Change positions:
To avoid too much pressure on one side of your infant’s skull, encourage them to turn their head both ways. For example, alternate the direction you lay them on the changing table because they will always want to turn their head towards you. You can do this same thing when you lay them down to sleep because they will most likely want to turn their head out towards the room when they wake up. - Watch for signs of torticollis:
Take note if it seems like your baby doesn’t want to turn their head a certain way. A little bit of physical therapy early on can go a long way in correcting torticollis and preventing plagiocephaly.
READ MORE: Why You Should Enroll Your Child In ISR Infant Swim Lessons
Plagiocephaly Treatment Options
If your baby has plagiocephaly and their flat spot seems to be getting worse over time, even after reducing time spent on their back, you may want to pursue additional measures to ensure that their head rounds out. Here are some of the treatment options available, depending on the severity of your child’s plagiocephaly. Make sure that you speak to your child’s physician about your concerns as soon as possible so that they can work with you to come up with a treatment plan. Your best bet for correcting any head shape irregularity is if you get started within their first year.
Repositioning
This is the first thing you should try when you notice your baby’s flat spot. Repositioning basically involves keeping your baby off the flat spot as much as possible. This can include rotating their head periodically while they sleep or even using small rolled-up towels to prop them up slightly away from the flat spot. Your baby’s pediatrician or even a pediatric physical therapist should be able to give you tips and tricks in regard to this. If over time there is no improvement, you may want to pursue other corrective options.
Helmet Therapy
If repositioning does not improve head shape over time, cranial remolding via helmet therapy is usually the most common option. With helmet therapy, an orthotics specialist will create a special band or helmet for your baby to wear. These work by applying steady pressure to the skull and encouraging the plates to shift into a more rounded position.
The length of time your baby wears the helmet for helmet therapy depends on the severity of their plagiocephaly and how early treatment gets started. The earlier the better! Your child’s pediatrician can refer you to an orthotist that specializes in infant plagiocephaly and they will take measurements of your baby’s head and help you decide if helmet therapy is your best option.
A helmet used for helmet therapy, also known as cranial orthosis or cranial helmet, is typically made of a lightweight, durable, and rigid material. The most common material used is medical-grade thermoplastic, specifically a type of polyethylene foam called expanded polyethylene (EPE) or a similar material.
Here’s a general overview of the materials and construction used in making a helmet used in helmet therapy:
- Expanded Polyethylene (EPE): This is a foam material that provides a combination of cushioning and rigidity that is key in helmet therapy. It is often used as the main material for the helmet because it can be easily shaped to fit the baby’s head and provides support to help guide the growth of the skull into a more symmetrical shape.
- Outer Shell: The outer shell of the helmet is typically made from a harder plastic material, often a blend of polycarbonate or other tough plastics. This shell adds an additional layer of protection and durability for helmet therapy.
- Lining and Padding: The inside of the helmet for helmet therapy is lined with a soft padding material, usually a combination of foam padding and fabric liners. This provides comfort for the baby while wearing the helmet and helps distribute pressure evenly.
- Adjustment Mechanisms: Many helmets have adjustable components to allow for a customized fit as the baby’s head shape changes over time. These adjustment mechanisms can include straps, buckles, and other fasteners that make it easy to remove or put on as well.
The helmet is custom-made for each individual baby, created through a process that involves 3D scanning or casting of the baby’s head to ensure a precise fit. The helmet’s design aims to gently redirect skull growth by applying pressure to specific areas that need correction while allowing other parts of the skull to grow naturally. It’s important to note that the materials used may vary slightly depending on the manufacturer and specific design of the helmet.
Craniosacral Therapy
Craniosacral Therapy (CST), an alternative form of medicine to helmet therapy for Plagiocephaly, in which therapeutic touch is used to manipulate the joints of the cranium and improve whole-body health and wellness. It has been found by many to be a successful treatment for infant plagiocephaly since CST therapists work through gentle touch to remold the plates of the scull to proper alignment. If you are opposed to helmet therapy, this may be a method worth looking into.
It’s crucial to approach alternative therapies like Craniosacral Therapy with a critical and informed perspective. While some individuals report positive experiences with CST, the scientific evidence supporting its efficacy is limited. If you are considering Craniosacral Therapy for a specific health concern, it’s advisable to consult with your healthcare provider to make an informed decision about your treatment options.
What about the long-term effects of plagiocephaly?
For the most part, plagiocephaly is a cosmetic issue that can lead to asymmetry of the ears and facial features. This can make wearing glasses or hats and sports helmets awkward in later years. In terms of physiological deficits, the research is still out. There are some claims that plagiocephaly is linked to more ear infections and visual impairment in some cases.
From One Mom To Another…
My son, Landon, wore a helmet for helmet therapy for four months to correct his plagiocephaly due to torticollis, rapid growth, and too much time on his back. It was one of the toughest decisions I’ve had to make as a parent because of the guilt I felt over his misshapen head, the cost of helmet therapy, and the fact that plagiocephaly has more to do with appearance than any serious physiological issue.
In the end, we made our decision to go with helmet therapy because we didn’t want to live with any guilt or regrets over how he looked when we could have done something relatively painless and easy to correct initially in his childhood like helmet therapy. I’m so happy we went for it! My advice to any of you who are worried about your baby’s flat head is to research and talk to your child’s doctor as soon as possible. Then, follow your gut instinct on what treatment is best for your baby and your family.
Helmet therapy is becoming a popular choice for treating plagiocephaly. It’s important to be vigilant about your baby’s head shape and to speak to your doctor if you have any concerns. To ensure the best results, it is important to get your child evaluated by a medical professional as soon as possible. With early detection and the proper treatment, you can give your baby the chance to grow healthier and stronger.
*This post is meant for educational purposes only. It is not intended to replace medical advice from your physician, doctor or health care professional. Please read our terms of use for more information.
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First, thanks for the article! As a mom of a helmet baby (ours was actually called a DOC band), I appreciate the discussion and especially the mentions of the different causes of flat heads. I felt tremendous guilt when my baby’s head was flat on one side because almost everything I read or heard in some way blamed the parents for leaving the baby on his head/back for too long (or at least that was my interpretation). My baby developed torticollis while lying flat on one side in the NICU for 2 months, which led to the flatness on ons side.
Second, when debating whether to get the helmet our physical therapist told me it would be harder for me than my child. I can tell any parent thinking about getting a helmet that was absolutely true. After a couple of days, my child barely noticed it and it helped tremendously. Like Landon’s mom, I am so happy we did it!
Third, I just wanted to mention our health insurance covered 100% of the cost of the helmet. Our insurance company required various things like a prescription, physical therapy for the torticollis for 8 weeks prior to getting the helmet, etc. This is another reason why it’s extremely important to get started early, even if you are not 100% sure you want the helmet.
Thanks again for writing about this topic!
Hi, Heather! Thanks for sharing your story! I agree that it was definitely harder on me than it was on Landon. He took to it like a champ! Unfortunately, our insurance only covered a very small portion of the cost, but it was still worth every penny. Is his head perfectly round now? No, but at least I know I did everything I could to fix it.