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Baby Helmet Therapy: Parent FAQs

Baby Helmet Therapy: Parent FAQs Baby Helmet Therapy: Parent FAQs

​​​​​​​​​Babies grow fast, and their heads are made for this quick growth.

Flexible skulls can protect a baby's growing brain, which roughly doubles in size during the first year. But if a baby's skull shape seems different, he or she may need helmet therapy.​

What is helmet therapy?

Helmet therapy (also called helmet orthosis) is a treatment that's prescribed to help mold the baby's skull into shape.

Babies skulls are made of many bony plates. The plates are joined by fiber-like pieces called sutures. Sutures help the skull protect the baby's brain. They also allow some flexibility and space so that the brain can grow.

To work, molding helmets must be worn during the time when the skull and brain are actively growing. Helmets will not help after brain growth is done, and three-fourths of brain growth happens by age 2.

What conditions cause a baby to need a helmet?

  • Positional skull deformity. Deformational plagiocephaly, brachycephaly and NICUcephaly are three conditions that cause a baby's skull shape to change. They are caused by pressure on the skull when an infant spends a lot of time in one position.

  • Craniosynostosis. This condition is caused when bony plates in the skull are abnormally fused together. As the brain grows in a child with craniosynostosis, the shape of the head becomes abnormal as the brain pushes out on the other parts of the skull. In some cases, the brain growth may be affected, as well. Craniosynostosis requires surgery and may be followed by helmet therapy. Some children with craniosynostosis may have other developmental needs.

Is helmet therapy the only treatment for a child with a positional skull deformity?

It depends. If the condition is not severe, changing your baby's usual positions or starting physical therapy may help.  If an infant has moderate or severe positional skull deformity that doesn't respond to changing positions, or if the baby is older, helmet therapy may be prescribed.

A positional skull deformity does not affect a child's brain development or cause any other medical condition. But not correcting it may affect the child's social well-being when he or she is older.

Physical therapy and stretching and strengthening exercises are especially helpful for babies with torticollis, which is present in about 20% of babies with positional flattening. This occurs when the baby's neck muscles are tighter and more contracted on one side. Torticollis causes the baby's neck to turn in a twisted position, which makes the baby's head to tilt one way and the chin to point the other way.

What is the first step to get a helmet?

A pediatrician may recommend a helmet after evaluating your baby's head shape. A referral is to someone who is trained to properly measure and fit the helmet is necessary.

What can I expect during helmet therapy?

A baby's head shape is measured, and a custom-fitted helmet is designed. This is so the helmet can properly support your baby's skull while allowing the head to gradually grow and round out on its own.

Babies usually wear their helmets for 23 hours each day. Most children quickly get used to wearing them. The helmet should be taken off when it's time for your baby's bath. It should be cleaned at that time. Problems such as skin irritation, discomfort, and bad odor should not occur. If there are problems, the helmet should be adjusted by the specialist who made it.

At what age should a baby with a positional skull deformity begin wearing a helmet?

  • A baby that starts helmet therapy at a younger age may wear the helmet for less time. The results of therapy also may be better.

  • Babies referred for helmets at a later age (e.g., after 8 months), or after position changes and physical therapy did not help can still get helmets. However, they may have to wear them for a longer time than if they had started at a younger age.

How long does helmet therapy take?

Every child is different. A lot depends on the child's age when he or she started helmet therapy. In early infancy, a baby's brain and skull grow very quickly. This means that the helmet can direct growth in less time.

The specialist will check your child's progress at each visit to see if the head shape is improving. Children may need to wear a helmet for several months. Some children may benefit from more time and a second helmet.

More information

Last Updated
American Academy of Pediatrics Section on Neurological Surgery and Section on Plastic and Reconstructive Surgery (Copyright © 2020)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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